Program helping northern Ontario ERs stay open set to expire

A program that helps rural and northern Ontario hospitals avoid temporary ER closures is set to expire at the end of the month, after a series of last-minute renewals, and hospitals are anxiously awaiting word from the government on what happens next.

Many of the province’s more isolated hospitals rely on doctors from urban areas filling shifts on what is known as a locum basis, and the Temporary Locum Program pays them a premium as an incentive.

Rural and northern hospitals have said the program has helped them keep their emergency department doors open as they struggle with shortages of local doctors, but they have not yet heard what will happen after the current expiry date of March 31.

“We are getting dangerously close to that April 1st, when we’ll be without that incentive for locums,” said Tim Vine, CEO of North Shore Health Network, which has three sites between Sault Ste. Marie and Sudbury.

“So, we wait with great anticipation and hope that it will be continued.”

The province established the COVID-19 Temporary Summer Locum Program during the pandemic, and it expired last March 31 before the government renewed it to Sept. 30, dropping the COVID-19 from the program title. Then in September the province extended it to March 31 of this year, again under a new name, the Temporary Locum Program.

The renewal announcement last spring came two months after it had actually expired, and in that interim period the lack of funding led to four temporary closures of Thessalon’s ER, which was relying entirely on locum physicians due to having no primary care physician in the community.

There are now two local physicians for that site, but it is still heavily dependent on outside doctors, Vine said. Across all three North Shore sites the network is 50 per cent locum dependent, he said.

“I’m really hopeful that…there will be an extension to the program because without it, I do fear for our ability and many small, rural hospitals’ ability to continue to staff our emergency department with physicians,” Vine said.

The Ontario Medical Association has also stressed the importance of the program to the Ministry of Health.

“The OMA is aware of the expiry date for the most recent extension of the Temporary Locum Program and has raised this issue with the ministry,” the doctors’ group said in a statement.

A spokesperson for Health Minister Sylvia Jones initially said she would have “more to say about the future of this program in the near future,” then later clarified that the statement meant it would be extended in some form.

“We are continuing to work with our partners, including the OMA, on a permanent solution to best support the sector beyond March 2024,” Hannah Jensen wrote.

NDP health critic France Gelinas said the government needs to come up with a permanent solution now, instead of constantly renewing the program on a temporary basis at the last minute.

“I don’t know why they keep doing this,” she said. 

“There are no Uber physicians who are just waiting for the phone to ring so they can go up north. That doesn’t exist. I mean, they book their locums a long time in advance.”

The province has noted that other ways it assists those hospitals include another emergency locum program, reimbursing expenses for medical residents when on clinical assignment in northern ERs, and a virtual peer-to-peer program for rural and remote ER doctors.

That other emergency locum program is meant as a backup, said Melanie Goulet, recruitment co-ordinator for health professionals at Notre-Dame Hospital in Hearst, Ont. Having something like the Temporary Locum Program in place permanently would be helpful, she said.

“It would be nice to know we have this program and we’re not always scared…are we going to have it in the next month,” Goulet said.

“Schedulers are already planning six months ahead so they’re already way late to give answers.” 

This report by The Canadian Press was first published March 15, 2024.

Allison Jones, The Canadian Press