Community urged to get informed about hospital models being considered

As one area resident out of about 60 people who attended the hospital meeting in Huntsville on Thursday, August 31 put it, some people are feeling as though a decision has already been made about the future hospital model. That could explain the low turnout.

“The perception is you’ve made your decision,” said Huntsville resident Jenny Kirkpatrick.

Cameron Renwick, chair of the task force made up of 25 people who will be meeting bi-weekly and are expected to choose one of three future hospital models by December 2017, assured those present that no backroom decision has been made.

“I can’t speak for any other person that’s on the task force but I can tell you I for one have not made any [decision],” said Renwick, who added that community input is crucial and will form part of the task force’s recommendation to the Board of Muskoka Algonquin Healthcare (MAHC), which manages both the Bracebridge and Huntsville hospitals.

The task force includes representation from the board of MAHC, administration, the North Simcoe Muskoka Local Health Integration Network, primary care providers such as doctors and nurses, members of both hospital foundations, representation from the hospital auxiliary, elected officials and municipal staff as well as representation from the Muskoka and Area Health System Transformation (MAHST), which is looking at the integration of all health care providers in the community under one governance model while stepping up the provision of out-of-hospital services going forward.

“Many of those people had very strong voices with respect to the planning work that was done previously and we have put them at the table so that their perspective and their concerns and their constituents can also be represented. So hopefully you will agree that’s a significant change,” said Harold Featherston, Chief Executive Diagnostics, Ambulatory & Planning at MAHC, referring to similar work done by MAHC in the past which resulted in the endorsement of a one hospital model by its board in 2015.

“What’s different going into this is that if we’re doing a culture change, we’re doing a shift away from the hospital to community-based health care provision,” said task force vice chair and co-chair of MAHST, Don Mitchell. MAHST has been focusing on the need to enhance the provision of care outside of the hospital and include primary care providers in transforming the way community health care is delivered as a way of not only saving health care dollars, but improving the overall health of residents.

“One per cent of you will cause 30 per cent of the entire spend and five per cent of you will spend 60 per cent and you don’t know which one you’re going to be in the next year or so. Unfortunately there’s a fellow who would love to be here tonight, the Mayor, but he suddenly became one of the probably five per cent. That’s quite a shock to him with all the rest of us. Most of what has happened to him is now going to happen to him outside of the hospital, and that’s where we’ve got to get things right for everybody,” noted Dr. David Mathies, who sits on both MAHST and the task force looking at the hospital models.

The task force will be looking at the following three models:

• Two sites with emergency departments in each but services and programs consolidated between the two, such as the recent single siting of services like gynecological surgery and cataract surgery. Where each service ends up would be based on “clinical needs and service co-location requirements to create greater efficiencies, larger volumes and critical mass, and reducing duplication of staffing and equipment,” according to literature provided by Muskoka Algonquin Healthcare (MAHC), which manages both hospitals.
• One site inpatient/one site outpatient. These two facilities would also have emergency care departments but one site would maintain an outpatient focus, meaning no or very little beds, while the other would maintain most of the beds. “Outpatient services could include some day surgery, specialty diagnostics (such as MRI), clinics (such as dialysis), etc. Inpatient services could include medical/surgical care, intensive care and obstetrics.”
• One hospital to be ‘centrally’ located and provide all hospital services and programs on one newly built site. “Comprehensive work would be done to determine the role of potential vacated building(s) including the ability to support local urgent and primary care needs, community services, health hub development, or other alternative models. This exploration will include determining best ways to support access to urgent care models.”

Since the Board endorsed the one hospital model in 2015, communication has continued with the Ministry, physicians have been brought onboard, and MAHST was created. The Ministry has also changed its focus by directing that patient care be shifted away from hospitals and into the community; a joint submission was made by both the towns of Huntsville and Bracebridge calling for a two hospital model; technology has changed; and, more recently, MAHC was given a one million dollar grant to firm up its capital planning process and garner community support, hence the formation of the task force.

The task force members will vote on one of the three models presented and their recommendation will go to the board of MAHC for approval. In its recommendation, the board will have to prove to the Ministry that it has community support for any decision it tries to move forward.

Status quo is not an option. We have to roll with the changes that are out there. We know there are advantages and disadvantages to a renovation versus a new build.
MAHC CEO Natalie Bubela

In terms of the models proposed, Bubela said, “None of them are perfect. All of them have some issues attached to them so there’s going to be a point when we need to look at what we think the best compromise might be as we move forward. We need a plan that all of us collectively can get behind.” She added that quality of care cannot be part of that compromise.

Bubela also said MAHC’s current infrastructure needs include things like infection control, patient privacy, dignity and an improved environment for providers – infrastructure that will require an estimated $30 million spend. “We know that the infrastructure requirements that I talked about, that $30 million or so that we foresee in the very near future, is not far off the 10 per cent local share requirements that we estimated in our earlier analysis when we were looking at the different models back in 2015,” she said, referring to building a new hospital.

As for looking at similar models once again, MAHST co-chair and task force vice-chair Don Mitchell said, “What’s really going to be different is that your doctor, your nurse practitioner, will have something to say about how this is going to roll out. What will be the best model for the provider to be able to help you in your community.” He said one of the aims will also be to improve the health care provider’s experience in order to retain and attract more health care professionals to the community.

Renwick emphasized the need to have input from the community and urged everyone to fill out a survey on the MAHC website here. If you are not able to fill out the survey online, you are asked to contact the hospital and have the survey sent to you by calling Allyson Snelling at 705-789-2311, ext. 2544. You can find information about the task force here, information about MAHST here, as well as what MAHC has done to date by going on their website here.

“We implore you, please ask questions. Get informed. Don’t listen to hearsay rumours out there,” said Bubela.

Local resident Catherine Cole attended the meeting and said people need to get involved in the decisions that are being made. “The deadline seems like it’s coming soon and then it will be a done deal and we’re all reacting,” she noted.

Huntsville resident Wayne Cooper was also at the meeting and said those involved need to be more proactive in getting the word out. “I think a lot of the community now thinks ‘oh it’s just the same old, same old. We’re going to end up with the same thing as we did two or three years ago, without us being totally consulted, so why should we even show up,'” he said, adding that the community needs to provide its input as it will be directly impacted.

Don’t miss out on Doppler! Sign up for our free newsletter here.