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 To my knowledge, this has not been rescinded and it certainly sends a message to the MAHST Committee.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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