Muskoka Algonquin Health Care (MACH) has certainly stirred things up this past week with their announcement of plans for future hospital care in Muskoka and East Parry Sound.
There can be no question that this proposal is different from that which was promised several years ago, and it is understandable that some people will have their noses out of joint.
But it is also time for a reality check.
Clearly, the plan approved by the MAHC Board and supported by the provincial government was for two fully equipped acute care hospitals in Muskoka. There were many at that time who predicted not only that this would not happen but also that it was not necessary. Time and circumstances have proven them right.
The reality is that given a number of factors including spiraling construction costs, increased interest rates, updated building codes, and serious post-COVID pandemic staffing shortages, two fully equipped acute care hospitals within 20 miles of each other are not feasible and are simply not going to happen. If that was not evident when the original commitment was made, it certainly is now. We can be angry about that, and we can play the blame game, but it accomplishes nothing.
What we need to remember is that were it not for the herculean efforts of then Bracebridge and Huntsville Mayors Graydon Smith and Scott Aitchison, working together to ensure hospital sites in both North and South Muskoka, we would now be staring at a single-site solution that would have effectively disenfranchised one of these communities.
The direct result of that, even in the face of necessary changes to the original model in order to stay within the province’s financial commitment which remains in place, is that a two-site solution is still both possible and viable.
In my view, we should stop thinking in terms of two hospitals to serve Muskoka and East Parry Sound and think instead of one hospital with two campuses. This is the corporate reality of Muskoka Algonquin Health Care as it is for a number of other hospitals in Ontario.
The latest proposal by MAHC for hospital care in Muskoka and East Parry Sound may not be perfect but it recognizes the reality of both costs and available funding, and it provides between the two campuses in Muskoka two sites with emergency and acute care facilities and an overall hospital facility that is state of the art in terms of equipment and services, with minimum duplication between the two campuses.
Over the years, I have been quite critical of the MAHC Board for the manner in which they handled discussions, proposals, and decisions related to hospital services in Muskoka and East Parry Sound. But with the exception of some transparency and communication issues, I am not this time. Indeed, they needed the wisdom of Soloman to decide how to divide hospital services between the two campuses in a manner that ensures one is not subordinate to the other, as well as the courage to do what had to be done.
And therein lies the rub. The manner in which MAHC decided to allocate services to the two campuses was primarily to differentiate between ambulatory and day surgeries and those that require more extensive in-hospital treatment.
I can see where people in South Muskoka would have difficulty believing that both hospital sites have been treated equally when one has 18 patient beds and the other 139 beds. But ambulatory, diagnostic, and day surgeries do not require nearly the number of beds that longer-term, in-hospital patients do.
On the other hand, the Bracebridge campus will be busier, with patients throughout Muskoka and East Parry Sound coming there for outpatient diagnostic and day surgery, services of which there were many thousands last year.
I find it interesting to note that at their public meeting in Huntsville recently, the MAHC Vice President, Corporate Services, and Chief Financial Officer, stated that the new hospital facility in Bracebridge would increase their total space from the 139,000 square feet they presently have, to 175,000 square feet, but to my knowledge, similar information about the Huntsville site has not been released.
For those who have not seen the MAHC media release, here is the gist of their proposal: “The Made in Muskoka Healthcare model concentrates day surgeries and other outpatient surgical procedures, as well as most outpatient exams such as non-urgent imaging, within a leading-edge Ambulatory and Surgical Centre on a new location in Bracebridge. The 24-7 emergency Department activity would be supported by full diagnostic and medical specialist support, 14 inpatient beds in single patient rooms for short stay admissions (up to 72 hours) and four Intensive Care Unit beds. The model envisions surgical expansion including orthopedic joint replacements in the future, closer to home.
