The recent news that the MAHC Board accepted the recommendation of the Task Force is good news indeed. The last three years of spin, public meetings where no questions from the floor were allowed, and misleading information are hopefully behind us. Gone too should be any suspicion or animosity between the municipalities over turf and ‘site A – B’ locations.
Unfortunately—not so fast on the last point.
First, we have to keep in mind what it was that the Task Force was deliberating. This was Stage 1A of a five-stage Capital Planning process that the arguments of the last three years took up. We are now late in line in a process that can take 20 to 30 years. While MAHC CEO Natalie Bubela and MAHC Chair Phil Matthews are excited that this stage has been settled there is still a long road ahead.
But what of the intervening years? The bitter reality is that until there is a significant change in the funding formula MAHC is very likely to be in perpetual deficit hoping for annual bail outs from the Ministry while rationalizing and cutting services we rely on so badly.
Interim Chief of Staff says all surgery should happen in Bracebridge
Currently the interim Chief of Staff is still in place, the very Chief who said publically three years ago that all surgery must pass through one door—and that door is in Bracebridge! Obviously, this does not represent the delivery of good, safe medicine for the community that doesn’t have surgical services under its roof. Where’s the guarantee that the related professionals that support surgical services are going to remain in the town that wouldn’t have enough work on a daily basis to support an Emergency Department in case of situations where surgery is necessary? They may stick around for a while, but soon will head for greener pastures and full-time employment.
On this very point there is a current situation in Bracebridge that hasn’t received much attention in the public domain. Central to a full-time operational emergency department, along with surgical services, imaging and a lab, is the Intensive Care Unit (ICU). This is the place where critically-ill patients (stroke, heart attack) who show up at an Emergency Department are admitted, to be looked after by Physician Specialists and specifically trained nursing staff.
But … Bracebridge currently has one internist
The Huntsville site currently has four internists. Bracebridge, in contrast, has one, who commutes from Toronto. Three short years ago Bracebridge had three internists, two of which left without having replacements lined up. What is important here is the on-call schedule. In Huntsville, the four internists are each on call one week per month. In Bracebridge, the one internist is on call for seven days and the rest of the month is covered by expensive locums (temporarily hired guns from other hospitals) otherwise Emerg shifts have no internist back-up coverage. This is critically important because all of these services are intertwined and rely on each other to deliver the vast array of services attached to our Emergency Departments.
Plastic surgeon spending most of his time in Bracebridge
Last week Doppler ran an article about a new Plastic Surgeon in the area. The article said he was working in Huntsville. However, because of a broken piece of equipment in Huntsville—that’s been broken for three years—he is, in fact, spending a lot of his time operating out of Bracebridge. I asked the Huntsville Hospital Foundation office to direct my Business Cares donation to replacing this equipment and was told that it’s not even on the capital replacement list!
So what’s going on? What is the status of recruitment of new Internists to Bracebridge? Why are they looking to move surgical services to a site with this ongoing situation? The reality is that Bracebridge has to recruit three new internists and have them all arrive at the same time. Recruiting one at a time won’t work because they will likely be made to take on more on-call shifts than they want.
As Hugh Mackenzie’s last opinion piece points out, the push to build a brand new hospital in Bracebridge will be strong given the challenges with the current location. We all remember Mayor Graydon Smith offering up a prime piece of highway-accessible land in the middle of the one-site debate a couple of years ago.
But without the ability to recruit and keep physicians it won’t really matter. The interim Chief’s opinion of where surgical services should reside won’t matter much either but in the ongoing push to provide a balanced budget some of these moves may prove too attractive to the MAHC administration and board to ignore. Ironically, this was the reason for the push for one central site.
Unlike the proverbial baseball diamond in the cornfield, a brand new hospital is not a “Field of Dreams.” If you build it—they may not come.
Tim Withey is the former Vice Chair of the MAHC Board, and is currently on leave from the board of the LHIN (North Simcoe Muskoka Local Health Integration Network ) as he pursues a seat at the District table in the upcoming municipal election.
