Huntsville Council confirms its support for MAHC’s hospital plan

Huntsville Council heard from several delegations at its Monday, July 22, 2024, meeting about Muskoka Algonquin Healthcare’s plan to move forward with the redevelopment of two hospital sites.

They heard from two physicians, the Mayor of Armour Township, who is also chair of Almaguin Highlands Health Council, and three former Huntsville mayors—all urging council to continue supporting Muskoka Algonquin Healthcare’s hospital redevelopment project. They also heard from two representatives of the Save South Muskoka Hospital Committee Inc., asking council to hit the brakes and put conditions on its local share of the redevelopment costs conditional on “two full acute care hospitals.”

“This is not a struggle between Bracebridge and Huntsville or the north versus the south, we want to get it straight for everybody in Muskoka and up in Almaguin… people have to just slow up and listen. We’re trying to be the voice also of the doctors,” said Bruce Kruger, Chair of a grassroots group calling themselves the Save South Muskoka Hospital Committee Inc.

Kruger said his organization represents the views of 51 doctors who he said are concerned with Muskoka Algonquin Healthcare’s patient transfer plan, how MAHC chose the current site for the new hospital site in Bracebridge, “but most importantly, they’re concerned about the [number of]beds and that they cannot seek the professional people that they need in a hospital to properly operate.”

Kruger recognized that MAHC did make changes in response to community concerns, such as moving from 18 beds at the Bracebridge site to 36 beds and including obstetrics as a service at the Bracebridge hospital site. Still, he said a group of doctors in south Muskoka are saying that the model is not acceptable, and Kruger explained that the committee is taking its guidance from that group of about 51 physicians.

“We urge you to pass a motion to withhold the commitment until things get sorted out,” added Tony Vanderstelt, who was also before Huntsville Council representing the Save South Muskoka Hospital Committee (SSMHC), noting that the Town of Bracebridge and the District had done the same. He said when the plan was first moved forward, it was stated that the plan would result in more beds at both sites, which has since changed. “Equitable and equal are two different things. We’re not saying it has to be an equal number, but it has to work for both, and when a bulk of the population said it’s not working, there’s something wrong.”

Huntsville Councillor Bob Stone said in 2018 the communities were fighting for two sites. “The only thing we really worried about is how far do we have to travel to get help if we’re in crisis.” He said the new model proposed by MAHC addresses that with two full acute care centres. “As far as the rest goes, with all the complexities and variables, including future technologies, I believe we need to leave it to the qualified professionals.” Stone asked the representatives of SSMHC if they or anyone in their organization had the expertise to design a hospital.

“No more than councillors,” responded Kruger. He said that is the reason the committee relies on the 51 doctors who say they are against the model.

“With all due respect to the physicians, they were educated to become physicians, not design hospitals. So I suggest that their information is anecdotal at best and some gut feelings perhaps, but they don’t design hospitals,” responded Stone.

Vanderstelt said that’s a fair comment but noted that doctors should be involved in designing the system they work in. Huntsville Mayor Nancy Alcock noted that doctors have been consulted and have been involved since the original design.

Councillor Helena Renwick noted that both sites will have emergency departments, emergency surgery, diagnostic imaging, and obstetrics. “That’s acute care,” she said, adding that she could not support what SSMHC was asking for. “I base my decision to not support your motion at this time but to trust the experts and not to base it on fear or emotion but to rely on those professionals that have been employed by MAHC and who understand the system and not just for now but for many years to come…” Renwick said health care is changing not just now but into the future and she wants to be part of that change for her children and her grandchildren.

Councillor Dione Schumacher said she can see both sides. She said travel to the hospital is not the main issue. “Ten years down the road, I don’t want to see family doctors lost in Bracebridge because I know what you’re saying; in this model, it does look like family doctors will locate more to Huntsville than the Bracebridge model.” She said everyone needs to make sure that doesn’t happen. “People shouldn’t have to travel to their family doctor; they’re going to have to travel to the hospital. I have a kidney condition, and I have to travel to Orillia. That’s our reality now, and that’s what we have. What I don’t want to see lost in this, and I hope that piece is not lost, is that family doctors don’t all locate to one area either.”