Inpatient care including obstetrical labour and delivery is concentrated in Huntsville with 139 beds for acute care for longer stays, the addition of specialized rehabilitation care to help patients recover from stroke locally and new reactivation care to ensure patients leaving hospital are equipped to transition home successfully. Also, a higher- level intensive care unit, growing to 10 beds will keep more advanced critical care patients in Muskoka. Just like in Bracebridge, the 24/7 Emergency Department also has access to surgery and full diagnostics. Magnetic Resonance Imaging (MRI) services for the entire region are also included.”
Although it was not mentioned in the MAHC media release, and I have not yet been able to confirm it, I have been told that chemotherapy and dialysis will be available at both campuses.
One significant problem, as I see it, is that the MAHC Board has not been as transparent about their overall plans as they should have been. For example, they have a job to do in reconnecting with municipalities within the region to explain why there was no transparency about changes they knew had to be made to the original plan when asking for local financial support.
Also, the Board has said that there could be some “wiggle room” in their proposal but they have not said what that would be. Does that mean, for instance, that Bracebridge could be given some additional beds to more effectively carry out the job they have been asked to do, without affecting what is required in Huntsville? If so, why not just say that?
I have spent almost my entire career in the field of communications, and I do believe that a strategy for effective communication, including transparency, was somewhat lacking here.
On balance however, it is my view, given the demographics and the statistical and financial realities of providing excellent hospital care to the Muskoka region, that both North and South Muskoka have been treated fairly in a manner that provides state-of-the-art hospital care in Muskoka and East Parry Sound within a model that the province can financially support in a climate where two totally equipped hospitals within twenty miles of each other is clearly no longer in the cards.
There is a long road ahead of us and the province still has to approve this proposal within the financial model they previously agreed to. In my view, we have two choices. We can work with the MAHC Board to fine-tune their proposal without penalizing either North or South Muskoka. Or we can fight it tooth and nail to the point that the province shrugs and directs their financial commitment to the many other priorities for hospital care in Ontario.
I know which one I would choose.
Hugh Mackenzie
Publisher
![](https://media-doppleronline-ca.s3-accelerate.amazonaws.com/2022/09/bapJ5qR6-Hugh-Mackenzie.jpg)
Hugh Mackenzie has held elected office as a trustee on the Muskoka Board of Education, a Huntsville councillor, a District councillor, and mayor of Huntsville. He has also served as chairman of the District of Muskoka and as chief of staff to former premier of Ontario, Frank Miller.
Hugh has also served on a number of provincial, federal and local boards, including chair of the Ontario Health Disciplines Board, vice-chair of the Ontario Family Health Network, vice-chair of the Ontario Election Finance Commission, and board member of Roy Thomson Hall, the National Theatre School of Canada, and the Anglican Church of Canada. Locally, he has served as president of the Huntsville Rotary Club, chair of Huntsville District Memorial Hospital, chair of the Huntsville Hospital Foundation, president of Huntsville Festival of the Arts, and board member of Community Living Huntsville.
In business, Hugh Mackenzie has a background in radio and newspaper publishing. He was also a founding partner and CEO of Enterprise Canada, a national public affairs and strategic communications firm established in 1986.
Currently, Hugh is president of C3 Digital Media Inc., the parent company of Doppler Online, and he enjoys writing commentary for Huntsville Doppler.
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Paul Boorman says
Thanks for your opinion as a media guy/ community volunteer from Huntsville. People in both towns would ideally like, in a perfect world, full hospitals in both towns. When 40 doctors in the South Muskoka region say this doesn’t work that has a lot of weight. Nurses found out about the plan at the same time as the public. The MAHC has said these decisions were made in private. I think your ask, that we support MAHC is premature. Sincerely Paul Boorman Milford Bay (45 minutes from the Huntsville hospital in good weather)
Frankie Dewsbury says
I like your comment regarding the first attempt of the build of a single site. MAHC was crucified. In fact, I recall the mayor of Huntsville receiving a cease and desist order. Scott Aitchison (who is now an MPP) was seen as a hero.
