How reduced bus service compromises health care in northern Ontario

By John Michael McGrath - Published on Sep 22, 2015
Greyhound's recent bus route cuts could affect the health of some northern Ontarians.

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As northern Ontario’s too-brief summer draws to a close, people in cities like Sudbury, North Bay, and Sault Ste. Marie have gotten another piece of unwelcome news: on September 20, Greyhound bus service started substantial cuts in northern Ontario, with service levels cut in half in some places.

Many in those communities will be affected, but among those that could be hurt most are people needing serious medical care. Thanks to changes in Ontario’s health care systems, bus routes have become a lifeline for many in the province’s north. And some are asking what the government is going to do for those patients now that transportation options out of northern Ontario are in decline.

Under both Tory and Liberal governments, medical specialties have become increasingly concentrated in Toronto and Ottawa. One count in 1998 found that Toronto, with 22 per cent of Ontario’s population, had 38 per cent of the medical specialists. That survey noted a worsening of the “maldistribution” of specialists across the province and, despite efforts to fight it (such as, the Northern Ontario School of Medicine, opened in 2005), the problem persists.

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But as these changes have left northerners with fewer choices for medical care, the understanding was that northern communities would have robust transportation systems so patients could travel to the help they needed.

“We know some specialized medical services will never be available in northern Ontario, we’re conscious of that,” says NDP Health Critic France Gélinas. “But the transportation system is crumbling under our feet … entire bus stations are being closed, and now Greyhound is cutting back.”

While Greyhound services will be cut across Ontario – places like Barrie, London, and Windsor will see cuts too – the steepest cuts will come in the north. Half as many buses will travel between Winnipeg and Sudbury, as well as the Sudbury-Ottawa route (in both cases, 28 buses have been cut to 14). The cuts are nearly as dramatic on the Sudbury-Toronto route.

Greyhound says the reductions are seasonal but in a statement emailed to TVO.org the company cautions that, “We have not yet determined what we will add back for the summer months.” That ambiguity, and the fear that these cuts will end up being a new normal, has northerners worried.

“Students, people with medical needs, the elderly all rely on those buses,” says Naomi Grant of the Coalition for a Liveable Sudbury. “These cuts mean the difference between having the option of travelling there and back in a day, and having to stay overnight.”

“If you’re travelling from Sudbury to Ottawa your only option may be a midnight bus,” says Gélinas. “Can you imagine trying to do that in a wheelchair in the middle of winter? It always endsthe same way – people choose to go without care.”

Transportation has always been inherently difficult in northern Ontario, where 5.5 per cent of the province’s population is thinly settled on 75 per cent of the land area. That’s why, in part, the province historically built and operated a substantial transportation service in the north, 60 years before the province would create GO Transit around the Greater Toronto Area.

The Ontario Northland Transportation Commission (ONTC) got its start as the Timiskaming and Northern Ontario Railway in 1902, and until 2012 the Ontario government subsidized a rail connection from Toronto’s Union Station to Cochrane. (The Cochrane-Moosonee “Polar Bear Express” train still operates, in the absence of any roads to James Bay.) In 2012, citing high costs and low ridership, the government replaced the Northlander train with ONTC buses, and began the process of dismantling the service’s assets.

The privatization process was only partly arrested by Premier Kathleen Wynne when she succeeded Dalton McGuinty, and a December 2013 report from the Auditor General found the government hadn’t studied ONTC’s costs in detail, and substantially overstated the savings from selling off Ontario Northland.

Progressive Conservative MPP Vic Fedeli says this month’s news is an argument for the continuing role of Ontario Northland.

“Ontario Northland has been in the business of serving the north for more than 100 years, where it’s impractical for the private market to serve,” says Fedeli. “These Greyhound cuts are an opportunity for Ontario Northland to investigate whether they can fill those gaps or expand their service. I’m not saying they should jump into it, but they should investigate it.”

Grant says private transportation on its own can’t sustain northern Ontario, and argues the province should think of transportation links as a basic need that the public should support.

“It’s the same as with public transit in any city. If you start looking at just what’s financially viable you’ll make cuts, but that becomes a vicious circle,” she says. “If you don’t offer decent service people will not use it, or might not even be able to.”

For medical care, if the government isn’t willing to support improved bus service, Gélinas says the government should invest more in local care for the north.

“Bring better health care to the north; it will be culturally more appropriate for people here. We have a large First Nations community; we have a large francophone population. If you bring better service to the north, it better reflects who we are,” she says.

Another option would be to change the way the provincial government regulates bus service. The Ontario Highway Transport Board currently regulates bus service in Ontario, granting operators a monopoly over the routes they serve. The system was originally justified, in part, by the objective of encouraging bus operators to subsidize rural routes with more profitable urban ones. That system, critics say, has broken down: profitable urban routes continue to be served while rural routes see service cuts.

Vic Fedeli says while he supports a government role in the north, deregulation of the bus industry is one option to look at.

“As a good Tory, anytime you can provide competition, that’s always good for the consumer,” he says. “Competition equals fairer prices, equals happy consumers.”

Many rural municipalities view deregulation with some anxiety, worried that they could be abandoned entirely. The Liberal government has been weighing what to do with intercity bus regulation since at least 2013, and it’s something Premier Kathleen Wynne (who was previously the Transportation Minister under McGuinty) has said is a priority.

Minister of Transportation Steven Del Duca tells TVO.org the government is looking at changing the regulation of the bus industry – but hasn’t landed on a preferred solution yet.

“Going back a few years now, we’ve had a discussion of how best to deal with intercity buses across the board, in northern Ontario and in the south, to figure out the best way forward,” says Del Duca. “We’re going to keep working on it … but we haven’t landed in the right spot yet.”

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