Kruger said doctors disagree about having to send their patients to Huntsville after six days at the Bracebridge hospital site and turn their care over to the physician who looks after patients in the hospital. “They object to losing control of their patients…,” he said.

In terms of physician relocation, Councillor Corey Clark said the same could be said of Huntsville losing doctors to Bracebridge because the Bracebridge site will be busier. “The majority of all the tests and specialist type appointments are going to be, in fact, in Bracebridge, so I think there’s going to be an ample opportunity for doctors to be in Bracebridge and the ability for Bracebridge to attract new physicians… I think, if anything, it might be easier for Bracebridge to attract doctors and specialists and less so for Huntsville.”

Vanderstelt said they’re taking their lead from the doctors and their concerns.

Huntsville Councillor Monty Clouthier said ten years from now, how healthcare is delivered in the community may be very different. He also expressed concern about losing the funding opportunity the area has been given to redevelop both hospital sites. “So I think we have to come up with a flexible plan, and I think we have the basis to start a flexible plan for the two hospitals that’s going to work…” He said funding is not guaranteed, so redevelopment needs to move forward while the money is on the table.

Councillor Dan Armour noted that the model would be a huge economic boost to Bracebridge. “You’re going to see somewhere, what, 140, 160,000 patients a year, and they’re all going to be spending money in Bracebridge, and that’s huge for Bracebridge, so I think we need to look at the bigger picture and what ten years is going to bring or 12 years, whatever it is.”

Prompted by Armour, discussions turned to the land issue residents and the doctor group in south Muskoka are concerned with, but Alcock cut that discussion short in favor of speeding up the presentations rather than spending time on speculation. Kruger said another property was donated by a community member as well as a large sum of money for the hospital. Why MAHC chose the property it chose is uncertain, and he said the organization is not forthcoming with the information despite repeated requests. “We have nothing to judge anything on with respect to this,” he said.

“For me, it comes down to all the information and misinformation, so it’s very hard to make a decision. What are the facts and I think we all can’t agree on what the facts are at any given point,” said Councillor Jason FitzGerald. “What I see is a broken model in healthcare and what they’re trying to do is move forward and fix that broken model. Whether they’re going to get it 100 per cent right, I don’t think that exists in our world today. It seems to me that steps are being made in the right direction and there’s always going to be people that are unhappy with the decisions that are made on our behalf.”

Former Huntsville Mayor Karin Terziano urged council to move forward with its support of MAHC’s proposal. “We’re here to lend our support to your decision to support MAHC, the MAHC model and your decision to commit to the local share,” said Terziano, speaking on behalf of the former mayors as well as Armour Mayor Rod Ward.

Terzianos said hospital discussions have been going on for over 20 years. “There is never going to be 100 per cent agreement on a model. There’s never going to be 100 per cent agreement between doctors. There’s just never going to be 100 per cent agreement, so it’s time to get on with it.” Terziano said she hopes a statement by MPP Graydon Smith noting that MAHC will not lose its funding is true, but she is not willing to risk it.

“Don’t second guess your decision. You are spot on,” Terziano told councillors. “We do have a billion-dollar opportunity to have so much more in health care in both Huntsville and Bracebridge than we have today.”

Former Huntsville Mayor Claude Doughty spoke of the hospital sites’ catchment area and how it has grown for Huntsville. He also spoke about how the Huntsville site has evolved. He said the use in different parts of the hospital has changed and noted that new hospitals have to be flexible to accommodate changes in healthcare.

“I think we have an opportunity for state-of-the-art hospital services in Muskoka, and one of the things I’ve been trying to emphasize is we should stop talking about two hospitals and start talking about one hospital with two campuses because even legally, that’s what we have at the moment,” said former Huntsville Mayor Hugh Mackenzie. “The fact is there has been a billion-dollar commitment made to this community, and the sooner we deal with it, the more likely it is that we’re going to be able to take advantage of it,” he said, adding that there could be an election as early as next year.