The outcome of all was a directive to go back to the table and carve out two full Acute care sites. We have quotes from Doug Ford and Graydon Smith providing assurances of two full Acute care site builds. So why wouldn’t the communities hold them to their word?
If the Board heard of a new directive, they should’ve disclosed. What we are going through now could’ve been completely avoided. Transparency is a requirement for trust to happen. So here we are.
Allen Markle says
So it’s as clear as mud now, eh! We won’t get two full service hospitals. The “Made in Muskoka” plan calls for two related “campuses” with comprehensive services. Knowing the track record of our PC government we could get a private ‘for profit’ build: as a ‘pilot program’. With the recent farming out of Service Ontario as an example, who knows?
And the “herculean effort” of two ex mayors leaves us no closer than we were before. I think it was more along the line of a display by two petulant children divvying up a chocolate bar and neither wanting the other to get a bigger piece. I don’t suppose we will hear much from either now. And as far as anything being for sure? Well, we still don’t know: for sure.
But you have to have a plan. Nothing to say it can’t morph along the way.
I commented earlier on there being few younger people at the MAHC meeting in Huntsville. A person responded that maybe the youngster have better things to do than worry about hospitals. I heartily disagree. I sat beside a very expectant young lady at that meeting and I am sure that she and others like her are quite, and will be, in need of a good hospital. We have two sons and had a good number of foster children; along the way we needed our hospital.
And because I am of an age, even before the ‘baby boomers’, that doesn’t mean I will throw in the towel. I am quite adept at forming an opinion. And voicing it if anyone wants to listen, or read it.
I do still wonder where the trained people are coming from. Fine new buildings and ideas go begging without fine ‘new’ people to do the work. Maybe our “Investing in Health Care” champions could look into that for us!
Richard Hogg says
Let’s not let this opportunity pass by. Two smaller full & separate hospitals lets the 2 communities to compete to attract MDs, staff and donations. Why would one donate a large sum of money to one hospital, knowing the possibility that a government allocation may eliminate its benefit. There is enough population north & south to support 2 smaller hospitals.
David Wexler says
Thank you as always, Hugh, for your voice of reason. There will never be enough public health care dollars available in my opinion to satisfy all healthcare related needs and effective leaders make tough decisions on how to best solve for these and other needs. I agree re the need for transparency and improved communications and hope that your advice is heeded. I for one am excited for us to get going so that we see and benefit from these new state-of-the-art hospitals sooner rather than later.
Verda-Jane Hudel says
Well written Hugh .
I have a question ..are many of the new comers who arrived to the area in the last ten years actually now leaving?
There was a point made a few days ago that is happening and thus many new builds will be left vacant.
Is there a decrease in the number of retired people building and moving into Muskoka?
I feel it is important to have that information clear.
Thanks
Bill Beatty says
You can please some of the people some of the time….Some of the people never! Politicizing the issue is not helpful .
Those that think they no better can be on the Hospital Boards where their criticisms/suggestions can make a difference .
Well done MAHC !
Gail Hewitt says
Well Hugh try reversing the plan and see the stink that causes
Hugh Holland says
In all fairness, I suspect the MAHC planning committee and Board were as surprised as the public about the latest but necessary directions from the province. And they had limited time to react. So, do they spend that time rehashing all the arguments from the last round of planning, or do they spend the limited time finding an optimum solution for the current situation?
Lee Iacocca was CEO of Ford Motor company when he was recruited to save Chrysler from bankruptcy. He is famous for saying, “You reach a point where you have 90% of the information you need to decide, and you will never have 100%. So, make your decision and get on with it.” The roads are covered with indecisive dead squirrels.
As Hugh said, communication is key to acceptance, and the MAHC staff is working an exhausting schedule to communicate the latest information. When all the stakeholders have seen and digested the new plan, I am confident that most will be comfortably on board. The reality is most people will have to travel that extra half hour only very few times in their life. A small price to pay for all the benefits.
