There are multiple issues here:
I will refer to ERs to further down.
On TEGH, the older wing of the hospital (which i have stayed in before myself), is way past its due date. This is known by everyone, including the hospital. That wing will be torn down in either 2011 or 2012. Fundraising is underway, and provincial funding approved, for a beautiful new main wing of the hospital, which should dramatically improve the physical conditions.
They are not the only older facility in need of doing over, St. Joes has been getting quite the facelift, Scarb. Gen. finally got their new ER, and HRRH will be replaced when the new mega hospital is built up Wilson/Dufferin area (I believe the target 2012 construction/2014 operational, but don't hold me to that)
That still leaves a few others, including some of the older parts of St. Mike's which are crap, but hopefully there will be new investment there too.
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Relatedly, Sick Kids, has moved to a 100% private room model with an in-room bed for parents to stay overnight with scared little ones. I believe this will be the province wide standard for care for minors.
Wards aren't gone yet, but in light of risks of contagious disease I expect you will see a shift towards semi-private as the basic standard of care for adults in Ontario in new hospital construction. But it will be a generation before that is pervasive.
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On ERs
This has long driven me nuts, if you see the internal schedule at many ERs it shows up to 4 doctors on M-F day shift. While there is only 1 overnights and weekends.
This is simply perverse. Since most minor ailments that bring folks to ERs can be seen in a family doctor's office, but the majority of those are not open overnights or on weekends, thusly those folks end up in an ER!
While some new staff for ERs (total number) would be helpful; a more important move is simply to staff to peak need. So the M-F day shift should get 1 doctor, and the overnight shift/weekend shift between 2-4.
This would cut average wait times by more than 1/2.
Another problem has been base-budget or 'block-servicing' hospitals. Which, in theory, is the most efficient way to fund, as its predictable, and the accounting is simple.
Under this system, a hospital is pre-funded for 'x' number of ER visits, and births and heart surgeries, they staff to that level, and schedule accordingly.
The problem of course, is that hospital administrators have no incentive under this model to make room for 1 more person to go through the door, as they receive the same funding, regardless.
McGuinty has just announced a move to funding hospitals on a service basis, meaning, see a patient, get paid.
I expect you will find them more diligent is processing times under this model.
They will also have to compete for all non-ER business. (ie each hospital will bid to do heart surgery based on what it will cost the province per case.)
This model has its own problems of course, such as rushing care, pre-mature release from hospitals, and its more complex to administer.
Not sure what the absolute answer is; but certainly in some respects, we can and should do better.
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I would add that we also need to provide better alternatives to ERs in off-hours.
Paris, France has an interesting system, where they will send a family doctor to your home, 24/7 for in-home, urgent, but not EMERGENT care. I would love to see that piloted here, in a mid-size city like London, or K-W and see if that helps, I suspect it would, and its much cheaper as the Doctor doesn't need an office, he/she has basic medical equipment, and a car.
I think also requiring those family health teams to at least have some Sunday hours would be good.
I note that the East General Family Health practice (right across the road) does not open Sundays, or after 7pm.
