Public Hospitals Act

1 In this Act, “administrator” means the person who has for the time being the direct and actual superintendence and charge of a hospital; (“directeur général”) “Appeal Board” means the Health Professions Appeal and Review Board under the Ministry of Health and Long-Term Care Appeal and Review Boards Act, 1998; (“Commission d’appel”) “board” means the board of directors, governors, trustees, commission or other governing body or authority of a hospital; (“conseil”) Note: On a day to be named by proclamation of the Lieutenant Governor, section 1 of the Act is amended by adding the following definition: (See: 2017, c. 11, Sched. 3, s. 12) “community laboratory services” means the services of a laboratory or specimen collection centre under the Laboratory and Specimen Collection Centre Licensing Act that are provided by a hospital designated under subsection 22 (1) of this Act to persons wh…

2 Nothing in this Act in any way relates to or affects a private hospital under the Private Hospitals Act or an integrated community health services centre within the meaning of the Integrated Community Health Services Centres Act, 2023. R.S.O. 1990, c. P.40, s. 2; 1996, c. 1, Sched. F, s. 4; 2023, c. 4, Sched. 1, s. 80. Section Amendments with date in force (d/m/y) 1996, c. 1, Sched. F, s. 4 - 01/03/1996 2017, c. 25, Sched. 9, s. 111 (1, 2) - no effect - see 2023, c. 4, Sched. 1, s. 67 2023, c. 4, Sched. 1, s. 80 - 25/09/2023

3 The Minister shall administer and enforce this Act and the regulations. R.S.O. 1990, c. P.40, s. 3. Approvals by Minister

4 (1) No articles shall be filed under the Not-for-Profit Corporations Act, 2010 in respect of a hospital until the articles have first received the approval of the Minister. 2010, c. 15, s. 240 (1). Approval of incorporation, amalgamation, amendment (1.1) No application to incorporate a hospital or amalgamate two or more hospitals under a private Act or to amend a private Act in respect of a hospital shall be proceeded with until the application has first received the approval of the Minister. 2010, c. 15, s. 240 (1). Approval (2) No institution, building or other premises or place shall be operated or used for the purposes of a hospital unless the Minister has approved the operation or use of the premises or place for that purpose. 1997, c. 15, s. 16. Approval of additions (3) No additional building or facilities shall be added to a hospital until the plans therefor have been approved …

5 (1) The Minister may pay any grant, make any loan and provide any financial assistance to a hospital if the Minister considers it in the public interest to do so. 1996, c. 1, Sched. F, s. 6. Terms and conditions (2) The Minister may impose terms and conditions on grants, loans and financial assistance provided under this section and may from time to time amend or remove the terms and conditions or impose new terms and conditions. 1996, c. 1, Sched. F, s. 6. Security for payment (3) Without limiting the generality of subsection (2), the Minister may, as a condition of providing grants, loans and financial assistance under this section, require the recipient of the funds to secure their repayment in the manner determined by the Minister. 1996, c. 1, Sched. F, s. 6. Reduce or terminate grants, etc. (4) The Minister may reduce the amount of any grant, loan or financial assistance, may susp…

6 Repealed: 2023, c. 19, s. 24 (1). Section Amendments with date in force (d/m/y) 1996, c. 1, Sched. F, s. 6 - 01/03/1996; 1999, c. 10, s. 5 (1-5) - 14/12/1999 2006, c. 4, s. 52 (3, 4) - 28/03/2006 2010, c. 15, s. 240 (2) - 19/10/2021 2023, c. 19, s. 24 (1) - 28/06/2024

7 Every hospital has power to carry on its undertaking as may be authorized by any general or special Act under which it was created, established, incorporated or empowered so to do. R.S.O. 1990, c. P.40, s. 7.

