That announcement is another nail in the coffin of the birthing unit, which closed Dec. 15. The hospital closed the unit after a shortage in full-time, ongoing coverage from obstetricians.

Last December, the hospital approached the Ministry of Health, with the help of Simcoe-Grey MPP Jim Wilson, asking for $1.1 million over three years to get the labour and delivery program running again.

The bulk of the funds would have been used this year to compensate obstetricians for the low number of deliveries they would be performing in Alliston. Over the next two years those top-ups hopefully would have been phased out as births at the hospital increased.

But SMH's board of directors learned the province has rejected its request.

"We got a letter last week and they said the government doesn't fund top-ups. They make it quite clear we shouldn't be using our operating budget for top-ups," said Dr. Nigel Gripper, chair of the hospital board.

He said the hospital managed to scrape by with a birthing unit for a number of years, but the board can't go on funding top-ups forever. They can, and have been paying upwards of $100,000 to $150,000 per physician per year.

The ministry's response is exactly what Gripper was expecting to hear, however, the letter said the hospital should wait to hear more from the minister's expert panel. That panel is set to visit the area March 29.

Gripper said the letter didn't make reference to the hospital's Integrated Birthing Model, which was handed to the province last May. The model uses obstetricians and midwives in a joint effort to serve the community.

While there is money in the hospital budget to run the unit and pay for nursing staff, the board isn't willing to add salary top-ups to the bill.

The hospital's Community Advisory Committee, created to find a solution to the birthing unit closure situation, is recommending a three-phase build-up of the birthing unit.

The first step they suggest it to re-open the unit with one OB/Gyn and backup in the form of a locum or certified general practioner as well as local midwives.

Step two includes another OB/Gyn.

The third step being suggested is implementing an Integrated Birthing Model with two obstetricians, complemented by midwives, doulas, an increased number of obstetrical nurses, as well as social service support for new moms. This phase would kick in when the number of births at the hospital reaches 584 in a year.

The ministry's latest decision means the hospital's only choice is to find obstetricians who are willing to come here without a top-up.

Gripper said it's tough when many different communities are competing for doctors.

He said it's not likely the SMH Foundation would seek community help to raise funds to pay the salary top-up.

"The Foundation is struggling to get money for capital projects, it's not part of their mandate. They're raising money for the ER and for our diagnostic imaging department. If someone wants to donate money specifically for that purpose (top-ups), it's up to them."

Members of the birthing unit advisory committee will present their findings and reccommendations to the board at a special meeting Mon., April 2 at 6:30 p.m. in the cafeteria at the hospital.