Huntsville medical community not broadly behind two-hospital model, says Mathies

Although the two-hospital model put forth last week at the joint meeting of Huntsville and Bracebridge Councils had unanimous Council support, it does not have broad support from the medical community, according to Dr. David Mathies, former chief of staff and one of the members of the local hospital advisory committee, the very committee that tabled the recommendation.

The proposed two-hospital model would see acute care offered at one hospital and chronic care in the other. This model is being touted by the mayors of Huntsville and Bracebridge as an antithesis to the closing of both the Bracebridge and Huntsville hospitals in favour of a single centrally located one.

Mathies said he’s been speaking about the issue to some of his colleagues in Huntsville and the sense he’s getting is that while there’s still a bit of ambivalence about supporting a single hospital model for Muskoka, the notion of losing acute care in Huntsville is not sitting well with the medical community here.

“They’re [the Huntsville medical community]quite alarmed at the idea that acute care may not be at all close by. So let’s say acute care is in Bracebridge, they’re now saying well that’s totally unacceptable. It’s too far away from people who live in say North-East Parry Sound or Algonquin Park and these are very important parts of the constituency here,” said Mathies who noted that physicians in Bracebridge probably feel the same way.

The Board of Muskoka Algonquin Health Care (MAHC), which administers both the Bracebridge and Huntsville hospitals, is recommending the closure of both hospitals in favour of creating a new hospital centrally located between the two sites. MAHC has been studying ways to solve its reoccurring financial woes and ailing infrastructure but closing Muskoka’s existing hospitals and having to provide the required infrastructure to facilitate the building of another hospital in a rural area of Muskoka is not sitting well with municipal representatives. They are pushing for the redevelopment of the existing hospital sites, albeit with a different configuration but one that would maintain emergency rooms at both locations.

The community with acute care at their hospital wins

“Part of the plan is that there’d still be emergency rooms at both sites but what I think our surgeons are saying is they would end up where the acute care site is and would no longer support the other emergency room in the same way that we’re used to. That’s what we’re hearing from them,” said Mathies, who ventured that eventually they would leave town and go where the infrastructure for acute care is located.

“You can see how we’re going in a circle. So a single site is okay but now we’ve got the municipalities saying ‘well it’s pretty costly why don’t we do this,’ but that doesn’t work either.”

Mathies said in his personal opinion Muskoka’s hospitals are simply not being funded properly by the Ministry of Health and Long-Term Care. He said when you consider the population of the Bracebridge and Huntsville communities’ catchment areas as well as the transient populations the hospitals serve, it translates to roughly 60,000 people. “Where in the province are communities of that size losing their hospitals? I don’t know why we are being singled out. I think the funding doesn’t quite suit Muskoka.”

Mathies argued that in the grand scheme of things a few million dollars to fund the hospitals properly is not a lot of money.

We’ve spent billions twinning the highway up to North Bay, I presume the government feels it’s worthwhile to have an economy in this area and we’re just talking a few million dollars of funding. The deficit is small.
Dr. David Mathies

He noted that MAHC has already cut a lot of cost and now it has hit a wall.

CEO for Muskoka Algonquin Health Care Natalie Bubela was at the Algonquin Theatre on February 1 when the mayors presented their proposed two-hospital model and said it was the very first time she’d had an opportunity to hear the proposal.

“There’s a lot of information to digest and we have lots of questions and are looking forward to exploring that with our municipal leaders at our next taskforce meeting,” she said.

Last year’s rallies were caused by this same idea of moving acute care to one hospital

Admittedly the two-hospital model presented by the mayors and consultants is very similar to one of the options MAHC looked at as a way of solving its financial woes. But the two-hospital model was eliminated, “given the risks that were identified with the model by our staff and our team of physicians,” said Bubela. She said while there was the possibility that it could work, it wasn’t ideal and it seems like the same model that initiated all the town rallies and the petitions that came forward against service cuts at any one given hospital.

When asked exactly why the two-hospital model, similar to what the mayors are proposing, was rejected, broadly speaking, Bubela said some of the concerns with that option involved the potentially adverse impact on the practice of physicians and the availability of specialists.

She also said travel times, transportation and access for all of MAHC’s catchment area, not just the towns, as well as the quality and safety of care was a concern under the two-hospital model with acute care only in one hospital, and noted that in some instances people will simply bypass the closest hospital to travel to the facility offering the service they’re after.

“Our travel information demonstrated that access actually for the whole area would be minimally impacted by placing it (one hospital) in a central location. And once again I’ll just reiterate we have not picked a site, it could be anywhere along that Highway 11 corridor and until we really know the exact site, it’s really hard to understand from either a volume perspective or from a travel time perspective what the impact will be.”

She said it is anticipated that with the one-hospital model primary and urgent care options would be better developed throughout Muskoka and East Parry Sound. “So that people for instance wouldn’t even have to come to the emergency department, they’d be able to get care more locally where they live. And granted that’s not for the urgent, life-threatening type of things,” said Bubela, adding the emergency department volumes are high and yet many of the cases could be treated elsewhere.

Regardless, Bubela said staff and the Board are committed to working with municipal leaders and understanding comments made during the mayors’ presentation at the Algonquin Theatre, such as the millions of dollars that could be saved under a two-hospital model. “We want to understand that better.”

She also said discussions around what is meant by core services at each location needs to take place. She said the taskforce set up by the North Simcoe Muskoka Local Health Integration Network (LHIN), which reports to the Ministry of Health, is scheduled to meet next week where some of the questions prompted by the mayors’ proposal are expected to be hashed out.

We have come full circle

Mathies noted the Gordian knot has come full circle. It started with rationalizing services in Burk’s Falls then closing down the facility there altogether, to closing beds at both hospitals and laying off dozens of people.

We’ve done all that, the next step now is eviscerating acute care in one hospital and the emergency care and all the rest of it, obstetrics and everything… we’ve finally hit a wall and now the solutions that are put forward all have huge problems. The single site which might be good for healthcare is not good for a municipality. The municipality’s idea, ‘well we rationalize services,’ well that’s not good for the hospital. Then there’s the community that doesn’t get it. And then government doesn’t want to give us more money. So around and around we go.
Dr. David Mathies

Click here to see our earlier story on the two-hospital presentation and the interesting comments from readers.