8 (1) The Lieutenant Governor in Council may appoint one or more persons to investigate and report on the quality of the management and administration of a hospital, the quality of the care and treatment of patients in a hospital or any other matter relating to a hospital where the Lieutenant Governor in Council considers it in the public interest to do so. 1996, c. 1, Sched. F, s. 7. Powers (2) An investigator has the powers of an inspector under this Act and the regulations. R.S.O. 1990, c. P.40, s. 8 (2). Obstruction (3) No person shall obstruct an investigator or withhold or destroy, conceal or refuse to furnish any information or thing required by the investigator for the purposes of the investigation. R.S.O. 1990, c. P.40, s. 8 (3). Delivery of report (4) The Minister shall cause a copy of the report of an investigation to be delivered to the chair of the board of the hospital. R.S…

8.1 (1) The Minister may issue operational or policy directives to the board of a hospital where the Minister considers it to be in the public interest to do so. 2016, c. 30, s. 46 (2). Restriction (2) A directive shall not unjustifiably as determined under section 1 of the Canadian Charter of Rights and Freedoms require the board of a hospital that is associated with a religious organization to provide a service that is contrary to the religion related to the organization. 2016, c. 30, s. 46 (2). Binding (3) A board shall carry out every directive of the Minister. 2016, c. 30, s. 46 (2). General or particular (4) An operational or policy directive of the Minister may be general or particular in its application. 2016, c. 30, s. 46 (2). Law prevails (5) For greater certainty, in the event of a conflict between a directive issued under this section and a provision of any applicable Act or …

9 (1) On the recommendation of the Minister, the Lieutenant Governor in Council may appoint a person as a hospital supervisor where the Lieutenant Governor in Council considers it in the public interest to do so. 1996, c. 1, Sched. F, s. 8. Notice of appointment (2) The Minister shall give the board of a hospital at least 14 days notice before recommending to the Lieutenant Governor in Council that a hospital supervisor be appointed. 1996, c. 1, Sched. F, s. 8. Immediate appointment (3) Subsection (2) does not apply if there are not enough members on the board of a hospital to form a quorum. 1996, c. 1, Sched. F, s. 8. Term of office (4) The appointment of a hospital supervisor is valid until terminated by order of the Lieutenant Governor in Council. 1996, c. 1, Sched. F, s. 8. Powers of supervisor (5) Unless the appointment provides otherwise, a hospital supervisor has the exclusive rig…

9.1 (1) In making a decision in the public interest under this Act, the Lieutenant Governor in Council or the Minister, as the case may be, may consider any matter they regard as relevant including, without limiting the generality of the foregoing, (a) the quality of the management and administration of the hospital; (b) the proper management of the health care system in general; (c) the availability of financial resources for the management of the health care system and for the delivery of health care services; (d) the accessibility to health services in the community where the hospital is located; and (e) the quality of the care and treatment of patients. 1996, c. 1, Sched. F, s. 8. No proceeding against Crown (2) No proceeding, other than a proceeding referred to in subsection 10 (2), shall be commenced against the Crown or the Minister with respect to a decision or direction under se…

10 (1) No action or other proceeding for damages or otherwise shall be instituted against any of the following persons for any act done in good faith in the execution or intended execution of any duty or authority under this Act or the regulations or for any alleged neglect or default in the execution in good faith of any such duty or authority: 1. An investigator or a hospital supervisor appointed under section 8 or 9, an inspector appointed under section 18 or a person, persons or a body to whom the Minister’s powers have been assigned under clause 32 (1) (z.1). 2. The staff of anyone mentioned in paragraph 1. 2007, c. 10, Sched. I, s. 2; 2010, c. 25, s. 27 (3). Crown not relieved of liability (2) Subsection (1) does not, by reason of subsection 8 (3) of the Crown Liability and Proceedings Act, 2019, relieve the Crown of liability in respect of a tort committed by a person mentioned in…

11 Subject to the Expropriations Act, a board may expropriate any real property necessary for the purpose of properly conducting the hospital. R.S.O. 1990, c. P.40, s. 11.