Paul Ferris says
Huntsville and Bracebridge are only 20 miles apart? It so happens that Orillia and Barrie are also 20 miles apart.
Agreed we do not yet have the population of our southern neighbours but the regions of Muskoka and East Parrysound are growing rapidly, summer populations triple the population.
These hospitals service a massive area. Bracebridge hospital services Bracebridge, Gravenhurst and Muskoka Lakes. Huntsville services Algonquin Park and north to Sundridge.
Parry Sound has 70 acute care beds and 110 long term beds for a population roughly one third the size of Huntsville. This reflects the needs of a hospital with a large catchment area and a massive summer population.
Let’s be honest Hugh. The Conservative government, with a huge surplus in the health care budget, would like to continue to string us along with inadequate services so that we will go for their two tier health care system concept. We are not interested.
Doug Beiers says
I am not qualified to speak in depth on this issue. However, common sense from my point of view is to prioritize 1st class emergency services in both hospitals, including having the best trained and available staff & equipment. Paramedics who are tasked to get those in severe distress safely to hospital are a key to life-saving measures. Beyond this, I hope reason and common sense prevail.
Kathryn Henderson says
Im with you Paul Ferris. Who gets the new MRI we donated too? Are we getting one new hospital in Huntsville or are they going to add onto the dilapidated Huntsville hospital? Dont understand really what they decided to do.
Erin Jones says
Good analysis, Hugh. Good comments from everyone else. We all wish that we could have everything but we have to accept the loss of the perfect, for the sake of the good compromise.
The clock is ticking on our aging medical facilities while we dicker. One thought that is not emphasized is that you can’t expect to attract personnel with aging and inadequate infrastructure. Old, unattractive, inadequately-equipped and deteriorating buildings, discourage prospective employees from wanting to be here. Labor studies have shown that upgrades to infrastructure increase employee morale and make them feel that management actually cares about them and the environment where they are pledged to do their very best. It is important to get something going before this window of opportunity closes and we have to start all over again!
The Real Person!
The Real Person!
Further to the hospital discussion. Last Tuesday, (Jan. 30/24) I attended a meeting in Dwight that was called to discuss the revised planning that was taking place concerning building two new hospitals. One in Huntsville and the other in Bracebridge. To say the least this is a very complicated project, in the development stage, that is addressing the physical aspects of construction, funding for such an endeavour, the various levels of approval and last but certainly not least the best way to use the system to serve the community at large. Yes, I just said “system” because in my opinion we are not just building a hospital to serve the community of Bracebridge and a hospital to serve the community of Huntsville we are building a system to serve the community of Muskoka and beyond. The beyond takes us halfway to North Bay, Parry Sound, Orillia and to the other side of Algonquin Park.
We as citizens of Bracebridge and Huntsville should be proud of the fact that these facilities will be built in our communities, we should also be very proud of a system that has the care available to meet the medical needs of people throughout a very large geographical area. I don’t think the focus should be on what community has more rooms or specific services but the fact that we are together the centre of a community that will have two new medical facilities. Two facilities that will maintain existing and draw new professionals to serve our needs and if I can end this by rubbing my crystal ball and forecasting that these new facilities will become an engine for both population and economic growth in our communities.
Len Ross
The Real Person!
The Real Person!
Michele Ineson
I wonder if we will see “Herculean efforts” from Smith and Aitchson for their constituents now that they are no longer mayors but representatives of the Conservative Party?
If anything, we should have an insider in our corner, no? Well Smith’s Facebook page is already thanking the Ford government for investing in the local healthcare model against the public outcry. I imagine both former mayors will use a move from the Ford playbook and lay low for the next while.
The Real Person!
The Real Person!
Why not use the air space and build over and up from the parking lots A good number of buildings in Toronto use the air space This would also give protection to parking and eliminate snow removal Pass this to the engineers and architects You already have the land Let’s consider alternatives
The Real Person!
The Real Person!
