Toronto has been in the grips of its worst health scare since the polio epidemics of the 1950s. The last few weeks have seen the breakdown of a hospital system compromised by years of neo-liberal cuts and "restructuring."
One single case of SARS, brought to Toronto on 7 March, began what has been the most severe outbreak of Sudden Acute Respiratory Disorder (SARS) outside of East Asia. As of Monday, 28 April, 21 people have died from SARS in the Toronto area, there have been 263 "probable and suspected" cases of the disease, and at the peak of the crisis over 1,500 people were in quarantine either because they had the disease or had come into contact with a someone with the disease.
On 23 April, the World Health Organisation issued an advisory against visiting Toronto. The declaration unleashed a torrent of criticism from business leaders and politicians more concerned about the effect of lost tourism on the economy than the need to prevent the disease from spreading. Conventions have been cancelled, hotels and restaurants have suffered, and the Bank of Canada has warned the drop in activity could lower overall economic growth. This is very bad news for the economy, which has already been affected by the downturn in the US, by far Canada’s main trading partner. In a desperate attempt to salvage the situation, Prime Minister Jean Chretien, leader of the Liberal Party, announced he would chair a cabinet meeting in Toronto on 29 April to show it is a "safe destination".
Collapse of hospital system
Given less notice is the almost complete collapse of the region’s hospital system in the face of the crisis. Almost all of Toronto’s SARS cases have been spread in hospital with most of the victims being health care workers, patients and their families. On top of that, the health scare has led to attempts to scapegoat the large Asian community, including the boycotting of Chinese food outlets.
The city’s hospitals are now reopening after having been largely closed to the public for weeks forcing the cancellation of thousands of operations. At least three patients with liver disease have died as a result of cancelled surgeries and the full toll of indirect victims of SARS may not be known for months.
Meanwhile, across the country in Vancouver, a single case of SARS has been managed without a similar spread of the disease. The reason why the spread of SARs has been so different between British Columbia and Ontario’s health care system, may well be that Ontario has suffered eight years of assaults on its health care by a neo-liberal government while the right has only been in power in British Columbia for one year.
Since 1995, the Tory government in Ontario (where Toronto is located), looking for ways to pay for tax cuts for the rich, has taken $1 billion dollars out of the health care system, closed dozens of hospitals and emergency rooms, cut thousands of beds, and fired thousands of nurses under a ‘restructuring’ scheme. This has resulted in emergency wards filled to overcapacity and nurses working 12 hour shifts because of understaffing – a perpetual crisis that has become the norm and which has made Ontario’s health care system incapable of dealing with a major health emergency such as SARS.
York Central Hospital is one of the two hospitals that have seen the greatest spread of the disease within its walls. Not coincidentally, in January it received a rating of one star out of five for patient satisfaction. Because of hospital ‘consolidations’ it has been stretched past the breaking point with 68,000 patients a year passing through emergency rooms built to handle 25,000 annually.
Any hospital has the potential of being a major incubator of disease, a risk that increases when staffing cuts, budget reductions, over-subscription and cutting corners result in a reduced ability to maintain a sterile atmosphere. SARS provides another argument against hospital consolidation schemes. Reducing the number of hospitals exposes the system to increased pressures from viruses like SARS because there is no ‘slack’ left in the system to cope with health emergencies. Neo-liberal policies in health care do not create diseases such as SARS, but they have a murderous effect by compromising the ability to combat disease in the name of cost savings and corporate greed.
Socialist Alternative (the CWI in Canada) campaigns for massive public investment in the health service across Canada and also into other essential public services. We also fight all attempts to scapegoat the Asian community for a health crisis that is the fault of neo-liberal polices.