Repurposing underused office space could relieve pressure on overwhelmed hospitals and address Canada’s looming health-care capacity crisis.
by Saad Ahmed. Originally published on Policy Options
April 16, 2025
Despite political posturing and promises, hallway medicine remains a fact of life across Canada. Available hospital beds have been declining for decades, although shortages have stabilized somewhat in recent years. But the economic and social costs, as well as the burden on patients and health-care professionals, remain substantial.
Here in Vancouver, as we’ve rounded the corner on the cold and influenza season, our hospitals are just starting to recover from operating at the usual seasonal overcapacity of more than 110 per cent. This is an annual occurrence which tracks across the Lower Mainland and the rest of the country.
More beds in hospitals, long-term care homes and supported housing will mean nothing if we can’t staff them. Our chronic shortages of health-care personnel have hit the point of a full-blown crisis. The federal government projects a shortage of 78,000 doctors and nearly 117,600 nurses in the next five to six years.
These numbers are staggering and underline serious long-standing issues in how we plan to attract, train and retain health-care workers. We need to make better workforce data collection and analysis a top priority so that long-term strategies can be co-ordinated between provincial governments, universities and licensing bodies.
Consistent bed blockages and overcapacity speak to the need for us to be creative in undoing the Gordian knot our health-care system has become. For one thing, we need to reconsider the need to admit patients to hospitals. Hospital-at-home programs and intensive outreach strategies are increasingly utilized, but these are not enough.
Enter the promise of building conversions. Can we turn empty office space that has persisted since the COVID-19 pandemic into health facilities or even hospitals?
The idea would be beneficial on multiple fronts. It would relieve the burden on existing hospitals and revitalize ailing downtowns — all likely for less than converting offices to housing or building new health-care facilities. Consider that it can now cost up to $2,500 per square foot to build a new hospital. A conversion project in the United States saved more than 20 per cent in total expenditures. And that while we are expecting a 1,500-bed shortage in Vancouver alone in the next 10 years, despite the current pace of building.
The moral distress of hallway medicine and ever-worsening wait times weighs heavily on health-care providers. It contributes to burnout as doctors, nurses and other support staff slog through predictable shortages in human and physical resources resulting from decades of underfunding.
This is frustratingly apparent in the consistent decrease in bed capacity over the last four decades. As of 2024 Canada had 2.6 beds per 1,000 people compared with 6.8 beds in 1985. British Columbia was even worse at 1.9 beds. These figures rank us near the bottom of countries in the Organization for Economic Co-operation and Development.
Other OECD countries have experienced similar declines in capacity, but it’s clear that Canada has needed more beds for some time. Our hospitals are consistently hovering at 85 per cent capacity when we factor out surges.
Many urban hospitals frequently go beyond 90 per cent capacity, at which point hospital operations can come to a standstill as new admissions wait in the emergency department or surgeries get cancelled because there are no beds for patients coming out of the operating room.
At the same time, office vacancies continue to be high in many suburban areas and downtowns. As of July 2024, Vancouver had a vacancy rate of just under 11 per cent. Other cities, including Toronto, were almost double that or more. These vacancy rates have led to increasing office-to-residential conversion projects, but they come with challenges.
Office buildings are not ideal for housing and conversions can require significant renovations. Deep floor plates mean living areas may be farther from windows and natural lighting. Buildings also tend to have limited bathrooms and central heating and air conditioning (HVAC).
Some of these hurdles would apply to office-to-hospital conversions as well. Modern inpatient rooms usually have a dedicated bathroom and hospital HVAC systems differ from those in standard offices because they must be able to reduce the transmission of infections. However, features such as ample elevator access and proximity to transit and parking may somewhat offset these concerns.
There are other options. For-profit insurers and health-care networks in the United States are looking to lower-cost retrofits of retail space to ambulatory care hubs. And some health authorities in Canada are looking into the small-house model for long-term care. Lower cost of acquisition and renovation is part of the appeal. Perhaps unsold condo prebuilds could be purchased and used as housing units with health supports for marginalized, underhoused patients who have a rotating-door relationship with our hospitals?
Our federal and provincial governments have underinvested in overall health care for decades. Whether they are up to the challenge of rethinking physical hospital spaces is a question. But we must seriously explore imaginative and unconventional ideas such as office-to-hospital conversions. Otherwise we will continue to fumble our way to collapse.
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This article first appeared on Policy Options and is republished here under a Creative Commons license.