How will the future hospital option be chosen?
By Ross Maund and David Wilkin
Planning the future of hospital delivery in Muskoka has been a very long journey, going back to 2012, yet it remains far from being concluded, given ongoing issues. Since the summer of 2017 we have authored numerous articles to provide important information to the broader community. This article focuses on ‘how’ the preferred hospital option decision is to be made.
The current (model and services) decision process, underway since last August, is similar to what was used before (it used defined criteria along with supporting advantages and disadvantages). Before comparing, it is important to understand how the three hospital models have evolved. What is clear through this journey, is the constant shifting of model names and definitions has confused and at times misled the people. The table below shows the changes:
Data sourced: MAHC website
So, it took three years and sustained community pressure to finally drop the “Not Status Quo” label, restoring the original two acute-care site option, giving the people what they have always wanted.
Importantly, how has the ‘community support’ criteria weighting changed in MAHC’s hospital model decision process? In 2015 there were seven equally weighted Criteria (Patient & Family Centered Care, Design, Construction, Financial, Fundraising, Approvals, and Community support). Community support therefore had an overall weight factor of 14 per cent. Now the Task Force’ has a new 5 equally weighted evaluation criteria (Patient & Family Centered, Financial, Alignment, Municipal Impact, and Community Support). On the surface it appears that the Community Support criteria has become more important to MAHC – moving from a 14 per cent weighting to 20 per cent. However, the new Community Support criteria now also includes the community’s capability of contributing to the development with an adequate local financial share. Obviously, this additional criteria should have been included in the Financial criteria, not Community. So now in fact, ‘Community Support’ really accounts for only a 10 per cent weighting factor in MAHC’s hospital model decision criteria which demonstrates its smallest regard for community in the seven years of the MAHC’s planning process thus far. One wonders how any public institution planning process could be so callous in their disregard for the need of community support – it is bewildering.
We have other concerns as well:
- MAHC’s 2015 Advantages & Disadvantages for each model option shows the top three advantages of the One Site option and seven of 11 disadvantages of the two Acute Site option were Financial (costs) related. Because we now know the two Acute Site option was highly over-sized and mostly new build, it suspiciously drove the two-site model costs way up, heavily disadvantaging it. We believe financial was the primary driver of the 2015 decision. This is a problem because model costing won’t be revisited/defined until a later (B) step, so we can’t see how the local share, (previously sized at $85 to $114 million), and more broadly the entire financial category, can be properly scored.
- The site locations have yet to be determined (and it’s unclear where in the process they will be). Until they are, properly scoring sub-criteria like “access to service”, “travel times”, or “municipal/regional planning” is impossible.
- The criteria “Aligns with MOHLTC/LHIN priorities” seems overstated at this point in redevelopment planning. To help understand how it was interpreted in 2015, the scoring was three times higher for the one-site model versus the two-site model, (despite the latter being 87 per cent new build). Such a huge discrepancy is hard to fathom. Our conclusion is that it was interrupted as alignment to MOHLTC cost-savings and related integration/consolidations objectives. Similar thinking appeared to be on display by the MAHC Chair during the April 23 Huntsville Town Council MAHC deputation, when it was stated the 2015 single-site decision had to remain officially on MAHC’s books. The Chair refused to rescind it, outrageously tying it to MAHC’s on-going deficit challenges. We know it is due to a MOHLTC flawed funding formula.
It appears the MAHC board has again failed to fully grasp the community accountable point, and the importance of backing the people they are supposed to serve. This implies standing up to the LHIN/MOHLTC, when necessary. Sadly, if it wasn’t clear before where MAHC stood with the Ministry, it certainly is now. MAHC received only a 1.4 per cent funding bump this year versus the 4.6 per cent provincial hospital average.
Many have pointed out the MAHC board failures to adequately listen to the people, their failure to effectively partner with elected representatives, local stakeholders and physicians, and their reluctance for full transparency (among other governance issues). It’s no surprise then the community and its leaders have responded with council motions, petitions, protests, municipal deputations, letters, media commentary, and viral social media posts.
Submitted by Ross Maund, (former) MAHC director, retired healthcare services senior exec., CAHHMA member and Dave Wilkin, (former) MAHC director, retired senior IT & banking executive, CAHHMA member.
Go to: www.CAHHMA.com for past articles and details.
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Ms. Jones: your continuing rants equating socialism to Communism, which leads invariably to murdering of the masses, is becoming somewhat tiring. So we cannot exercise our individual right to vote NDP in fear for our very lives? I have had leftist leanings all my life. I have never murdered anyone. I have exceptionally high moral standards, and am “intellectually challenged” with an I.Q. north of 150 and a MENSA membership. I should also mention that using “intellectually challenged” as a pejorative is a violation of the AODA 2005, the OHRC, the Charter of Rights and Freedoms, and the International Treaty of Rights for Persons with Disabilities (and the subsequent Protocol).