12 (1) A hospital shall pass by-laws as prescribed by the regulations. 1996, c. 1, Sched. F, s. 10. Idem (2) A hospital shall pass, amend or revise its by-laws and submit them to the Minister after receiving notice to do so as prescribed by the regulations. R.S.O. 1990, c. P.40, s. 12 (2). Idem (3) No by-law, or amendment to or revision of a by-law, made under subsection (2) has any force or effect until it is approved by the Lieutenant Governor in Council upon the recommendation of the Minister. R.S.O. 1990, c. P.40, s. 12 (3). Rotation of directors (4) A hospital may provide by by-law for the election and retirement of directors in rotation, but in that case no director shall be elected for a term of more than five years and at least four directors shall retire from office each year. R.S.O. 1990, c. P.40, s. 12 (4); 2010, c. 15, s. 240 (3). Special directors (5) A hospital may provide …

13 (1) No action or other proceeding for damages or otherwise shall be instituted against any member of a committee of the medical staff of a hospital or of a board or of the staff thereof for any act done in good faith in the execution or intended execution of any duty or authority under this Act or the regulations or for any alleged neglect or default in the execution in good faith of any such duty or authority. 1996, c. 1, Sched. F, s. 11; 1998, c. 18, Sched. G, s. 70 (2). Same (2) No action or other proceeding for damages or otherwise shall be instituted against any witness in a proceeding or investigation before a committee of the medical staff of a hospital or a board or the Appeal Board for anything done or said in good faith in the course of a meeting, proceeding, investigation or other business of such committee or board. 1996, c. 1, Sched. F, s. 11. Section Amendments with date…

14 (1) The record of personal health information compiled in a hospital for a patient is the property of the hospital and shall be kept in the custody of the administrator. R.S.O. 1990, c. P.40, s. 14; 2004, c. 3, Sched. A, s. 96 (2); 2006, c. 4, s. 52 (5). (2) Repealed: 2019, c. 5, Sched. 3, s. 19 (2). Section Amendments with date in force (d/m/y) 1996, c. 1, Sched. F, s. 12 - 01/03/1996 2004, c. 3, Sched. A, s. 96 (2, 3) - 01/11/2004 2006, c. 4, s. 52 (5, 6) - 28/03/2006 2019, c. 5, Sched. 3, s. 19 (2) - 01/04/2021

15 No hospital by-law authorizing the board to elect a management committee and to delegate to the management committee any powers of the board requires to be confirmed at a general meeting of the members of the hospital corporation. R.S.O. 1990, c. P.40, s. 15; 2010, c. 15, s. 240 (6). Section Amendments with date in force (d/m/y) 2010, c. 15, s. 240 (6) - 19/10/2021

16 No member of a hospital corporation shall vote by proxy at any meeting of the corporation. R.S.O. 1990, c. P.40, s. 16.

17 (1) It is not necessary to send written notice of any general or special meeting of the members of the hospital corporation to each member of the hospital corporation. R.S.O. 1990, c. P.40, s. 17 (1); 2010, c. 15, s. 240 (7). Idem (2) It is sufficient notice of any general or special meeting of the members of the hospital corporation if notice is given by publication at least once a week for two successive weeks next preceding the meeting in a newspaper or newspapers circulated in the municipality or municipalities in which members of the hospital corporation reside as shown by their addresses on the records of the hospital. R.S.O. 1990, c. P.40, s. 17 (2). Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 17 (2) of the Act is repealed and the following substituted: (See: 2016, c. 5, Sched. 24, s. 1) Same (2) Notice of any general or special meeting of …

18 (1) The Minister may appoint one or more inspectors for the purposes of this Act and the regulations. 2010, c. 25, s. 27 (4). Powers (2) Without limiting subsection (1) or the power under the regulations to prescribe the powers and duties of inspectors, an inspector may, if directed by the Minister, (a) conduct a review, including an audit, of all or part of the operations, accounts, records and other affairs of a hospital; and (b) upon completion of a review, make a report in writing to the Minister. 2010, c. 25, s. 27 (4). Confidentiality (3) An inspector and his or her agents shall keep confidential all information that comes to his or her knowledge in the course of his or her duties under this Act and shall not communicate any information to any other person except as required by law or except where the communication is to the Minister or a person employed in or performing service…

19 Repealed: 2009, c. 33, Sched. 18, s. 26. Section Amendments with date in force (d/m/y) 2009, c. 33, Sched. 18, s. 26 - 15/12/2009

20 A hospital shall accept a person as an in-patient if, (a) the person has been admitted to the hospital pursuant to the regulations; and (b) the person requires the level or type of hospital care for which the hospital is approved by the regulations. 2006, c. 4, s. 52 (7). Section Amendments with date in force (d/m/y) 2006, c. 4, s. 52 (7) - 28/03/2006