Bait and switch by the MAHC Board. Sell the full two hospital solution (or at least not being transparent about it) while collecting financial commitments from the Muskoka taxpayers. Shame on them.
Now are we being blackmailed by the Province on funding if we don’t go along with the new plan? Scaremongering?
Sounds like another financial fiasco in the making similar to the new Bracebridge arena. Some of the same players involved.
How about an outside investigation?
The Real Person!
The Real Person!
Shame on you, Mr. McKenzie for using your editorial page, on behalf of the Conservative Party of Ontario, to try to frighten the residents of South Muskoka into accepting a plan that diminishes the services we already have. Take this inferior plan or get nothing? I’m disappointed you would sink this low.
It is easy for you to applaud the proposal- you live in northern Muskoka and will not have to drive for twenty minutes to visit someone in hospital or be transported the same length of time should you need to be hospitalized. Your family physician can visit you in your local hospital to monitor your state of health. Physicians are not going to travel to Huntsville to see their patients, nor should they.
This plan was hatched behind closed doors and now you have the gall to not only support it, but try to bully south Muskoka to accept it. Disgraceful.
The Real Person!
The Real Person!
A little fact checking on your comment Flo Adams. I did not write my article on behalf of the Conservative Party of Ontario. In fact, I am not currently a member. I call shots as I see them on all sides of the political spectrum although personally I do lean toward the right as you apparently do toward the left. As well, this latest plan for hospital services in Muskoka was not developed by the Province but by the MAHC Board and most of those members are not members of the Conservative Party. Their task was to find a model for excellent hospital care in Muskoka within the financial envelope the Province committed to at a time when costs were much more reasonable than they are now. The Province has not reneged on that commitment. My opinion remains that under these circumstances MAHC has done a pretty good job. Assuming the logistics were the same, I would not have thought differently if the services to the two hospital sites had been reversed. It was my opinion that both North and South Muskoka should work with the MAHC Board within the scope of their proposal. I do not see winners or losers here. I do see a Muskoka hospital with two campuses that together offer a very high quality of hospital service. That is my opinion. I also have too high an opinion of most people in Muskoka to believe they would see that as frightening or bullying, but rather, simply my perspective. I am happy however to see that you reject bullying. Your comment certainly reflects that
Verda-Jane Hudel says
Can you imagine how much tax money has been spent and wasted on the hospital meetings , so called research etc.when all they had to do was talk to the doctors and professionals for the proper and correct planning?
David Hough says
Now that we have all been critical of the process. It is time to come up with constructive proposals that will satisfy South Muskoka while still keeping the integrity of the two hospitals in place. The projections on population growth is that within 10 years Bracebridge/Gravenhurst/Bala/Pt.Carling will be twice the size of Huntsville. Bracebridge is the fastest growing community in Muskoka ( 8.1% ). My point is that if Orillia and Barrie can flourish with there 2 hospitals there is no reason why we can not build hospitals in Muskoka with a 50 year vision. What is proposed in South Muskoka is totally unacceptable based mostly on a total lack of understanding of the dynamics of Muskoka. It is based on supposition and assumptions not based on the facts and in some cases total misinformation.
In the next month South Muskoka will have a draft proposal for both the government -Mr Graydon Smith- and the board. Quite frankly the board has little, to no credibility in South Muskoka and a complete review should be made as relates to their transparency and information.
This proposal will be constructive but will be presented with the view that we intend on keeping our doctors and growing our services which will attract new doctors and keep the growth of the area in full perspective. This will allow us to attract more doctors and nurses to the area and grow with the community.
We will be heard and if it means delays so be it but change must be addressed.
David Hough Really Concerned Citizen
Erin Jones says
Flo, if you regularly vote “left of centre”, this is what you have voted for. Liberals are mostly socialists (but some are even trending toward being communistic these days). Socialism spawns huge bureaucracies that suck up tax dollars like giant vacuum cleaners, leaving local communities scrambling for whatever tax dollar crumbs are left over.
