Central West LHIN
MISSISSAUGA HALTON & CENTRAL WEST LOCAL HEALTH INTEGRATION NETWORKS (LHIN)
POTENTIAL FUTURE HOSPITAL SITE(S)
CENTRAL WEST LHIN
MISSISSAUGA HALTON LHIN
1 INTRODUCTION
This is a study by the Mississauga Halton & Central West LHINs to review long range urban growth in Peel and Halton Regions (excluding Burlington) to determine whether there is a need to reserve property presently owned by a public agency or facilitate the purchase of property for possible future Hospital site(s). The projected growth in the study area between 2006 and 2031 is 731,000 people. Given that we are seven years into the existing local official plan period – there are further Provincial “Places to Grow” requirements to update growth projections to 2041 which will result in an increased population of approximately 1.000,000 people in the study area from the 2011 census.
The majority of the growth in the study area will occur in Milton and Brampton. Recent studies by the City of Brampton have identified that the 2031 projections for the City of
Brampton are underestimated by 115,000 people. These studies have projected the current population of 580,000 persons will grow to 842,800 by 2031 and 899,500 by
2041. The study (1) stated “between 2006 and 2011 Brampton grew at the highest rate among Canada’s twenty largest cities”.
(1) Hemson Consulting - 2013 Population and Employment Forecasts –
City of Brampton, October 9, 2013
2 While there are programs to provide some primary care services within the Community,
Hospitals remain as the hub for the delivery of primary care and should be evenly distributed to serve the needs of the Community.
If the decision to locate a new hospital is done after the area is planned for development
– sites are difficult to acquire and expensive. By planning ahead and reserving / purchasing a site – the health care system can better plan for the future. Site costs can be minimized given hospital oversizing requirements such as traffic and water service can be planned into the area infrastructure. If circumstances change – the site can be released / sold.
PROVINCIAL / MUNICIPAL PLANNING
The Ontario Planning Act provides for the Province to set out Provincial Policy with respect to planning. Specifically the Provincial Green Belt and Places to Grow legislation have both restricted and directed growth. Other Provincial agencies such as
Metrolinx are also important in providing Provincial direction for the public transit network which affects the direction of growth as well as the intensification of growth along transit corridors.
Region & City Official Plans are required for the following purposes:
To limit the boundary for urban growth
To designate existing and future land uses
To direct public expenditures for infrastructure 3
Region and Municipal Official Plans also address general health and wellness objectives to encourage physical activity, support aging in place and improve the environment. These three initiatives have a significant impact on the well-being of society and health care in particular. The Region of Peel and the City of Mississauga have been leading in developing policies and programs addressing the determinants for health promotion and disease prevention. The Region of Halton has also lead in the area of planning for better general health and well being.
PLANNED URBAN GROWTH
Peel / Halton Regions
The Mississauga Halton LHIN includes the municipalities of South Etobicoke,
Mississauga, Halton Hills, Oakville, and Milton, and covers approximately 900 square kilometers. While it is one of the most geographically compact LHINs in the province, it is the fourth largest LHIN in Ontario based on population, with over one million people residing in the region. The Mississauga Halton LHIN does not include the City of
Burlington within the Region of Halton.
The Central West LHIN includes all of Dufferin County, the northern portion of Peel
Region, and small parts of Toronto and York Region. The Central West LHIN is home to
720,300 people, or approximately 5.8 per cent of Ontario’s population. Fifty two percent 4
of the population (about 325,400 people) of the Central West LHIN live in Brampton.
Approximately 131,700 people in the northwest portion of the City of Toronto is included in this LHIN. The Central West LHIN includes people in portions of
Mississauga and Vaughan, and all of Dufferin County and Caledon.
Peel Region Growth Projections
Brampton Caledon Mississauga Peel Total
2006 452,800 57,050 697,900 1,210,000
2011 523,443 59,460 713,443 1,296,346
2031 727,000 108,000 805,000 1,640,000
2041 899,400 131,800 864,000 1,895.200
Peel Region - 598,854 additional people between 2011 and 2041 (30 years).
5 Halton Region Growth Projections (without Burlington)
Oakville Milton Halton Hills Total
2006 172,000 56,000 58,000 286,000
2011 182,520 84,362 59,008 325,890
2031 255,000 238,000 94,000 587,000
2041 - not available for individual municipalities other than the Places to Grow 2041 allocation for all of Halton including Burlington - 1,010,000
Study Area portion of Halton Region growth is 261,110 people between 2011 and 2031
(25 years).