21 Nothing in this Act requires any hospital to admit as an in-patient, (a) any person who is not a resident or a dependant of a resident of Ontario, unless by refusal of admission life would thereby be endangered; or (b) any person who merely requires custodial care. R.S.O. 1990, c. P.40, s. 21; 2006, c. 4, s. 52 (8). Section Amendments with date in force (d/m/y) 2006, c. 4, s. 52 (8) - 28/03/2006

22 Repealed: 2009, c. 33, Sched. 18, s. 26. Section Amendments with date in force (d/m/y) 2009, c. 33, Sched. 18, s. 26 - 15/12/2009 Note: On a day to be named by proclamation of the Lieutenant Governor, the Act is amended by adding the following section: (See: 2017, c. 11, Sched. 3, s. 13)

22 (1) The Minister may designate one or more hospitals to provide community laboratory services. 2017, c. 11, Sched. 3, s. 13. Same (2) A hospital that is designated under subsection (1) may provide community laboratory services, subject to any conditions, restrictions or requirements that may be prescribed in the regulations. 2017, c. 11, Sched. 3, s. 13. Section Amendments with date in force (d/m/y) 2017, c. 11, Sched. 3, s. 13 - not in force

23 Repealed: 2009, c. 33, Sched. 18, s. 26. Section Amendments with date in force (d/m/y) 1996, c. 1, Sched. F, s. 13 - 01/03/1996 2009, c. 33, Sched. 18, s. 26 - 15/12/2009

24 No person shall be employed as an intern in a hospital unless he or she is a member of the College of Physicians and Surgeons of Ontario. R.S.O. 1990, c. P.40, s. 24; 1998, c. 18, Sched. G, s. 70 (3). Section Amendments with date in force (d/m/y) 1998, c. 18, Sched. G, s. 70 (3) - 01/02/1999

25 In the event of the death in a hospital of a patient who is an indigent person, or the dependant of an indigent person, the municipality in which the patient was a resident at the time of the patient’s admission shall pay to the hospital any expenses of his or her burial that it incurs. R.S.O. 1990, c. P.40, s. 25.

26 Where under this Act the charges for burial expenses of a deceased patient are payable by a municipality, the hospital to which the patient was admitted shall from time to time render to the clerk of the municipality statements of account of any such charges with full particulars thereof, and if the amount of any such account is not paid within a reasonable time after it has been rendered it may be recovered as a debt in any court of competent jurisdiction. R.S.O. 1990, c. P.40, s. 26.

27 Upon the payment by a municipality of any account rendered to it by a hospital for any expenses of burial of a deceased patient, the municipality may recover from the patient, or, in the event of the patient’s decease, from his or her estate or personal representatives, or, in the case of a dependant, from any person liable in law with respect to the dependant, the amount of the payment so made, and the same may be recovered as a debt in any court of competent jurisdiction. R.S.O. 1990, c. P.40, s. 27.

28 Upon payment by a municipality to a hospital of any account for expenses of burial of a deceased patient by reason of the patient having been assumed to be a resident in the municipality and it being ascertained that the patient was not resident therein but at the time of admission to the hospital was resident in another municipality in Ontario, the municipality that made the payment may recover the amount thereof as a debt from the municipality in which the patient was resident, and upon payment by that municipality it is entitled to exercise the rights of recovery conferred under section 27. R.S.O. 1990, c. P.40, s. 28.

29 Any person who is an Indian within the meaning of the Indian Act (Canada) shall be deemed for the purpose of this Act not to have established residence in unorganized territory. R.S.O. 1990, c. P.40, s. 29.

30 Every person who contravenes or is a party to the contravention directly or indirectly of any provision of this Act or the regulations is guilty of an offence and on conviction is liable to a fine of not less than $50 and not more than $1,000. R.S.O. 1990, c. P.40, s. 30.

