Every year, about 350 people in the area served by the Thunder Bay Regional Health Sciences Centre are sent to hospitals in Hamilton and Toronto for cardiac surgery.
“These are locations well out of the community,” says Glenn Craig, CEO of the hospital’s foundation. “It’s a plane ride, not a drive.”
So when the provincial government announced an expansion of cardiovascular services for the northwestern Ontario region last June — one that would allow most surgeries to be conducted on-site — Thunder Bay Regional’s administration was understandably thrilled.
With this government support, however, comes another challenge: In order to receive the operational funding from the Ministry of Health and Long-Term Care has announced, the hospital’s foundation will have to raise the capital funds to get the program going in the first place — including equipment and any new buildings required. While the amount to be raised for Thunder Bay Regional hasn’t yet been determined by either hospital or province, Craig says that “aside from building the hospital, this will likely be the largest campaign the foundation’s ever undertaken.”
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Community fundraising is a reality that every hospital in the province faces. For those in smaller, rural or northern regions, however, fundraising is a bit more difficult than in the city.
Hospital fundraising broadly is a challenging environment, says Dr. David Klein, a professor of medicine and health policy at the University of Toronto and physician at St. Michael’s Hospital.
“Donors are interested in things that are sexier: cancer research, large pediatric institutions. So they attract and literally have $100-million-a-year targets for institutions like Princess Margaret or Sick Kids.” As a result, trends in donations themselves can cause inequities not only geographically, but in the types of health care being funded. “There’s not as much money that addresses things like homelessness and marginalized health,” Klein says.
“One of the things people don’t realize is we do not have a publicly delivered health care system,” says Raisa Deber, a health policy scholar at the University of Toronto’s Dalla Lana School of Public Health. “We have what’s called a public contract model; it’s private delivery of publicly funded care.”
This means that hospitals, which run as private institutions, pay for most start-up or capital costs out of pocket, from a portion of building the facility, to infrastructure, to equipment.
The province provides funding for operational costs, or the delivery of care: staff, medication, and costs associated with running the facility. When a hospital wants to make an equipment purchase for an item such as a PET scanner, it first needs to apply with its Local Health Integration Network and the ministry, which considers factors such as the volume of patients who require the service and would otherwise be sent elsewhere.
For smaller hospitals, this can make the prospect of paying for things such as equipment a drawn-out process. Pembroke Regional Hospital in northeastern Ontario, for example, took more than four years to raise the $4.5 million necessary to purchase its first MRI before the province would foot the $800,000 annual bill to staff and operate the machine. More recently, Health Sciences North in Sudbury received approval to purchase the region’s first PET scanner nearly five years after applying, but needs to raise at least $3 million first in order to qualify for the $1.6-million annual operating funding.
“Often we find there are challenges in the north, but those same kinds of challenges are seen geographically everywhere in the province,” says Tammy Morison, president and CEO of the North Bay Regional Health Centre Foundation. “You don’t have to leave the GTA to see a difference between University Avenue and Scarborough.
“Sometimes it requires you to have innovation and relationships and connections with donors outside your area,” she says. For example, in order to purchase an MRI machine upgrade, North Bay Regional looked outside its traditional area for fundraising support in 2011-13. “We actually raised $750,000 through one of our volunteers who had relationships with people in Toronto who had the capacity to give six-figure gifts.”
Thunder Bay Regional serves a population of just over 120,000, compared with cities such as Hamilton, which has more than 500,000 people.
“We have a resource-based economy, like forestry, which has been on a multi-decade slide. Mining hasn’t picked up as well, so in economic down times like now it affects our efforts,” Craig says.
“Like other northern health care regions, Thunder Bay receives less in corporate philanthropy, since most headquarters are located in Ottawa or Toronto.”
“That said, we have a generous population,” says Craig, pointing to Thunder Bay Regional’s recent Exceptional Cancer Care campaign, which raised more than $7.2 million as of last spring — well in excess of its original goal of $5.9 million. He’s hopeful about the prospects for the cardiac care program. “There’s a 24-month planning period,” he says. “We’re already starting right now on the behind-the-scenes work.”