Hospital task force recommends two acute-care sites

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Main photo: Capital Plan Development Task Force chair Cameron Renwick (second from left, at back table) and vice-chair Don Mitchell (right) deliver the task force’s recommendation on a future hospital model to the hospital board.

The Capital Plan Development Task Force has spoken. Stick with two, acute-care hospital sites. That was their message to the hospital board of directors at their Wednesday, Aug. 8, 2018 meeting.

The Task Force, made up of 25 community members comprised of hospital board members and administrators, politicians, doctors, North Simcoe Muskoka Local Health Integration Network representatives, representatives of the hospital auxiliaries and foundations, as well as health system users came together in August 2017. They’ve since been analyzing three hospital models for the future: two acute-care hospital sites, two sites comprised of an in-patient site and an out-patient site, and a single hospital site. The latter was recommended in 2015 by the then board of directors, but it resulted in demonstrations and vehement outcries from the community and municipal representatives.

Both task force chair Cameron Renwick and vice-chair Don Mitchell told hospital board members and those who attended the meeting that no model is perfect.

“While there are some advantages to consolidating everything into one site, it does come at the cost of increased travel time as well as decreased access,” said Renwick. “Muskoka already experiences higher than average travel times to acute care and a report presented to the task force showed that if single sited in one of our urban centres, average travel times would become some of the longest in the province.”

He said while all models are going to be financially expensive to build, the estimated costs were similar across all three models. “As expected, the operational cost of two-acute-sites model would be more than a single-site model or the in-patient, out-patient model but in spite of this the task force felt that this should not be a limiting factor if all of the criteria identified the two-acute-care site model as the preferred approach,” said Renwick, who reiterated what many have been saying: that the provincial hospital funding model needs to change.

It’s been acknowledged by politicians, by the Ministry of Health, by the Ontario Hospital Association that the funding formula disadvantages medium-sized hospitals and that needs to be fixed now in order to ensure stability in the future.
Cameron Renwick, chair of the MAHC Capital Plan Development Task Force

He said while all three models studied fit within the LHIN and Ministry expectations, the task force felt that the two-acute-care sites model better aligned with the philosophy of providing patient care closer to home. In terms of land-use planning, the recommendation heard by the task force was that hospitals should be located in urban centres, “which meant that considering a central location between Bracebridge and Huntsville, let’s say, was not advised.” He said that became a game changer because if the task force chose a one-site model, it would have to be located in one of the existing urban centres.

In terms of the economic impact, Renwick noted that while the overall impact of all three models was positive for the District of Muskoka, the one-site and the in-patient/out-patient model would have resulted in an uneven distribution of both jobs and financial impact in the respective urban centres of Muskoka.

As for community support, he said the two-site model was preferred by most. “The community has consistently identified travel times and access as two of the criteria for future planning and the two-acute-sites model thus met this need.”

In addition, how the community will come up with its share of the funding must also be demonstrated as part of its capital plan development proposal. “And the task force felt that no model would ever be completed if those responsible for helping to pay for it weren’t in support of it,” said Renwick. He said the task force also heard from elected officials who also noted that their willingness to consider contributions to the local share depended a great deal on the model and their preference was also for the two-acute-site models.

While the model chosen by the task force appears similar to what is in place today, it is not the same. Those present heard that some of the services currently offered at the hospital will be moved to organizations in the community, and there are plans to add an MRI in one of the sites as well as stroke rehabilitation beds, to name some of the changes proposed, according to Renwick.

Mitchell has stated repeatedly that the integration of health care services is the way of the future with the patient at the centre and the hospital becoming simply one component of a greater system.

“So the question we get is, ‘well what will it look like in 30 years?’ and the answer of it is, I don’t really know… things change very rapidly, I think we all know that, and they’re expected to continue to do so in the future,” he said, adding that the model being recommended by the task force aims to remain flexible “to accommodate those things that we don’t know.”

Renwick said the recommended model will continue to be reviewed, updated and revised as necessary through the various Ministry-mandated stages of planning.

The task force will continue working on the model, provided its recommendation is endorsed by the hospital board. Renwick said the next step would be to move to part B, the bricks and mortar part of the model. “Many questions abound about the bricks and mortar, the part B part, you know, where will the two sites be located? Will we reuse all or some of our existing buildings? Will we use it as one large project? Will we take a phased approach? What’s the best costing method available?” he questioned, adding that the task force will continue to oversee that work and communicate its progress as it moves forward.

“The devil’s in the detail,” said Huntsville Mayor Scott Aitchison after the meeting. Aitchison also sits on the task force and said he is pleased with its final recommendation.

Renwick recognized and thanked all of the task force members who have lent their time to study the three models as well as senior staff at MAHC for their support.

A webcast of the presentation can be viewed here.

