Across the province, local Hospital CEOs are attempting to inject the need for local hospital infrastructure funding into the municipal election debate. They have put property taxpayers on notice that they may need a slice of the municipal tax base for hospital infrastructure costs. This raises some fundamental questions.

Why the demand for money now

To be fair, the need for new hospital infrastructure is not new. Our ageing population combined with unprecedented growth in several metropolitan areas just makes the situation more acute. When the Health Services Restructuring Commission (HSRC) closed and merged hospitals, it grossly underestimated transition and new construction costs.

Now, several communities have been put on notice that tens - if not hundreds of millions - of dollars are required for new construction. And Hospital CEOs are looking for some of this money to come from the local tax base.

This is due to a provincial formula that covers 70% of infrastructure related to restructuring - communities must cover the other 30%. And the split is 50-50, for non-restructuring endeavours.

Is this a local ratepayer responsibility

To a degree, yes. Communities should continue to play a role in funding their hospitals through the various hospital foundations through individual and corporate charitable donations. However, using the property tax base is a quite another matter. What's next Will school boards ask local taxpayers on top of their provincial taxes to build new schools Such a move would set a very dangerous precedent.

Are there other options

Yes. Hospital restructuring was supposed to save hundreds of millions of dollars. Indeed, the province says it has. So where did all the money go And where are the opposition Liberals on this file

Earth to Dalton McGuinty, come in Dalton. Moreover, with Ontario projected to run a $4 billion surplus this year alone, combined with a federal cash infusion from the recent federal-provincial health care deal, surely, the 70-30 funding formula can and must be changed.

The issue is one of simple accountability. Given HSRC's province-wide botching of the cost projections for hospital infrastructure needs, Dalton McGuinty has a duty as opposition leader to hold the Harris government to account for this colossal screw-up. Even though the HSRC was supposedly an arms-length body, the Premier and Health Minister Witmer are ultimately accountable for its failings. For Mr. McGuinty not to pursue this demand for increased funding more rigourously is a political and strategic, if not, critical mistake. While we have praised much of the Harris government record, this is one area where the province has failed, and miserably so.

At the same time, local communities must continue to prepare, even if Queen's Park reconsiders and arrives at an 85-15 split because raising 15% in most centres will still require a monumental charitable fundraising effort.

Where do we go from here

Until this debate is fully engaged at Queen's Park, (Memo to Dalton: Wake Up!), candidates seeking municipal office are wise to remain uncommitted on this file. Once we have a clearer picture from Toronto and hopefully, a more realistic funding formula in place, then we can move forward.

If local taxpayer support is still contemplated, Councils should use the province's new referendum law and go to local voters for a binding decision on a specific hospital levies or tax hikes. If this infrastructure is designed to benefit the people, then let the people decide.