If you assume 70% of the Halton Growth between 2031 and 2041 will be in Oakville /
Milton (140,000) combined with the 261,110 in the Halton portion of the study area to
2031 as well as the 598,854 in Peel to 2041 – the study area will house approximately
1,000,000 additional people by 2041.
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SPACIAL DISTRIBUTION
The following map provides a visual analysis of the spacial distribution within the study area. Generally speaking the existing hospitals are well situated to the existing population. In addition the sites are adjacent to the transportation corridors for improved public transit.
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EXISTING HOSPITAL SITES
Existing Sites Present Beds Potential
Mississauga 751
Queensway 0 overnight beds
Credit Valley 382
Brampton Civic 608 (Capacity)
Peel Memorial Centre 128 Rehab / CCC
Etobicoke General 264 257 Beds
Trafalgar 272 (to 2015)
New Oakville Hospital 457 (Capacity)
Georgetown 53
Milton 63 50 / 70 beds (under construction) 8
FUTURE BED REQUIREMENTS
While there are significant differences throughout the Province which range from 0.9 to
1.6 beds per 1000 population – for the purposes of this study we will use an average of
1.25 beds per 1000 population. This study does not address the hierarchy of Hospitals other than to recognize that there is a variation between Community and Regional sites based on the level of specialties. Community Hospital locations should be located centrally to the population served for their general needs. For the purposes of examining potential requirements for a new Hospital, the size of a new Hospital could be between 150 & 450 beds.
There is also a significant demand difference for health care services based on the age of the population where intensification might attract a higher proportion of an aging population requiring a higher level of service. Generally speaking this may be more of a significant factor in the Mississauga area where the area is generally built out and the future growth is focused on intensification along the main arterial corridors. There are similar node and corridor locations throughout the other communities that are also targeted to serve an aging population.
If we assume a new Hospital would be between 150 and 450 beds and further - if the bed requirement is approximately 1.25 beds per 1000 persons - then a new hospital would serve approximately 190,000 to 560,000 people. There are many other factors in determining the timing and specifics for a new hospital that are part of the detailed 9
planning for a new Hospital. For future site planning purposes, it would be prudent to reserve sites where there are projected new growth areas that would have over 200,000 people that cannot be accommodated in nearby existing facilities.
The planning - construction for a new hospital can be a 7 to 12 year process – especially when site selection and acquisition could take 2 to 4 years. Advanced knowledge of the future site assists the Municipality in planning future service and transportation requirements. Municipal infrastructure planning is an ongoing process with horizons from 10 to 25 years. Detailed design and environmental approvals are completed for infrastructure works in the 5 to 10 year range.
In addition to planned population areas, it is important to overlay the major transportation corridors and trunk servicing schemes to understand the best location(s) for Hospital(s). There are major transportation systems being planned in the West
Brampton / Caledon area to provide east west and north south arterials. Specifically there is a Halton Peel Boundary Area Transportation System (HPBATS) being implemented within the study area.
The existing Hospitals in Mississauga are well located to serve the majority of the existing Mississauga urban area with the exception of the north-west area of
Mississauga. The north-east portion of Mississauga is predominantly employment based.
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The location of the new Brampton Civic is in the north eastern portion of Brampton whereas the significant growth over the next 25 years will be in West Brampton.
Some of the projected growth has been incorporated into the new Oakville and
Brampton Civic Hospitals. Another significant asset is the size of the Milton site to accommodate the significant projected increase in the Milton population.
Given there is a need within the municipal planning process to increase the existing
Official Plan projections to 2041 and there will be reconsideration of the present urban boundaries by all the Municipalities to meet 2041 requirements - it would be more appropriate to plan for an increase population of 1,000,000 people in the study area.
Assuming 1.25 beds per 1000 persons – there could be an approximate need for an additional 833 beds in the study area.
To understand the distribution requirements, it is more appropriate to look at the significant growth areas separately (based on 2011 census):
1. Oakville / Milton – 370,000 to 2041 (70% Milton – not including Halton Hills)
2. NW Mississauga and Brampton – 526,514 to 2041 (majority in Brampton)
3. Town of Caledon – 72,340 to 2041
11 Oakville – Milton Area
The existing Milton and new Oakville sites are well located to serve the existing and planned growth in Milton - Oakville. Approximately 70 % of the growth is planned for
Milton. The Milton site is approximately 30 acres which could ultimately serve a population in excess of 250,000 people.