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Well, that’s the best news I’ve heard in years. If Premier Ford can wave his magic wand and suddenly make half of the Toronto council members and the elected District Chairs disappear, just think what he could do by eliminating all of the LHIN’s. An entire level of government gone. Think of the taxpayers money saved that could be put towards new hospital buildings and services. I’ll drink to that with my one-dollar-beer.
Thanks for your comment Len. I appreciate your obvious passion for this subject. Your comment, however, is a bit convoluted as to who is responsible for what between the LHIN and the Ministry and, in fact MAHC. Each Spring the Minister of Health sends a ‘mandate letter’ to the LHIN that outlines it’s goals, objectives and deliverables for the coming year. It’s a very detailed document that this space won’t do justice to.
My apologies for not being as clear as I could have to make the distinction between the Task Force and the ongoing pressures of balancing the annual budget at MAHC. They are two very different things. The Task Force came up with the correct decision for the future as far as physical locations 20 to 30 years down the road – it’s what happens between now and then is the question. Therefore the Task Force report would not contain anything about the location of services between sites.
Pre-amalgamation, Huntsville Hospital enjoyed many years of balanced budgets. But that was before the current funding formula and before amalgamation ( a decision I voted against at the time ) which gave rise to the debate surrounding a multi-site hospital and the location of each service.
Who knows, Len – there might not be a LHIN to go back to by the election date if I’m unsuccessful. I try not to think too far ahead on that front!
Again, if you would like to meet to discuss in more detail – I’d be happy to, anytime. My office is in the plaza beside Kelsey’s restaurant.
Mr. Whithey, as a member of our LHIN, isn’t it YOUR JOB to advocate for a change in the funding formula for the hospitals in North Simcoe Muskoka? What have YOU done about it? You are bringing up comments made three years ago, as if the work accomplished by the MAHC task force during this past year never happened.
I read the report. I didn’t see anything in it that said that all surgery would be moved to Bracebridge. And you characterized the efforts to balance the budget as being a bad thing when it is in fact a requirement made by your LHIN board.
If you aren’t elected to the District Council, you should officially resign from the LHIN board. Clearly you are unable or unwilling to be of any assistance to MAHC.
As mentioned, Mr. Withey, relevant health care events in Muskoka will unfold over almost a complete generation. Surprisingly, the most difficult item to contemplate is not the simultaneous hire of 3 internists in Bracebridge. Rather, it would be any significant increase in active, healthy individuals in this group. How many times have we heard politicians bemoaning this fact, while doing nothing? It is not a corporate responsibility, e.g. Canadian Tire, but a personal and political one.
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Talk is cheap: there is nothing unique in what I’m saying. If youth (and young adults) spent even 10% of the time they spend passively in front of TV/monitors, engaging in active games/sports; then the ever-increasing demand for many health services could be reduced to manageable levels.
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What happens to the additional income tax that is devoted to healthcare? Instead of going to general levies, perhaps some of these monies could be devoted to announcing worthwhile initiatives toward active, healthy living. Maybe the LHIN could develop a new funding formula, at least partially based on level-of-health indicators. Income tax, at least for persons without disabilities, could be lowered for non-smokers, non-drinkers, and persons with acceptable BMI’s (Body Mass Indices).
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I quite realize that it all sounds completely fanciful, but without political will, the next generation will be born with matchstick legs and enormous thumbs.
It is absolutely imperative that we maintain our Surgery dept.
Huntsville has the best surgeons, Doctors and nurses. Without surgery we will see the demize of our Hospital and our economy.
People won’t come to Huntsville without a surgery dept.
Dr Kirkpatrick is recognized at the Northern Ontario School of Medicine for his excellence teaching surgery skills along with other Physician for their teaching abilities.
Leave things alone!
Thank you Mr. Withey for such an in depth explanatory opinion piece. Huntsville citizens and those of our Northern neighbours who depend on our Huntsville hospital location, are very fortunate to have you in their corner to interpret some of these veiled announcements and all that trails along with it!
As you mentioned , this is only stage 1. Has one million dollars been spent so far to only get to this far… and what was is spent on !
Where is the non-confidence motion sitting… many questions unanswered still.