Hugh Mackenzie
Huntsville Doppler
Is the Writing on the Wall?
When it comes to the future of hospital care in Muskoka it has occurred to me that we have been hit with so many Committees and Boards, so many acronyms, like MAHC, NSM-LHIN, MAHST and so on, so much bureaucracy and so little solid information, that it is impossible to know what is really going on. Frankly, in terms of hospital care in Huntsville, I am becoming increasingly worried.
The latest acronym, MAHST (Muskoka and Area Health System Transformation ) presented a Project Update to Huntsville Council in late February. The accompanying slide presentation was a bit too bureaucratic and too full of buzz words for me, but nevertheless, it is clear the Committee has done a lot of work. For example, they are proposing a single governance structure for hospital care and other health care services in Muskoka. That is clear and it certainly has its merits. What is less clear however, is how health services, especially hospital services, are to be provided across Muskoka.
One section of the MAHST update is titled, ‘KEY DESIGN ELEMENTS FOR THE DELIVERY OF CARE’. Here are a couple of the priorities they list.
* Effective location of urgent and emergency care services, with focus on Quality. To me that is code for saying there will be Emergency Departments in both Huntsville and Bracebridge.
* Quick and effective primary-care based management of care trajectory. Apart from the initiated, hands up if you understand what the heck that means. Certainly, I do not but the cynic in me suggests it has something to do with the Site A and Site B proposal made by the Hospital Retention Committee with only one of those sites designated for primary care. No doubt, someone will set me straight on this.
Sadly, there is little in this slide presentation from MAHST to convince me that much has changed about where primary care hospital services will be delivered in Muskoka. When I put all the pieces together however, I wonder whether the fix is in and the writing is on the wall. Let’s look at some of these pieces.
* Huntsville Council has passed a resolution endorsing the recommendation of the Hospital Retention Committee for two hospital sites in Muskoka, one for primary care and the other for ambulatory and long-term care. To my knowledge, this has not been rescinded and it certainly sends a message to the MAHST Committee.
* The Mayor and Chief Administrative Officer of Bracebridge are on the MAHST Committee as is the Chair of the District of Muskoka. Our Mayor and CAO are not. Huntsville was entitled to municipal representation and Mayor Scott Aitchison appointed Rob Alexander who was Chair of the Hospital Retention Committee that was established by Huntsville Council. The Mayor had his reasons for this but the fact remains; there is no elected representation from Huntsville on MAHST.
* The Board of Muskoka Algonquin Health Services (MAHC) has recommended a single site hospital in Muskoka.
* The Town of Bracebridge has purchased or optioned a site for a new hospital at the southern end of their municipality.
* Evelyn Brown, the Chair of MAHC, is also a principal in an organization called One Muskoka. The name speaks for itself.
* MAHC recently announced the appointment of Dr. Biagio Iannantuono as the Acting Chief of Staff for the two hospital sites in Muskoka. He is from Bracebridge which is appropriate, as the former Chief of Staff was from Huntsville. As well, from all accounts he is an excellent surgeon. However, there are some issues. Dr. Iannantuono appears to have a prejudice when it comes to what services should be available in Huntsville. He has been reported as saying at a LHIN Consultation meeting about hospital services in Muskoka, that surgery has to go through one door and that door is Bracebridge. It should also be noted that last time the single siting of surgery was discussed, Bracebridge surgeons said they would not cover in Huntsville. A hospital cannot offer primary care without surgeons. In his new position, Dr Iannantuono clearly has a conflict of interest. One cannot help but wonder if that is what the powers that be had in mind when he was given a one year contract. In addition, Dr. Innanantuono was disciplined in 2009 by the College of Physicians and Surgeons of Ontario for inappropriate behaviour toward a staff member. At a time when Muskoka is already under fire for its lack of response to issues of sexual abuse, one wonders again at the appropriateness of this appointment and what kind of message it sends.
