So Where is Brantford’s New Hospital?

Our community has been growing for sometime, and so has been the advocacy for the approval of Brantford’s new hospital redevelopment. With wait times in the emergency rooms sometimes cresting over the 12 hour mark, and patients having to stay in beds in the hallways for days at a time, the Brantford General Hospital is in need of a serious upgrade. This isn’t a new revelation either, this has been an ongoing problem for a while, which has only been magnified by our rapid growth in population.

“We need a new hospital now!”

– Almost every Facebook commenter in Brantford. Kind of.

Why Does Brantford need a New Hospital?

Brantford is a growing city, as are the areas connected to it. Brant County and Six Nations territories also rely on the facilities and programs provided by the Brant County Healthcare System (BCHS) on a daily basis

The Brantford General Hospital has already been running at an exceeded capacity, and there are parts of the building that are not up to par or even viable for their intended use anymore. The Willett Hospital out in Paris, ON definitely needs to be expanded to accommodate the growth in Brant County as well.

So Then What’s the Hold Up?

It feels as though we’ve been hearing that we are 10 years away from a new hospital in Brantford, for the last 10 years. So what’s the hold up? Why don’t we have a new hospital in Brantford yet? Can’t we get shovels into the ground right now? Unfortunately there’s a few dominos that need to fall first.

Ontario’s hospital planning and redevelopment process is detailed in the Hospital Capital Planning and Policy Manual by Ontario Health. The process typically involves a number of milestone stages:

1. Pre-Capital Submission: Initial proposal and needs assessment.
2. Stage 1: Proposal: Preliminary planning and feasibility studies. <- we are here
3. Stage 2: Functional Program: Detailed program requirements and initial design.
4. Stage 3: Preliminary Design: Preliminary architectural design and budget estimation.
5. Stage 4: Working Drawings: Detailed architectural and engineering plans.
6. Stage 5: Implementation: Construction and commissioning of the facility.

Each stage requires approvals from the Ministry of Health, ensuring that the project meets all regulatory standards and aligns with provincial healthcare priorities. This thorough and tedious process helps mitigate risks and ensures that the new facility will meet the community’s needs effectively​ (Ontario Health).

Brantford’s New Hospital Timeline of Significant Milestones

• 2010: Initial discussions and planning for the expansion and redevelopment of Brantford General Hospital begin. Community health needs assessments indicate a growing demand for improved healthcare facilities.
• 2018: The Ontario Nurses’ Association highlights issues with patient care and staffing levels at Brantford General Hospital, emphasizing the urgent need for modernization and expansion​ (CHCH)​​
• February 2020: Brant Community Healthcare System (BCHS) requested approval to move it’s planning from the Pre-capital phase to Stage 1 and for a planning grant of $3M to complete this work.
• March 2022: Premier Doug Ford announces a $2.5 million investment into BCHS. This funding is allocated to support the redevelopment of Brantford General Hospital and Willett Hospital, aiming to increase the total number of beds from 310 to 384 across the two sites. This investment also includes provisions for enhanced healthcare services for patients in Brant, Brantford, and surrounding communities​ (CHCH)​.
• May 2022: Brantford General Hospital faces staffing shortages and patient care challenges, leading to an independent panel investigation. Recommendations from the panel are expected to guide future improvements and staffing strategies​​.
• September 2022: Community advocacy for the hospital redevelopment gains momentum, with enhanced campaigns directed at securing government approvals and additional funding. Local fundraising efforts are also intensified to bridge financial gaps and support the project​​.
• October 2023: Stage 1.2 Proposal Submitted which included includes two parts. The program and services description (what is to be included as part of the new redeveloped Hospital project) and the Facility Development Plan (FDP) that included three options for the BGH site and two options for the TWH site
• March 2024: The province approved the Brant Community Healthcare System (BCHS) to go to stage 1 for the planning of a new hospital in Brantford.
• April 2024: FDP Enhanced Business Case to support the proposal submission presented to Infrastructure Ontario (IO) and MOH
• May 2024: Comments from Ontario Health and Ministry of Health on the proposal were received and responded to.
• June 2024: BCHS launches a detailed report outlining the progress made so far and the next steps for the hospital redevelopment. This report includes updates on funding, community impact assessments, and revised timelines based on current approvals and financial status​.

Development Feedback for Brantford’s New Hospital

Location, Location, Location…

What’s interesting is that using a new greenfield site for the BGH has been asked and advocated for from the provincial government multiple times, but it was turned down, and is not a part of the agreed upon planning parameters with the MOH set in March 2022. The $2.5M grant that the city received had specific language requesting the redevelopment and reuse of existing infrastructure. This included towers B, and C of the BGH which have been deemed beyond their useful life by an engineering consultant while the fate of tower D (which had a tunnel collapse recently) is to be determined.

It hasn’t been decided yet if a greenfield or a redevelopment/rebuild solution will be applied for the Willett Hospital. The next stage of the process will finalize programming and planning .

Feedback from MOH, OHW & IO

The Program and Services part of the proposal (referred to as Part A) was acceptable, but the Facility Development Plan (FDP) and Business Case would need to be reviewed. It was determined that the submitted FDP did not lend itself to the current marketplace and planning limits that have been issues across the province:

• Capacity and availability within the Construction industry related to large scale hospitals are limited.
• There are a number of projects already underway across the province
• 2-3 contractors have the resources to take these projects on
• Shortages in Labour, materials and supply chain issues, rising construction costs and bonding were all itemized as hurdles.

