Results of a Muskoka Algonquin Healthcare (MAHC) survey that sought public feedback on three proposed hospital models are being reviewed amid criticism of the way the survey was designed.
The survey closed October 13 and an estimated 2,200 responses are being analyzed by the Capital Plan Development Task Force, a group of 25 people who will be responsible for making a recommendation on the preferred future hospital model for this area. Their recommendation will be submitted to Muskoka Algonquin Healthcare (MAHC), which manages both the Huntsville and Bracebridge hospitals, sometime next spring.
But the survey, compiled to gather community input for roughly six weeks, has come under criticism. Concerns have included the fact that anyone can stuff the survey as no controls were put in place to limit the number of responses by one individual, and speculation that all three options for a hospital model presented in that survey ultimately amount to either the Bracebridge or Huntsville hospital site losing its vital acute care services.
Huntsville Mayor Scott Aitchison, who sits on the task force, did not mince words.
It’s a terrible survey. It’s a waste of time.
Mayor Scott Aitchison
Aitchison added that he’s been trying to hit that point home at the task force meetings along with his counterpart in Bracebridge, who also sits on the same, but there’s been no real response. He maintains that the million dollars that MAHC received to gather input as it moves through the initial stages of the capital planning process to come up with a viable hospital model should be spent on making the existing two-site model work.
Aitchison said that in his mind 2,200 responses are not very much. “People don’t really trust them. People don’t trust the MAHC board,” he said, referring to MAHC’s board going on record in 2015 that its preferred hospital model is one single hospital site in an undetermined central location in Muskoka, instead of the existing two-hospital model.
Aitchison along with other municipal representatives are on record saying that they want two fully functioning hospitals in Huntsville and Bracebridge. He said he is on the task force to make sure that point of view is heard. “They think I’m a royal pain in the ass and they prefer I wasn’t there, but I just keep coming back [saying] you need two sites… and by the way, you’re never going to convince me, no matter how many millions you spend, that one site is a good idea, unless of course it was in Huntsville and that’s not going to happen,” said Aitchison, adding that it wouldn’t be fair to Bracebridge either. “They need a hospital there. Both these sites are absolute mayhem in the summer months.”
MAHC has maintained that its current sites are old, and that a brand new hospital would be better for the community. Aitchison has a different view. “When they bitch and moan about how old and tired the buildings are, go visit St. Mike’s sometime in downtown Toronto. Yes there are parts of it that are brand new and stunning, but there are parts of it that make our buildings look like they were built yesterday.”
Aitchison said he thinks renovating the Huntsville site and building a new hospital in Bracebridge on donated lands will still not cost as much as one big new hospital. “I don’t think it would actually cost as much as their single site program because in that first initial blush they didn’t put anything in there about what they would do with the remaining sites. And by the way, at the end of the day, if they don’t have the community support, in other words the municipality and the taxpayers contributing to the capital cost of this project, it’s not happening anyhow,” he argued.
The task force’s chair, Cameron Renwick, who is also a member of the board of MAHC, maintains that the purpose of the survey is to understand what is important to the community at large.
“To me, it was about identifying values. We wanted to understand how important some of the proposed criteria the task force will use to evaluate the models were to people, or if any were missing. We also asked them for preliminary feedback, such as pros and cons, as they saw them for each of the three models,” said Renwick, who was thankful for the feedback. “All of this feedback is critical to the task force’s work and helps us as a group to address the concerns or challenges identified by the public for each model.”
In terms of the ability to respond more than once, Renwick said, “It was important that there were no barriers to all members of any given household to complete the survey from the same computer or a shared device – ie: parents, youth, etc. This is a complex, thought-provoking topic where additional thoughts/feelings or feedback could come to mind after further contemplation, or talking with others. So while there may be a risk, we believe the risks of limiting responses were far greater and that people appreciated the ability to sleep on it and add further thoughts, if necessary,” he said in a statement to Doppler.
Renwick said a recurring theme in the responses was that “safe, high-quality care is imperative, and access to care, especially emergency care, is extremely important. The survey results have also demonstrated that reasonable travel times are essential and that most respondents identified the recruitment of health care providers and the adaptability of any future hospital concept (being able to grow/change, expand or specialize programs/services) is vital.”
He said the task force heard from those who responded that a two-site model is preferred, but many indicated that they were not sure what the two-site model as presented in the survey meant and wanted more clarification.
“We acknowledge there was a lack of definition or understanding around the models as we had only begun the planning process when we reached out to our communities. I want to assure everyone that this work is occurring as part of this planning process and involves looking at care from clinical perspectives through workshops. An initial workshop was held in September, and in November we are bringing together a group of doctors, nurses and care providers from the hospitals and the community again to explore how best to configure the two two-site models. This includes fleshing out what “not status quo” means in the Two Sites – Not Status Quo model, and what services would be in each of One Site Inpatient and One Site Outpatient model.
“Once the models are further developed by clinicians they will be shared broadly with the community and we look forward to consulting the public for feedback again,” said Renwick, adding that a lack of trust in the process was also evident from the responses.
The task force, who is responsible for overseeing the planning work and making a recommendation for a preferred model, found (lack of trust in the process) troubling. I want to reinforce quite strongly on behalf of the task force that no decisions for the future have been made, and this group with its broad membership is committed to an open, comprehensive process and ensuring the very best hospital care for all of Muskoka.
Cameron Renwick, Chair of the Capital Plan Development Task Force
You can find a summary of the Muskoka Algonquin Healthcare’s Capital Plan Development Task Force’s October 16 meeting, which includes a list of the members on the task force, here.
The task force is currently looking at the following three models:
TWO SITES (not status quo) – Maintain two sites with Emergency Departments, recognizing the need to further consolidate programs and services across the two sites. Recent examples of single sited services include Gynecological Surgery, Ophthalmology (cataract surgery), and Chemotherapy. Service siting 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.
ONE SITE INPATIENT / ONE SITE OUTPATIENT – Maintain two facilities with emergency care. One site would have a primarily outpatient focus (few or no beds) and could include services such as some day surgery, specialty diagnostics (such as MRI), clinics (such as Dialysis), etc. The other site would have a primarily inpatient focus (majority of beds)and could include inpatient services such as medical/surgical care, intensive care and obstetrics.
ONE HOSPITAL (centrally located) – Provide all programs and services on a single hospital 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 for urgent care needs.
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Thanks for this update Tamara. We must all be diligent and ensure that the community is kept informed. Although one would assume and hope that MAHC and the Task Force are working with our wishes / needs as a priority, it hasn’t felt like that so far.
Agree with Brenda. It was a push-poll. The survey could not be turned in unless you voted for one of the three options even if you liked none of them. I added in a comment “My vote is NOT to be counted but was only made to enable you to see my other input,” but I don’t know that they’ll listen to that. Very unprofessional, and, yes, no real researcher doing actual science would design it thus, and if a PhD student tried it their thesis committee would roast them.
This survey was a joke. It was biased beyond belief. Any researcher worth his/her salt would be ashamed to have submitted this.
Why does designing an effective survey seem to be such an impossible task for our community? I would suggest that given the recent failures associated with the “Pipeman” survey, Mayor Aitchison might want to be slightly less critical of MAHC’s attempt at the same, even if the observations are warranted.