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Sunnybrook slashes 15 percent from HIV clinic budget

Cost-cutting move eliminates nutritionist and administrator

Credit: Joshua Meles
In a move aimed to control costs at Sunnybrook Hospital, the organization’s board of directors is slashing 15 percent from the budget of the hospital’s HIV clinic.
Sunnybrook had to eliminate a $6.6-million funding gap from its $750-million budget and had directed the HIV clinic to find nearly $200,000 in savings from its $678,000 budget. The clinic managed to cut just $104,000.
The budget cut forces the clinic to eliminate its part-time nutritionist and an office administrator, as well as cut back on orders of office supplies. The cuts were implemented last week.
More than 1,000 people rely on Sunnybrook’s HIV clinic.
Craig DuHamel, Sunnybrook’s vice-president of communications and stakeholder relations, says the cuts are largely cosmetic.
“I doubt if patients will notice,” he says. “No service hours are cut back.”
As for the special services provided by the clinic’s nutritionist, “We’ll be able to cover it off with others in the organization,” he says. “We have some other nutritionists in the hospital that can provide that or the attending physician or nurses.”
But those assurances don’t hold water for some HIV activists and caseworkers. It’s unclear how the hospital’s other nutritionists will be able to handle the added load from the HIV clinic, says Murray Jose, executive director of the Toronto People with AIDS Foundation.
“It’s naive to think they’ll be able to find a nutritionist in the hospital. They’ll be busy with their own loads,” Jose says. “The impact is going to be huge.”
A patient with HIV needs a nutritionist who’s aware of the particular dietary and health needs created by the virus and medications. Both the virus and treatments can affect how vitamins and minerals are absorbed, and HIV meds may have contraindications against otherwise useful supplements. Medications may also cause side effects that require dietary responses.
“It’s as much a specialty for a nutritionist as it is for a doctor to be able to treat HIV well,” Jose says. “You can’t just go on the handbook that they use with the general population.”
A nutritional specialist is key to HIV patient care, Jose says.


“I know money is tight, but it’s much more effective from the perspective of trying to keep someone well, rather than give them more acute care later on.”
Still, Sunnybrook says that the cuts were necessary and were done with sensitivity to patients’ needs, and DuHamel insists that the hospital’s current complement of nutritionists can handle the volume of demand.
“Every hospital has to fund the gap between what they’re funded by the government and inflationary pressures,” DuHamel says. “They evaluated the reductions on whether or not it would affect patient care. We reduced [the budget] to the point where it wouldn’t impact patients at all.
“Those who require services in the clinic will still be able to access the services,” he said.
Sunnybrook is funded by the Ontario government through the Toronto Central Local Health Integration Network. Its budget is supplemented through fundraising and parking and other fees.
Andrew Morrison, a spokesperson for the Ministry of Health, noted that the government’s allocation to hospitals province-wide has increased from $10.9 billion in 2003 to $16.3 billion in 2011.
“[Sunnybrook has] assured us that they still are able to maintain the level of service that they’ve had at their HIV clinic,” he said.