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I enjoy your thoughtful commentary on all other topics, but politics; where you insist that all opinions but yours are incorrect. And then you generally proceed to denigrate those who do not agree with you.
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Each of us is allowed independent thought and the right to express it. For someone so averse to totalitarianism, you seem very comfortable with a one-thought-fits-all solution. So please lighten up a tad, and enjoy the beauty of summer in Muskoka.
Apparently Wharton did not teach Trump how to understand basic trade data and the principles of fair reciprocal trade. Canada buys more from the US than China, Japan and Germany combined. But Trump says Canada is taking advantage of the poor little USA. The fact is that Canada is one of only 3 countries with perfectly balanced trade with the USA. So why does he continue to try to bully Canada into a stupid trade deal? As he did in private business, Trump seems to think that the USA should have all the money and leave nothing for anyone else. The US does indeed have many problems but they are all self-imposed. It was not China and Mexico that moved jobs to China and Mexico. It was US companies that moved them.
Your ELITE behavior is shinning through … your prejudice thinking is shinning and this is EXACTLY why people get fed up with your condescending, people degrading attitude and ‘better than thou” attitude! You must remember in a election .. ALL people get one vote … and that includes you!
Your biases is showing loud and clear ,,,,”The depth of Fords thinking about one dollar beer and selling pot in convenience stores does not inspire confidence.” The pot … is your socialist friend Trudeau responsibility! Some people like beer so take it easy!
How did you make the leap from liberalism to socialism to communism to Animal Farm? If we wake up on June 8th. with Premier Ford in Queen’s Park, it can be said: “The people have spoken and now they must be punished.”
Trump has a degree from the prestigious Wharton School of Economics at the University of Pennsylvania. Neither Trump nor Doug Ford is a leftist and I find that refreshing. Anyone with a thinking brain understands that socialism DOES NOT WORK. And communism that it seems to drift into leads to totalitarian control of the masses to the point of murdering them. Socialism eventually fails when they run out of other people’s money. The morally and intellectually challenged folk who are “true believers” in socialism, then double down on their ideology and become more and more oppressive of individual liberties. Where you end up is a place where no one except the communist party bosses want to be. In such a system, to quote Animal Farm, “All animals are equal, except some animals are more equal than others.”
Ron, the two acute-site hospital solution should prevail because logic says it is the right thing to do, not because a single politician says so. If Ford succeeds in getting elected, our Muskoka hospitals will be well down the list of his priorities and frankly his support (because of his cottage) smacks of the kind of self interest that we dislike in politicians.
Today’s complex problems cannot be solved by yesterday’s simplistic solutions. Today, people can get to the other side of the world in 12 hours and information gets there in 12 minutes. You cannot cure cancer with Tylenol. Tylenol will make people feel good for a short time but if you rely on that to solve the problem, it gets much worse.
Populist leaders like Trump and Ford do not provide the kind of careful deep thinking required. If you were searching for an average or better mid-level manager for a mid-sized company, you would look for someone with an average or better education. In today’s world, a degree is a good indication that a person has the ability and self-discipline to succeed. It is unheard of to have a person of Ford,s generation, without a degree, in an important leadership position, unless they inherit it.
It is unthinkable that we would accept such an unqualified and unpredictable person to be leader of 40% of one of the worlds important G7 countries. Sorry, but his brother made a laughing stock of Toronto on the world stage and based on recent examples, we can expect Doug to do the same.
Given the appetite for change that seems to be sweeping the province, the best we can hope for is a short-lived minority government. That would force a leadership change in both the conservative an liberal parties. I lived in Quebec when an appetite for change swept that province. Quebec lost its prominent position when it elected the PQ and Montreal will never be Canada,s financial capital again.
Erin, I agree that the hospital planning process to date has been disjointed to say the least. But the blame for that belongs to both the MAHCboard and the LHIN as much as
the province. I have seen zero to indicate that a Ford led government would do any better. The depth of Fords thinking about one dollar beer and selling pot in convenience stores does not inspire confidence.
The 2 acute-site solution should prevail because logic says it there right thing to do and not because of another off the cuff statement by a single politician.
By the way, your statement about theGuardian article saying the level of socialism in Nordic countries is unsustainable is incorrect. In fact the article says their reliance on resource extraction is unsustainable. It says nothing about the level of socialism.
Doug Ford stated loud and clear there would be two hospitals in Muskoka. It’s our one and only opportunity to quote a possible premier as on our side, no one else with that clout has said it.
That’s why we need to vote the Liberals out. They follow the neo-liberal rule of, “We will decide what the people get–not them.” When they vote, people need to remember, “When the government fears the citizens, you have liberty, when the citizens fear the government, you have tyranny.”
We may have gotten what we always wanted, but this is only on paper.
I give odds the final decision will be anything ,but what we want.
We all know how governments work, don’t we”?