Hospital parking: Patients meet the Ministry

Hospital parking has become an issue for the Ministry of Health and Long-term Care (MOHLTC) in Ontario. I attended a meeting last week to hear what patient groups had to say about reducing the cost of parking for patients and families who make frequent or extended use of hospital parking lots. Five groups with special interest in the patient perspective were called to meet with the Ministry to discuss the development of new guidelines for parking.

The Ministry has recognized the importance of high parking costs to patients and has committed to working on it with The Ontario Hospital Association along with other patient groups. As one of those patient groups, it’s our view at Patients Canada that it would be a better idea for patients and hospitals to work on this together to ensure that the patient perspective is brought to the discussion more directly.

There is no doubt that parking costs are too high for some patients to bear. If someone with a sick relative must park at Toronto General Hospital for a month, the cost for parking can be as much as $868. This is no small amount. At a much smaller scale, the daily rate of between $20 and $28 becomes effective after as little as two hours in the parking lot. A single visit to a hospital specialist generally takes more than two hours if you include typical waiting time and travel to and from the parking lot. These and other travel related out-of-pocket costs contribute to the impoverishment of families with relatives who are ill for any length of time, despite our “free at the point of delivery” healthcare system.

At the meeting these concerns were expressed by many groups. I believe that our collective input will have some effect on the guidelines that the Ministry will issue. But that remains to be seen since patients are not yet privy to the negotiations.

Some of us feel that the ultimate goal should be to make hospital parking free for all patients and families. The principle behind this is that according to the Canada Health Act, healthcare services should be free at the point of delivery. Because it can be argued that parking one’s car at a hospital parking lot is part of the health service provided by the hospital, there should be no charge for it. Parking is free in Scotland and Wales for that reason, but not yet in England. (Parking fees have recently become a live issue in England.) We recognize that there is a way to go if we are to achieve free hospital parking in Ontario, including finding alternative sources of revenue for hospitals.

We believe along with some of the other groups that alternate funding sources for parking can be found through sponsorships or major donors. While some sponsors might not consider it to be prestigious enough to have their names associated with a parking structure, others might – Wouldn’t the Chrysler Corporation like its name associated with parking at the University Health Network? Or a Honda dealership with the Sunnybrook Hospital parking garage? Or, better yet, a major toy company associated with parking at SickKids?

Parking policy discussions

At Patients Canada, we try to find very clear and concrete changes that might make the patient experience better. We develop these ideas after listening carefully to the many experiences that patients and families have when they encounter the health care system. Over these last few weeks we have been talking about parking. We pointed out that there was a very big difference between the views of providers and patients about the place of parking policy in health care. We noted some strong opposition to parking charges presented in the Canadian Medical Association Journal, which claimed that charging for parking violates the Canada Health Act because it means health care is no long free at the point of delivery. We noted that although parking is a miniscule part of the hospital budget, it is considered to be an important source of income because it is free of governmental or other restrictions, and allows for a greater flexibility in its use. Some patients do not object to high parking costs because they see them as a contribution to the good work of the hospital.

But still for many patients, parking costs are inordinately high and a significant cost associated with long waits in the emergency room or an appointment to see a specialist or visiting an inpatient. There are lots of ways to reduce the burden of parking in these cases.

Free parking

The most obvious way is the one adopted in Scotland and Wales where parking is free. In Canadian hospitals, this could easily be associated with voluntary donations for parking if people really wish to donate to the hospital. A major donor might be asked to donate to a fund that would provide free parking for all. The parking structure might be named after such a donor who would be appreciated by all those who park in her building. Various modalities can be introduced to decide who to charge for parking and who should get it as part of the hospital service. These discussions of hospital policy might by themselves be instructive and a useful basis for moving forward. In our discussions, we have come up with some ideas, for example: if an emergency room visit takes more than a designated time, free parking chits would be given to patients. These can be paid for from the emergency room budget, or the ER doctors’ joint budget or some other source relevant to ER funding.

Valet parking

In some hospitals, valet parking is offered at a slight fee to a patient with mobility issues so that they don’t have long walks to their appointments. This is an example of making the parking experience better for patients. Another similar service might include providing such valet services at the door of the Emergency Department so that accompanying family members can be right there when the sick person comes in to register.

Subsidized parking

Most hospitals and long-term stay facilities offer reduced rates for parking if there are going to be regular visits over a period of time from family members or others close to a patient. Often this practice is not well enough publicized. In the USA, specialists offer parking chits to their patients. Can this happen here? Might it relate to waiting time before the visit?

As you can see, there is no shortage of ideas about parking. We encourage you to write to us with your ideas of how parking policy can be improved.