As a result, an alternative FDP would need to be prepared by the BCHS to package the project which will be reviewed by Ministry Officials.

Projected Costs for Brantford’s New Hospital

Although the costs for a new hospital in Brantford can be estimated to be in the billions of dollars, until the project is put out for Request for Proposals (RFP) but here is a breakdown of how the costs are shared between the community and provincial government:

• The provincial government covers most hospital construction costs, while the hospital is responsible for the remaining portion, known as the “local share.”
• Hospitals must contribute 10% of the hard construction costs and bear the full expense of new furniture, patient equipment, technology, and non-shareable items such as parking facilities. This results in a blended local share that typically ranges between 15% to 25% of the total project cost.
• The government acknowledges that this imposes significant financial pressure on communities, especially as hospital construction costs continue to rise.
• At the next planning stage, known as the Functional Program stage, the BCHS must submit a plan for the “Local Share” costs, outlining how it will fund the estimated share of the costs. The project’s cost estimate will become clearer at this stage.
• The “Local Share” plan is expected to evolve over time as the project moves closer to Financial Close (the start of construction), at which point the final project costs will be known.

The “local share” is what the community has been focused on for a while. It is a key part of the next phase and the plans to meet the costs will be an ever evolving as the RFP is put out and submissions are reviewed. The major part of the advocacy of fundraising centres around this local share figure being in the 100’s of millions of dollars by the time the government gives the green light. A strong plan to fundraise and secure these funds would definitely bolster our position with the province. The current hospital reserve fund is north of $15M which was accumulated in a matter of 13 months which is a great start.

… But We Aren’t Alone in the Fundraising Efforts!

It’s not just up to the city of Brantford. The county and surrounding areas covered by the BCHS will all need to pitch in for Brantford’s new Hospital as well. The funds would need to be available near the end of the project, meaning the fundraising efforts can span the 10+ years it might take to complete the project. If all the surrounding communities who are serviced by the BCHS can’t come together to support one vision/plan/location for the hospital, the provincial government wouldn’t be as gung-ho to approve this project for the 2025 budget.

In the 2024 provincial budget there was over $50B allocated to infrastructure projects across the province but there isn’t a list of cities that are to receive new hospitals at this time. There are hospitals that have received planning grants that are in the same stages of the process as Brantford is, but currently no indication as to which ones will be included in the 2025 budget.

Collaborating with the MOH to review and package together an alternative FDP that will encompass the feedback received. This will be submitted in end of Q3 / start of Q4 2024.

The Next Steps for Brantford’s New Hospital: Advocacy is Key

Continuing to advocate for government approval to construct, and develop and implement a communications plan to align the understanding between the board, BCHS, and the community. The goal is to secure the approval in the 2025 Ontario budget for the Stage 1.2 FDP submission and proceed to the next stages of the project.

Recently Ward 4 Councillor Richard Carpenter started a sign campaign to bring awareness to the advocacy needed to keep Brantford’s new hospital at the forefront of the provincial government’s priority list. He is calling to attention the news-worthy advocacy that was spearheaded by the Mayor of Whitby, Elizabeth Roy, for her city. It’s not exactly comparing apples to apples though as they are a few steps ahead in the process compared to where we are here in Brantford right now.

What about other Priorities in Brantford?

This is where a lot of citizens are torn. The new hospital should be top of the priority list for the city’s council, and every new project or proposal that the city posts about seems to bring the same comments “What about a new hospital?”

The fact of the matter is that the city is in a growth period, so it also needs to focus on fostering and sustaining the proper economic development needed to “grow up” as a city. There is obviously a dire need to improve our current health care situation here in Brantford, but should that come at the expense of other priorities and opportunities? If you believe the commenters online, it’s as if the city can’t juggle a few projects at one time so any mention of anything else seems to be pitted against the new hospital in the comments. As an example, look back at any post on social media about the proposed new Sports and Entertainment complex and you’ll see how quickly the internet pitch forks and torches come out.

The Reality: We Are Still 10 Years Away

Aside from construction, the rest of the stages are bureaucratic in practice and usually take 1-2 years from start to finish. There’s an argument to say that with minimal revisions to plans and proposals, we could shave a few years off the total length of the project, but that would need a huge push from the provincial government to push this to the top of their priority list.

With growing concerns over the rising costs of construction, a strain on labour resources and materials, and a shortage of contractors capable of taking this project on, we could be in it for the long haul. In the meantime, the city can keep their fingers crossed that the improvements to the Emergency Room at BGH (which are scheduled to be completed by 2026) will help relieve some of the strain to the community’s health care needs.

Geek Out With Me!

I will be following up on the progress of the redevelopment of Brantford’s hospital in future posts. Everything will be linked at the top of this article as they are written so if you’d like to geek out with me on this topic, feel free to bookmark this post.

Frequently Asked Questions

Bonus Geek Stuff: Hospital Construction Timelines and Approval Processes in Ontario

Building a new hospital in Ontario involves a multi-stage process governed by provincial regulations and extensive planning. Understanding the timelines and approval processes from recent hospital projects can provide valuable insights into why these projects take time and how they are managed.

South Niagara Hospital

The South Niagara Hospital, which began construction in July 2023, provides a clear example of a typical hospital construction timeline. Here is a breakdown of its key milestones: