As I passed through Sudbury’s Health Sciences North emergency department last Thursday, the mood among staff was noticeably tense. Doctors spoke in hurried whispers between patients. Two nurses, clearly exhausted, leaned against a wall during what appeared to be their first break in hours.
“We’re already running beyond capacity most days,” Dr. Sarah Newbery told me when we finally found a quiet corner to talk. “These funding changes aren’t just numbers on a spreadsheet. They’re going to determine whether someone’s grandmother gets timely care during a heart attack.”
Newbery, who has practiced family medicine in Marathon, Ontario for over 25 years, is among dozens of Northern Ontario physicians raising alarm about recent changes to emergency department funding. The changes, announced quietly in government memos, will disproportionately impact smaller and rural hospitals across Northern Ontario.
According to documents obtained from the Ontario Medical Association, hospitals will now receive substantially reduced funding for physicians who cover emergency department “standby” hours – the critical periods when doctors must be available but may not be actively seeing patients. In communities where the nearest alternative hospital might be hours away, these standby hours ensure someone is always available when crisis strikes.
“This isn’t Toronto, where another hospital might be ten minutes away,” explained Dr. Lionel Marks de Chabris, an emergency physician in Sudbury. “When someone has a serious car accident on Highway 17 at 3 a.m., they need to know there’s a doctor waiting when that ambulance arrives.”
The Ontario Health Ministry defends the changes as necessary “modernization” of a funding model that hasn’t been substantially revised since 2006. Ministry spokesperson Hannah Jensen stated via email that the government has “invested over $80 million in emergency departments” across the province, but didn’t address how these specific cuts would affect Northern communities.
The reality on the ground tells a different story. At Manitoulin Health Centre’s two sites, CEO Lynn Foster estimates they could lose nearly $400,000 in annual funding – roughly equivalent to three full-time emergency physician positions.
“We’re already facing physician shortages,” Foster said. “If we can’t guarantee income stability, doctors simply won’t come north, and some already here will leave.”
The Northern Ontario School of Medicine (NOSM) has worked for years to address physician shortages in remote communities. Dr. Sarita Verma, NOSM’s Dean and CEO, fears these cuts will undermine those efforts.
“We’ve made remarkable progress recruiting doctors to underserved areas,” Verma told me. “But new graduates carrying substantial student debt need predictable income. These funding changes create exactly the kind of uncertainty that drives new doctors toward urban centers.”
What makes the situation particularly frustrating for Northern healthcare advocates is the sense that decisions affecting their communities are being made without understanding Northern realities.
When I visited Sioux Lookout’s Meno Ya Win Health Centre last month, Chief of Staff Dr. Barbara Russell-Mahoney showed me their emergency department board. Eight of ten beds were occupied, with three patients waiting. For a 60-bed hospital serving 30,000 people spread across an area the size of France, those numbers represent a system already at its limits.
“Our communities have unique needs,” Russell-Mahoney said. “Many of our patients are from remote First Nations. They often arrive with complex health issues after hours-long flights. When funding models change without considering these realities, it’s our most vulnerable populations who suffer.”
The Ontario Medical Association and the Rural Ontario Municipal Association have both formally requested that the Ministry pause implementation of these changes pending further consultation.
Dr. Andrew Park, who practices in Red Lake, summarized the frustration many Northern physicians feel: “We’re not asking for special treatment. We’re asking for recognition that providing emergency care in Northern Ontario is fundamentally different than in Toronto or Ottawa.”
For communities already struggling with healthcare access, the potential loss of reliable emergency services creates profound anxiety. In Hearst, where the nearest neighboring hospital is over 100 kilometers away, Town Councillor Josée Vachon told me residents fear what these changes could mean.
“Our hospital is the heart of our community,” Vachon said. “If emergency services are reduced, some families will simply leave. Our economic development, our schools, everything is connected to having reliable healthcare.”
As Ontario navigates post-pandemic healthcare challenges, Northern physicians are asking for solutions that recognize geographic realities. They point to alternative models, such as the Rural and Northern Healthcare Framework developed by healthcare leaders across Northern Ontario, which proposed sustainable funding approaches based on population needs rather than patient volumes.
“We need to stop applying urban solutions to rural problems,” Dr. Newbery said as our conversation ended. “The strength of any healthcare system should be measured by how it serves its most vulnerable communities, not just its most populated ones.”
As I left Sudbury that evening, watching the rocky landscape give way to forests along Highway 17, I couldn’t help but think about the invisible safety net these emergency departments provide across the North. For the million Ontarians who call this vast region home, these funding decisions are about much more than budgets – they’re about whether help will be there when they need it most.