31 Repealed: 2002, c. 24, Sched. B, s. 25. Section Amendments with date in force (d/m/y) 2002, c. 24, Sched. B, s. 25 - 01/01/2004

32 (1) Subject to the approval of the Lieutenant Governor in Council, the Minister may make such regulations with respect to hospitals as are considered necessary for, (a) their creation, establishment, construction, alteration, equipment, safety, maintenance and repairs; (b) their classifications, grades and standards; (c) their inspection, control, government, management, conduct, operation and use; Note: On a day to be named by proclamation of the Lieutenant Governor, subsection 32 (1) of the Act is amended by adding the following clauses: (See: 2017, c. 11, Sched. 3, s. 14) (c.1) prescribing conditions, restrictions and requirements for the purposes of subsection 22 (2); (c.2) providing for provisions of this Act or the regulations that do not apply with respect to community laboratory services provided by a hospital designated under subsection 22 (1); (d) prescribing the matters upo…

32.1 (1) The Minister may assign hospitals to the different hospital classifications and hospital grades established by regulation under clause 32 (1) (b). 1998, c. 18, Sched. G, s. 70 (4). List (2) The Minister shall maintain a list of hospitals and their classifications and grades. 1998, c. 18, Sched. G, s. 70 (4). Same (3) The list referred to in subsection (2) shall be available for public inspection from the Ministry. 1998, c. 18, Sched. G, s. 70 (4); 2007, c. 10, Sched. I, s. 3. Section Amendments with date in force (d/m/y) 1998, c. 18, Sched. G, s. 70 (4) - 01/02/1999 2007, c. 10, Sched. I, s. 3 - 04/06/2007

33 Where, (a) the application of a physician for appointment or reappointment to a medical staff of a hospital is rejected by reason of his or her incompetence, negligence or misconduct; (b) the privileges of a member of a medical staff of a hospital are restricted or cancelled by reason of his or her incompetence, negligence or misconduct; (c) a physician resigns from a medical staff of a hospital or restricts his or her practice within a hospital and the administrator of the hospital has reasonable grounds to believe that the resignation or restriction, as the case may be, is related to the competence, negligence or conduct of the physician; or (d) a physician resigns from a medical staff of a hospital or restricts his or her practice within a hospital during the course of, or as a result of, an investigation into his or her competence, negligence or conduct,

the administrator of such hospital shall prepare and forward a detailed report to The College of Physicians and Surgeons of Ontario. R.S.O. 1990, c. P.40, s. 33; 2014, c. 14, Sched. 2, s. 8. Section Amendments with date in force (d/m/y) 2014, c. 14, Sched. 2, s. 8 - 01/08/2016

34 (1) Where the medical staff of a hospital is not divided into medical departments, the chief of the medical staff or, where there is no chief, the president of the medical staff may be made responsible by by-law of the hospital to advise the medical advisory committee with respect to the quality of medical diagnosis, care and treatment provided to the patients of the hospital. R.S.O. 1990, c. P.40, s. 34 (1); 2006, c. 4, s. 52 (11). Idem, in hospitals with departments (2) Where the medical staff of a hospital is divided into medical departments, the head of each department may be made responsible by by-law of the hospital, through and with the chief of the medical staff or, where there is no chief, through and with the president of the medical staff, to advise the medical advisory committee with respect to the quality of medical diagnosis, care and treatment provided to the patients o…

35 (1) Every board shall establish a medical advisory committee composed of such elected and appointed members of the medical staff as are prescribed by the regulations. R.S.O. 1990, c. P.40, s. 35 (1). Duties (2) The medical advisory committee shall consider and make recommendations to the board respecting any matter referred to it under section 37 and perform such other duties as are assigned to it by or under this or any other Act or by the board. R.S.O. 1990, c. P.40, s. 35 (2).

36 The board may, (a) appoint physicians to a group of the medical staff of the hospital established by the by-laws; (b) determine the hospital privileges to be attached to the appointment of a member of the staff; and (c) revoke or suspend the appointment of or refuse to reappoint a member of the medical staff. R.S.O. 1990, c. P.40, s. 36.

37 (1) Every physician is entitled to apply for an appointment or a reappointment to any group of the medical staff of a hospital established by its by-laws or for a change in hospital privileges and, upon receipt of a written request, an administrator shall supply an appropriate application form. R.S.O. 1990, c. P.40, s. 37 (1). Term of appointment (2) Every physician appointed to the medical staff of a hospital shall be appointed for a period of not more than one year. R.S.O. 1990, c. P.40, s. 37 (2). Idem (3) Each application shall be submitted to the administrator who shall immediately refer such application to the medical advisory committee. R.S.O. 1990, c. P.40, s. 37 (3). Recommendation of medical advisory committee (4) Each application shall be considered by the medical advisory committee which shall make a recommendation thereon in writing to the board within sixty days from the…

38 Where the applicant does not require a hearing by the board in accordance with subsection 37 (7), the board may implement the recommendation of the medical advisory committee. R.S.O. 1990, c. P.40, s. 38.