So….. is the deck stacked against Huntsville? I wonder. I will say, that the silver lining in all of this, may be our Mayor. Since the beginning of his term he has taken the lead in demanding adequate hospital care in Huntsville that is not subordinate to any other area of Muskoka. He is well aware of the economic and social consequences to Huntsville if that does not happen. The Mayor wears the hospital issue and he knows it and that makes me confident that he has a plan that will leave us with much more than an emergency department when it comes to hospital care.
Scott Aitchison is an excellent communicator so I do find it frustrating that we don’t know more about what is going on and why he has taken some of the actions he has. But there may be good reasons for this. Whether we like it or not, some sensitive issues can only be negotiated and resolved behind closed doors and in confidence. I suspect that our Mayor is knee deep in these discussions. He may also believe that as mayor, he can exercise more influence on the eventual outcome with the LHIN and the Province than he can as a member of the MAHST Committee. He has said he will protect our interests and we should trust that he is doing so.
I just wish I could stop worrying.
See the MAHST slide-show presentation here.
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Very quiet on the Hospital issue….Maybe time to rally the troops again. Health care is in transition and some service realignment can be for the betterment of the citizens of our community. Local Physicans are first class and really care about their community, giving of themselves to have Locums working with them side by side for 8 months of the year …from the Northern Ontario School of Medicine and other teaching facilities from time to time. The Huntsville site is the most sought after for 3rd year students . “A recruitment program at its best.”
Without ER and Surgeons, none of this will be possible. Seniors will not relocate to a Community without these services.
What about our own Citizens from the area ?
I am not sure we realize what we may lose.
Time to ask the hard Question.
Survey results posted on CBC today clearly indicate that we need more health care services in our area not less. I hope the decision makers are paying attention to this important data.
I agree with everything Mr. Tapley said in his comments and I also know a lot of older people have told me they will move to another town if Huntsville loses its hospital. Not everyone has a vehicle to get to Bracebridge or Port Sydney. And the bus service is a joke if you are planning on using it, a bus every two hours yeah that makes sense and I don’t see them paying to run it to Port Sydney. All of the people on this committee need to sit and use their brains, add up how much longer it will take from outlying areas, and think about the possible deaths that will be laid at their door. Oh yes and if this goes ahead do they count the money they will have to spend to use the air ambulance service a lot more. If you want this to be a fair decision then put it to a vote, let everyone in Muskoka vote on it.
Port Sydney!!!
With respect for my friend Brian Tapley. It is just not reasonable to believe the province is going to continue to fund two full service hospitals. I am not convinced they will continue to fund even one full service Hospital in Muskoka.
It is time to dig in and come up with an out of the box idea for a state of the art hospital on Hwy 11 half way between Orillia and North Bay. Save operating expenses and serve all Muskokans. A parochial attitude will only defeat good intentions.
Hope is not a strategy folks, Huntsville needs to present a strong plan now.
I think we need two full service hospitals, Bracebridge and Huntsville and for several reasons.
1- As indicated there is a big geographic area that is served, especially by the Huntsville hospital, that lies outside “Muskoka” and really has no other place to go for service.
2- The land is already owned in Huntsville, it is not an “optioned parcel” and the site is well serviced with things that hospitals need. (Helipad, Ambulance, etc.)
3- It is a well accepted fact that people in hospital respond better if they have regular contact with family members. That extra 3/4 hour to go between Huntsville and Bracebridge is a big detriment to this ability. One is not likely going to drive to Hunsville from maybe Dorset, do your shopping and then drive to Bracebridge to visit Mom or Dad all in the same day. At least not as likely as if they were that bit closer.
4- Time again, in that there is a short period, the “golden hour” some call it, after an accident and during which intervention is most effective. Spending most of that hour in a bouncing ambulance on the way to hospital is nowhere as good as being IN a hospital. If you have a heart attack in Sprucedale, Dwight, Kearny, Dorset your odds of survival are not going to be as good if you have to be transported to Bracebridge and this works the other way too!
5- The reliability factor increases with two hospitals on different sites. It might be possible for a major failure to cause closure of one hospital (contamination, heat plant failure, power or water failure etc.) but much less likely for such an event to close two hospitals at the same time. This increases reliability, granted at some slightly higher cost but what are we looking for here…. safety and security and timely service or the cheapest engineered cost regardless of human consequences??
