Ontario hospitals facing a cash crunch shouldn't expect a bailout from the province, even if that means laying off nurses and closing beds, Health Minister George Smitherman suggested Tuesday.
  
"I don't prefer that in any circumstance," Smitherman said.
  
"But the alternative is to have a free-for-all where hospitals spend whatever they want and send the bill at the end of the year, and the people's health-care system can't be sustained on that basis."
  
Nurses who may find themselves "displaced" by cuts will have opportunities to find work elsewhere as the province plans to hire 9,000 more nurses over the next three years, he added.
  
Smitherman has taken a hard line in recent weeks against handouts for deficit-prone hospitals in what's shaping up to be another chapter in the province's annual power struggle with hospitals over funding.
  
By law, Ontario hospitals have been forbidden to carry deficits and many are racing to balance their books, which may result in cuts to services.
  
Up to 220 jobs are expected to be cut at the Ajax and Pickering hospital and Centenary Health Centre in east-end Toronto, which are part of the Rouge Valley Health System. The measures are part of a three-year cost-cutting plan by Rouge Valley, which is forecasting a deficit.
  
But Rouge Valley — which Smitherman said has been badly managed — is not alone. The Ontario Hospital Association warned last month that 75 of the province's 154 public hospitals are facing a deficit for the fiscal year that started April 1, increasing to 104 the following year.
  
Hospitals receive more funding each year and those that can't balance their books shouldn't expect a handout from the province, Smitherman said.
  
"I think the taxpayers are going to say, 'Thank goodness, for once, there's a minister of health and a government that doesn't allow hospitals to operate on a blank cheque basis and to send us a bill at the end of the year,' " he said.
  
"[The hospitals] have difficult work to do for sure."
  
When asked about the cuts, Premier Dalton McGuinty noted that health-care funding has jumped 37 per cent since the Liberals came to power in 2003.
  
"We've got a lot of money in the system, we have many more nurses who are out there working," McGuinty said. "But we'll work with the hospitals to find a way to help them balance their budgets."
  
Health-care spending is expected to increase by $2.3 billion to $40.4 billion in the next fiscal year, according to budget figures released in March.