39 (1) Where an applicant requires a hearing by the board in accordance with subsection 37 (7), the board shall appoint a time for and hold the hearing and shall decide the matter in the exercise of its powers under clause 36 (a) or (b). R.S.O. 1990, c. P.40, s. 39 (1). Parties (2) The applicant or member, the medical advisory committee and such other persons as the board may specify are parties to proceedings before the board under this section. R.S.O. 1990, c. P.40, s. 39 (2). Continuation of appointment pending reappointment (3) Where, within the time prescribed therefor, a member has applied for reappointment, his or her appointment shall be deemed to continue, (a) until the reappointment is granted; or (b) where he or she is served with notice that the board refuses to grant the reappointment, until the time for giving notice requiring a hearing by the Appeal Board has expired and, …

40 Repealed: 1998, c. 18, Sched. G, s. 70 (5). Section Amendments with date in force (d/m/y) 1998, c. 18, Sched. G, s. 70 (5) - 01/02/1999

41 (1) Any, (a) applicant for appointment or reappointment to the medical staff of a hospital who was a party to a proceeding before the board and who considers himself or herself aggrieved by a decision of the board not to appoint or not to reappoint him or her to the medical staff; or (b) member of the medical staff of a hospital who considers himself or herself aggrieved by any decision revoking or suspending his or her appointment to the medical staff or under section 34 or the by-laws cancelling, suspending or substantially altering his or her hospital privileges, is entitled to, (c) written reasons for the decision if a request is received by the board, person or body making the decision within seven days of the receipt by the applicant or member of a notice of the decision; and (d) a hearing before the Appeal Board if a written request is received by the Appeal Board and the board…

42 Service of a notice under sections 37, 39 and 41 may be made personally or by registered mail addressed to the person to be served at the person’s last known address and, where the notice is served by registered mail, it shall be deemed that the notice was served on the third day after the day of mailing unless the person to be served establishes that, acting in good faith, through absence, accident, illness or other cause beyond the person’s control it was not received until a later date. R.S.O. 1990, c. P.40, s. 42.

43 (1) Any party to proceedings before the Appeal Board may appeal from its decision to the Divisional Court in accordance with the rules of court. R.S.O. 1990, c. P.40, s. 43 (1). Record to be filed in court (2) Where any party appeals from a decision of the Appeal Board, the Appeal Board shall forthwith file in the Superior Court of Justice the record of the proceedings before it in which the decision was made, which, together with the transcript of the evidence if it is not part of the Appeal Board’s record, shall constitute the record in the appeal. R.S.O. 1990, c. P.40, s. 43 (2); 2006, c. 19, Sched. C, s. 1 (1). Powers of court on appeal (3) An appeal under this section may be made on questions of law or fact or both and the court may exercise all the powers of the Appeal Board, and for such purpose the court may substitute its opinion for that of the Appeal Board or board or other…

44 (1) Subsection (1.1) applies if, (a) a board of a hospital determines that the hospital will cease to operate as a public hospital; (a.1) the Minister responsible for the administration of the Connecting Care Act, 2019 has made an order under that Act that requires a hospital to cease to operate as a public hospital; (b) Repealed: 2019, c. 5, Sched. 3, s. 19 (4). (c) Repealed: 2019, c. 5, Sched. 3, s. 19 (5). (d) Repealed: 2019, c. 5, Sched. 3, s. 19 (6). 2006, c. 4, s. 52 (13); 2019, c. 5, Sched. 3, s. 19 (3-6). Same (1.1) If one of the conditions set out in subsection (1) applies, the board of the hospital mentioned in that subsection may make any decision in the exercise of its powers under section 36 that the board considers necessary or advisable in order to implement the decision or requirement to cease to operate as a public hospital, including, (a) refusing the application of …