North West Mississauga / West Brampton Area
This is the most significant area for growth in the study area that warrants further site analysis to determine whether a future site is likely to be required in the next 15 to 20 years. While the growth projection for the NW Mississauga area - north of Brittannia
Road and west of Hurontario is relatively small from 121,330 in 2011 to 128,210 in
2041- the shifting of 128,210 people to a south west Brampton location would allow the existing hospitals in Mississauga to accommodate the additional 150,000 people between 2011 and 2041 which will be located near the two existing hospitals in
Mississauga..
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This study looks in more detail to the area of northwest Mississauga and southwest
Brampton where there is a projected increase in population in excess of 520,000 additional people to 2041. Brampton will increase in size from the present population by a further 40% by 2041 with the majority of the growth designated for the west portion of
Brampton. In other words if you consider the 128,000 people in NW Mississauga (2041) along with the growth projections of 373,957 people in Brampton to 2041 – there is going to be an additional population of approximately 500,000 people in this area. The spatial distribution map demonstrates the geographic need for an additional hospital in this area to serve this new population.
Caledon Area
Given that the majority of Brampton will be urbanized between 2031 and 2041 - there will be increasing pressure for growth in Caledon between 2031 and 2041 and beyond.
The 2011 population of Caledon was approximately 60,000 and projections for 2041 range between 130,000 and 150,000 persons resulting in growth of 70,000 to 90,000 people by 2041. The majority of this growth will occur immediately north of Brampton in
Bolton and Mayfield West. The Mayfield West population would be near a new site in
West Brampton.
Although Caledon may not warrant a Hospital in the next 25 years it may be possible to begin with a plan for an urgent care / ambulatory facility where the site would have the potential to evolve into a Hospital beyond the 2041 planning period. 13 SUMMARY
This study contains significant “numbers” in terms of population projections. It is important to note that these projections are highly probable given they are Provincial projections for the most desirable area within the Greater Toronto Area. While the study does not consider the aging cohort within the study area, the siting of future Hospital sites in areas of new populations ranging between 200,000 and 500,000 people provides sufficient demand and rationale for a site to be secured. The details of the
Hospital would be determined through the standard Ministry procedures and guidelines.
There is sufficient knowledge and demand to warrant securing a site in West Brampton.
The following observations are the summary of the population demand portion of this study:
1. The most significant growth in the study area is in West Brampton and Milton.
2. Milton growth can be accommodated at the existing Hospital site. Oakville may
require urgent care / ambulatory care south of the QEW as the new site must
meet the growth demands north of Highway 5 (Dundas Street).
3. West Brampton would be an ideal location for a site to be secured well in
advance of the need for an additional Hospital.
4. Caledon may have a need for an urgent care / ambulatory site that could evolve
into a Hospital site when the need is warranted beyond the 2041 planning period.
14 We have undertaken a preliminary investigation of provincial and municipal lands in the
West Brampton area. The material is attached to this report. There are no existing properties that would be a candidate for a request to reserve the property for possible future hospital use. We did have a preliminat discussion with the City of Brampton staff and there is interest at the staff level to persue a possible institutional campus in West
Brampton that would include a Hospital site – similar to the process undertaken by the
City of Vaughan. Given the planning process being undertaken for West Brampton by the City – it would be appropriate to make an intial request to the City in the last quarter of 2014 to include the planning for a possible Hospital site in West Brampton.
Alternatively there may be sites just on the outside of the Brampton boundary which may be serevicable and may access the HP Bats corridor which could be viable as well.
RECOMMENDATION
That the Central West LHIN further investigate the possibility of securing a future
Hospital site in South West Brampton. This initiative would begin in the last quarter of
2014 when the planning for West Brampton begins to look at specific neighbor planning that could provide for an institutional campus with the appropriate servicing and access requirements.
15 DETAILED ANALYSIS OF LAND HOLDINGS FOR A PREFERRED SITE WITHIN
THE STUDY AREA
ASSESSMENT DATA – PARCEL SIZES AND OWNERSHIP
16 17 18 19 ______Bill MacLeod CEO Scott McLeod CEO MH LHIN CW LHIN
------Donald May MCIP, RPP Ontario Land Economist
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