It might do us all good to remember that any hospital has to be somewhat inefficient by having empty beds and unused services and staff because an emergency, by it’s very nature is always unplanned. A bus accident on Highway 11 could result in 40 or more people in immediate need of emergency services and the hospital needs somewhere to handle these potential “customers”. This is just a necessary cost of the hospital and emergency service. The operation cannot be run like a factory, like say Kimberly Clark, where everything is well planned in advance and minimal staffing can be calculated well in advance. Also in an industrial setting the loss caused by a lack of ability to service needs is usually merely financial, whereas in a hospital setting someone’s live is usually the cost.
Last, I have to note that we never seemed to have any funding issues until they came up with all the acronyms they use today. Maybe there are just too many acronyms? At first you would be forgiven for thinking this is just a joke but think further. Good old plain language and accountability at all levels of government might help. This is something we seem to be losing as our higher levels of government make themselves more and more secure and unaccountable to the average person. They seem to forget easily that they work for that average person, one way or another. That is ultimately why government exists.
I think that we, in Huntsville, have good reason to worry, with regard to the hospital.
If an ambulatory and long-term care facility is located at Site B, then Site B will not be an acute-care hospital.
The Ministry of Health has avoided accountability by creating the LHINs and giving them responsibility for dispensing the funds. Those who are part of the LHIN are not elected. There is no recourse for the public because LHIN board members cannot be voted out of office.
Patients who seek emergency care at the ambulatory and long-term care facility will soon learn that it is a waste of time and possibly unsafe to go there under those circumstances and will go instead to Site A. It won’t be long before ambulances will bypass Site B and go immediately to Site A with any real emergency.
Our LHIN region extends only a short distance north of Huntsville (I believe just south of Burks Falls) hence, our LHIN is not interested in funding or providing care to people who do not reside within our LHIN region, nor are the given the resources to do so;
Our LHIN extends quite far south and our MAHC board includes many members from centres that lie south of Huntsville, hence the bias toward a more southerly location for the acute care site.
There are many positives to having one new acute-care hospital for Muskoka (concentration of resources, staffing, equipment, expertise, technology etc.) however, since Gravenhurst and Bracebridge are reasonable close to South Muskoka Memorial Hospital in Orillia, I believe that the acute-care hospital would be best situated closer to Huntsville, with quick access to Highway 11.
I also believe that there is no reason why the committee and council could not communicate in clear, simple language that everyone can understand, unless it is to obscure what is going on.
The public should, in my opinion, be kept informed at every step in the decision-making process, via the local news media and information communiques.
Mr. Makenzie’s comments as well as Mr. Froude’s seem to further emphasize the big word, MUSKOKA coming from all things MAHC. For us in Almaguin or South Parry Sound, the folks in Algonquin Park, Dorset who are not in Muskoka but count on Huntsville Hospital, this is not what we want to hear. We need a full service hospital in Huntsville. There is plenty of property belonging to MAHC where the hospital is. If Muskoka needs a bigger hospital build it next to Huntsville hospital and take advantage of the facilities we already have while and after it is built. MAHC board wants to spend money, our taxpayer money on something brand spanking new that they can brag about rather than provide the citizens in the Huntsville catchment area with the services they need locally. We can’t let a group of surgeons blackmail us into losing our hospital. Our own local doctors are united in opposing MAHC’s board. We have to get more vocal in standing up for our Hospital in Huntsville
Things are surely getting ready for spring in Muskoka. We are currently still covered with snow and it appears to be the time of opinions (everybody has one) For me (pretty much a novice) I have been involved in this exercise since October and I have yet to form my own. We as a committee have certainly discussed many various topics and unless I missed a meeting we have yet to have the discussions surrounding bricks and mortar.
The discussions we have been having are certainly (in my opinion) heading in the direction of a better delivery model for all of MUSKOKA and surrounding area. We are about to enter into discussions with the community to help shape that direction. So if you want to have a voice in this matter stay tuned and make sure we have the information you want us to have to make Muskoka’s Healthcare model the best it can be.