The hospital board will hold a closed session meeting on Thursday, Aug. 9 and is expected to vote on the recommendation and issue a press release on Friday, Aug. 10. Whether a recorded vote takes place depends on whether one of the board members asks for it, according to MAHC Corporate Communications Officer Allyson Snelling. It is not clear whether the press release from the hospital board will detail how each board member voted on the task force’s recommendation.

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12 Comments

  1. Charles Wilson on

    I have read the report of the MAHC Capital Planning Taskforce and I agree with their recommendation for a two acute site hospital. I agree especially with their concern regarding the land use planning at a one site hospital either at highways 11 and 141 or at Highway 11 and High Falls Road.

    However accompanying this decision must be a focus on service delivery to under-serviced areas especially in the Port Sydney, Utterson, and Stisted Communities. The reality is that we are in the midsts of a demographic shift and we must be aware of the implication of a population less reliant on person transportation in our official plan and our transit plan.

    The Town must continue to advocate for quality medical service delivery throughout Muskoka, especially in under-serviced areas (my priority #4) and engage in long term planning to ensure we are equipped for the demographic change ahead of us (priority #1). This must be done with a light to ensuring our most vulnerable citizens can have access to quality medical care regardless of where they live.

  2. Terrific news! Now the two hospitals must proceed with developing their own areas of specialization (without acrimony). Huntsville has recently added plastic surgery: perhaps, therefore, Bracebridge should get the MRI machine, or develop a laser eye surgery program. The two mayors are onside; but the staff from the two locations must also work together, and discuss the most sensible approach to dividing various areas of specialization. This will further reduce travel times for many procedures which are currently only available in North Bay, Orillia, or Barrie.
    .
    In the end (facing a toss-up financially), it was very satisfying that the people were heard.

  3. Why does the Board believe that it is necessary to have a closed meeting? One would think that they should be open about their recommendations, so that the general public wouldn’t misunderstand their decisions.

    • Len Macdonald on

      All that matters is that they vote “yes.” Who cares if the meeting is open or closed? That’s their business. The announcement will come tomorrow. How about someone publicly thanking those 25 citizens who worked all this past year to come up with this recommendation?

  4. Closed meetings allow work to be done. Open meetings are oftentimes hijacked by people who manage to speak at length to their own version of things.

    If thanks are in order, I vote we extend our thanks to the people who work at giving us a voice through this Doppler medium.

  5. The recommendation is for two acute care sites – finally. Three years later after countless hours and energy put forward by the community to make their voices heard. Now let’s wait for the vote. Even so the Task Force and the MAHC Board have once again stumbled in their reporting of their recommendation at their board meeting last evening, in my opinion. Notwithstanding the blatant avoidance of having a vote, once again hiding behind closed doors which is a specious move at best, the Task Force recommendation results in more questions than answers. Many of these will need to be analyzed after the final decision is made.
    One question in particular, however, stood out to me and can be asked now.
    Mr. Renwick stated in the meeting that the Task Force will continue its work onto the next stage in the process. This last stage cost the taxpayer $1 million (from the MOHLTC – not the board or hospital budget – not even from the LHIN for that matter) for their work over the past 12 months that resulted in no new data from 2015, as pointed out by Michael Walters, current Board Director last evening. What the Task Force did accomplish was to finally come to the answer the majority of citizens wanted three years ago. How much is the next stage projected to cost? Why isn`t the board undertaking this project itself?
    I could spend more time analyzing the report handed out last night but until the decision is made, there isn’t much point.
    So we will have to wait until tomorrow to find out what the board’s decision will be. Only then will we be able to assess next steps.

    • Len Macdonald on

      Tim, aren’t you on the board of the LHIN? What did YOU do to help in this process during this past year? It’s so easy to take shots from the sidelines after the game in over, especially now that you are running for public office, again.

  6. Hi Len: I am on official leave of absence from the LHIN while I am running for municipal office. I would be happy to meet with you to explain the role of the LHIN and my role as a director. I can assure you that these are not “shots from the sidelines” as you so eloquently put it and can also tell you why that, in my opinion, this is not a “game” and it is far from over. I’m not aware of your role in all of this but you seem to hold a strong opinion which I respect. Happy to meet anytime.

  7. Terry Russell on

    One fears that–even in the face of such massive repudiation–the MAHC is unlikely to now take the honourable course and resign en masse.

  8. Karen A Insley on

    Let’s hope Belinda’s Dandelions prevail and that the provincial government short circuits this expensive politicised redundancy that has missed the mark incredulously for Muskoka’s future. Leadership seems to be missing so far in this formula to make the appropriate decision.

    • Len Macdonald on

      I don’t know who “Belinda” is but I do think that several thousand leaders made their views known and two hospitals were confirmed by MAHC. And don’t forget that the current Premier of our provincial government promised us our two hospitals.

  9. Karen A Insley on

    One would think, if looking at the bigger picture, this was an expensive taxpayer exercise for an even more expensive drip and ship proposed solution?

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