Rajendra Kale is an Ottawa neurologist and a former interim editor of the Canadian Medical Association Journal. The views expressed here are his own.
In November, 2011, I wrote an editorial for the Canadian Medical Association Journal titled "Parking-centred health care," calling for free parking for hospital patients. It ignited a debate about hospital parking charges and provided a public forum for patients and relatives to vent their anger and resentment.
We heard heartbreaking stories about parents not visiting their children in hospital because they could not afford parking. We listened to children who left the bedside of a dying parent to top up parking meters.
The power of their collective anguish could not be ignored by lawmakers. The Ontario government this week announced several welcome changes to hospital parking charges, including an immediate freeze to rates of more than $10 a day, and instructions to start offering multiday discount passes by October. I expect that many patients and their families will benefit from these measures.
These changes acknowledge that there was something wrong with hospital parking charges that needed to be remedied. The government has done that, and should be applauded for it. However, some questions remain unanswered. For example, if parking is a barrier, why lift it only partly? Why will the changes take several months to kick in?
Hospital administrators will now have another challenge on their hands, especially when health-care funds have been frozen. Some will feel they have lost a valuable source of revenue at a difficult time (the government estimates that parking fees bring in about $100-million a year for Ontario hospitals). But there is never an easy time for hospital budgets.
Hospitals would benefit if they changed the way they look at these measures. They need to look at the money they have "lost" as money that patients have saved and acknowledge that these changes will increase access to health care. This is what improving health care is about: removing barriers, and improving the lot of patients.
Some hospitals will say that the money they make from parking is used to buy much-needed equipment for patients. If hospitals need money from patients, then they should ask for donations or voluntary contributions. They should no longer look at parking lots as a source of funding. The caring attitude that all hospitals display inside their doors must extend to their parking lots and meters on nearby streets.
Surely the companies that own or run parking lots in and around hospitals make money. They are not there for altruistic reasons. Can we know how much money these companies make? Shouldn't such information be in the public domain and perhaps displayed in their parking lots?
Unfortunately, my CMAJ editorial did not stimulate research into evaluating the impact of hospital parking charges on the use of hospital services by individual patients. Such research should be encouraged so that we can make evidence-based decisions to guide us forward. We need research to quantify the effect that the new hospital parking charges will have on access to health care.
Ontario Health Minister Eric Hoskins should be congratulated for what he has achieved to improve access to hospital care. It must not have been easy for him. We must now support him to complete the marathon and make hospital parking free for patients. And we all should ask ourselves if it is ethical to provide free parking to gamblers at our casinos, while we charge patients to park at hospitals.