TORONTO - Ontario hospitals will get a 1.5 per cent funding increase in this year's budget, below the minimum they were hoping for as they struggle to stay out of the red to maintain services.

The best-case scenario hinted at by Premier Dalton McGuinty was a two per cent boost, but critics warned even that would be a challenge because inflation is expected to rise this year.

The Ontario Hospital Association has said that even with a two per cent increase they would have been forced to find a one per cent operational efficiency. That's on top of dealing with the deficits they already have.

That will undoubtedly lead to a reduction in services, said critics, adding that move will put lives at risk as hospitals are forced to close beds, shut emergency rooms and cut staff to save money. Even though hospitals can't run deficits by law more than a third were in the red last spring, amounting to a $154-million shortfall.

Activists have pointed to the death of an 18-year-old girl in the Niagara area as an example of a tragedy that could have been avoided if two emergency rooms in her community had stayed open.

NDP Leader Andrea Horwath said the message to patients in Thursday's budget was a clear "tough luck."

"We need a responsible plan for health reform that protects the front-line services that people rely on," she said.

"The increase in hospital funding won't even keep pace with inflation much less the actual increases in costs, and the government has no plan to relieve the pressure that hospitals will face."

The Liberals are also promising changes to lower generic drug prices but didn't release any details about how or when that plan will be rolled out, or what savings it will generate.

The drug plan will also increase support for pharmacies in rural and under-serviced communities and support the expansion of clinical services provided by pharmacists.

Overall health spending will be capped at three per cent growth each year according to the budget, even as the Liberals hold the growth in other program spending to an average of 1.9 per cent beyond 2012-13.

Finance Minister Dwight Duncan said the level of base hospital funding "speaks to the challenge in front of all governments across Canada in the coming years about health care."

"That is why we're taking steps today on generic drugs and some other things to begin the process of sustaining the public health-care system that Ontarians value so much."

Health sector expense is projected to increase by $6 billion from 2009-10 to 2012-2013, amid funding that includes $100 million in 2010-11 to reduce wait times and $8.5 million to create up to 14 regional centres to manage local diabetes programs.

Health care spending accounts for about 46 cents of every program dollar, an amount that's expected to grow as the province's population ages.

If left unchecked, the Liberals say health care spending could grow to 70 cents of every dollar in 12 years.

"The province will continue to face challenges managing the growth of health-care spending without crowding out other priorities such as investing in schools, helping the vulnerable, protecting the environment and investing in infrastructure and economic development," the budget said.