In an earlier time, hospitals were owned and funded by the local community through locally elected groups who kept a watchful eye on how the dollars were spent. Some larger communities had more expensive hospital plants and some of the smaller communities had their hospitals but scaled to the size of the communities. Heroic efforts on the part of local fundraisers helped some smaller communities to erect shining examples of how local initiatives could produce stellar results.
Now, we wait for our bureaucracies to bestow our own tax dollars on us (while scraping off much of the “cream” for themselves). The Minister of Health and Long Term Care makes an obscene amount of money and top bureaucrats make salaries that exceed what they would likely receive in the private sector. Last time I checked the Health Minister made in excess of $700,000, plus fringe benefits (generous pension contributions, large amounts of holiday time, etc.). Meanwhile, those who actually do the work of caring for patients, receive a fraction of that. Again, last time I checked, the top earning physician only received something like $400,000 (and out of that, he/she must fund an office staff, office expenses, and his/her own pension, sick pay, etc.–although, I think the Province helps a bit with that). Nurses don’t even get their lunch periods covered–the half-hour they are expected to limit themselves to, is unpaid time. At times, they are so busy, they do not even get a lunch break or their morning and afternoon breaks. Is it any wonder that we can’t find enough nurses to keep our hospitals adequately staffed? And yet, management challenges them to “do more with less”. Burnout is real and it is high.
Cliff Walker says
I have never been in favor of two hospitals in such close vicinity of each other. I suggested earlier that the property owned by the provincial government left over from the construction of the four lane highway, located between Huntsville & Port Sydney be considered. Flat level land, adjacent to highway, approx. 50 acres. Similar to North Bays site, Barrie<s site, New Liskeard site and fast access for EMT drivers.
Murray Christenson says
Agree with you Hugh, this appears to be a reasonable solution under the current circumstances. It must drive you crazy though seeing so many comments filled with misinformation. Take Erin Jones’ comment that the Minister of Health for Ontario makes $700,000 plus plus…in reality, Ontario cabinet ministers make $165,000, far less than specialist doctors make.
Dave Wilkin says
This current situation was predictable. I looked back at the many previous Doppler articles that Ross Maund and I authored, some dating back over 6 years, on the future of our hospitals. (https://doppleronline.ca/huntsville/time-for-change-in-hospital-board/ , https://doppleronline.ca/huntsville/we-believe-mahcs-plan-for-two-new-hospitals-will-be-rejected-by-the-province/,)
As concerned former MAHC board members, we were critical of MAHC over their mishandling of the capital planning process.
This journey started about 12 years ago, and yet, here we are today with no hospital capital upgrades done and fighting again in the community over what is still an unaffordable plan.
If they had listened to our and the majority of community voices back then, and instead of brand new hostipals, they opted for incremental existing site upgrades, we would be well on the way to the much-needed capacity expansion and hospital renewal, at an affordable cost. This is the route the vast majority of hospitals in Ontario take.
So sad.
Tim Withey says
I believe one of the main issues that doesn’t get enough focus is our ability to attract and maintain our important medical community. We remain the location of choice for NOSM students when they pick a community to continue their studies in, but few return to set up practices here. I had some insight with this when Muskoka hosted the annual Docs on Ice hockey tournament some years ago. My nephew, then a relatively new emerge doc in Brantford, and 5 of his (relatively new) doctor friends stayed over at my house for the weekend. Over breakfast one morning I posed the question. You see how beautiful our communities are and the opportunities to set up successful practices here, why aren’t you considering moving here to serve our communities and raise your families? The answer was very revealing. To a person they remarked on the instability of our medical facilities. They weren’t sure where the hospitals would be and what services they would be providing. It’s a big decision for them and they weren’t willing to risk such a move only to have to uproot and move to an area that would guarantee a long term career and stability for their families. The sooner this issue is solved, the more likely new professionals will choose to settle in our communities, in my opinion. There needs to be more focus on attracting people than what our built infrastructure looks like.