Mackenzie said working with MAHC and the Province and keeping the rhetoric down has never been more important. “We’re at a point where things could fall apart very quickly or come together, as Graydon Smith has said, very quickly.” Mackenzie also questioned how many of the 51 doctors who are criticizing the efforts to date have hospital privileges.

Mackenzie also noted that everyone is making sacrifices under the current model. He said in the last six months he’s had to go to Huntsville hospital for diagnostic tests seven times. “I live five minutes from that hospital. When this is done, if it’s done, I will be 35 minutes every time I need to do that and that’s the sacrifice that people in Huntsville are going to have to make.”

Armour Mayor Rod Ward told councillors a story about working on a team on the creation of electronic health records. He said there was resistance from the medical community and the public because change is not easy. At the time, every healthcare provider was an island. He said even the links between Bracebridge and Huntsville hospitals were rudimentary.

Ward said the healthcare community needs to come together and work on improving the system together. “If money was no option, we’d say put a half-billion-dollar centre in Sundrdge… It’s not going to happen. We’re taking this opportunity as a chance to change our community and the way we deliver healthcare,” he said. “We don’t need another hospital. What we need is services in the community. this is what we’re going to build on. The hospital, frankly, is just the starting point,” said Ward. He also said time is of the essence. “We need an eye for the future. By the time these hospitals get built they won’t look like what is planned today, at least they shouldn’t. I hope we are adapting as we move forward. This means constant attention and adjustment and, most notably, cooperation.”

Doctors Melanie Mar and Deb Harrold echoed some of those sentiments. “We are clinicians. We, as you said, are trained to look after people, not to develop a hospital plan. And I think it’s important that we leave that to people who have the experience to do so, and we do our job, and we trust that the consultants who have been doing this for 40 years know what they’re doing,” said Mar.

“There’s three sort of common themes that our physician group has relayed… that we cannot do status quo, it’s not an option. The second is that we have a need now and an opportunity to be really innovative in planning for the future of our healthcare and the third is that in Muskoka we have a unique position to use our greatest asset, which is our ability to access a really core dedicated team of not only healthcare professionals but as municipalities as well and community partners to develop a really good plan.”

Mar said staying status quo is failing patients. “On a daily basis, we see our patients who are in emerg, you know, on a stretcher for days with dementia. That’s not where they should be. We have people waiting longer periods of time for specialized services like orthopedics and patients who have to travel out of the community for rehab services and higher levels of ICU.” She said the community is being presented with an opportunity to be innovative. “So we need to think outside the box. We need to think about what we anticipate the needs to be and not be focused on what our current work practices are like.”

Mar said the plan will hopefully provide more diverse services to patients so they won’t have to drive as far to get them and attract more physicians to the area. “We already are an attractive place to be, and having the diversity of services between both sites allows us to attract all kinds of different providers, and I think that’s a huge asset.”

Harrold reiterated the existing model is not working and needs to be addressed. “This is an exciting time. This current healthcare system that I work in on a daily basis is not sustainable. This is not okay how we are caring for our patients currently. We do have great staff, and we work as hard as we can to make this work, but we cannot keep doing this. We need to think outside the box, and I give great kudos to the MAHC group for being bold and taking on a very courageous change and challenge that is not going to be supported 100 per cent, but we need to do something different, and we need to think outside of the box,” she said.

“This would be a totally exciting time to be a new doctor in south Muskoka when that brand new hospital [is built]with outpatient clinics, and I could run a pain and symptom management clinic, and I could change the world for palliative care, and that would be so exciting…,” added Harrold.

Council unanimously confirmed its support for MAHC, its model, and Huntsville’s local share of the cost.

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Her sentiments were echoed by former Huntsville Mayor Hugh Mackenzie and Claude Doughty.