Listen Up! At this time Huntsville needs to support the recommendation for two new hospitals

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Hugh Mackenzie
Huntsville Doppler

Don’t throw out the baby with the bath water

There have been some negative postings on-line recently, about members of Huntsville Council remaining mute after Councillor Tim Withey attacked the recommendations of the Muskoka Algonquin Health Care (MAHC) Task Force, in relation to hospital care in Muskoka.

I believe they did exactly the right thing.

Anyone who reads my column on a regular basis, knows that I have been highly critical of the MAHC Board as it relates to future hospital care in Muskoka and believe that there was a bias toward Bracebridge. I still believe there are members on that Board whose first priority is a new hospital site in Bracebridge no matter what effect that might have on hospital care in North Muskoka. However, I also believe there is a time for confrontation and a time for cooperation and on that basis, in my opinion, Councillor Withey’s outburst was pre-mature and potentially harmful to Huntsville.

The recommendation of the Task Force, which has not yet been approved by the MAHC Board, is for two new hospitals in Muskoka, one in Bracebridge and the other here. During all of the discussions, debates, committees and task forces over the past several years, Huntsville’s position, as articulated by Mayor Scott Aitchison, has consistently been in favour of two hospitals in Muskoka, as long as one is not subordinate to the other. Assuming that there will continue to be two hospitals in Muskoka, it is highly likely, for a number of reasons, that there will be a new site in Bracebridge. If that occurs, and Huntsville does not keep pace, it will only be a matter of time before at least some of the acute care services here, are moved to the more modern and up-to-date facility in South Muskoka.

In my view, if immediate criticism of the Task Forces recommendation continues from Huntsville, someone on the MAHC Board is going to ask, “What part of ‘YES’ don’t you like?”.

Huntsville has asked for an acute care hospital that is not subordinate to Bracebridge and if the MAHC Board approves the recommendation of the Task Force, that is what they will be supporting. It is a far cry from positions they have taken in the past and for that they  deserve some credit. Had Council condemned the Task Forces Report, it would be easier for the MAHC Board to look at other alternatives, which may not be in Huntsville’s best interest. That is why, the members of Council that did so, were wise to keep their mouths shut.

Of course, there is the question of cost and affordability and it is a good one. In his comments to Council, if I understood them correctly, Tim Withey believes that the costs indicated in the Task Force Report are misleading and would never be accepted by the Ministry of Health. He may be right, but he may be wrong. In my view, the place to have that conversation, or any other conversation related to hospital care in Muskoka, is inside the tent and not out.

If the MAHC Board indicates they want to support two new hospital sites in Muskoka, we should be working with them, no matter how daunting the task, no matter how much we suspect ulterior motives by a few of them, and not against them. If things go wrong, by being there, that is where we will make the difference. Even if the recommendations of the Task Forced are proven to be not feasible, at least we would be at the table, to look for a compromise that would not be at odds with either community.

The MAHC Task Force consists of 25 volunteers, all with different areas of expertise. In addition, they have used Consultants recommended by the Ministry of Health and who have deep experience with what the Ministry will and will not accept. Also, I know, from speaking to various members of the Task Force, that they have pushed back, and not taken anything at face value. Councillor Withey may know better than all of them, but we should at least give them the opportunity to make their case, and ourselves the opportunity to evaluate their arguments before condemning their recommendations.

I have had the opportunity to see the report of the MAHC Task Force. Is there a huge difference between renovating our hospitals or building new ones? No. Is the cost of building a single site hospital in Muskoka less? Yes. But it is not a huge difference and with that option, one community is going to win and the other lose, with significant health care and economic consequences to the loser. No matter the argument we would have for a Huntsville site, under those circumstances, there is at least a 50 per cent chance that the loser would be North Muskoka. Will there be a cost to local taxpayers to maintain two up-to-date acute care hospitals in Muskoka? Yes. Is it a reasonable cost? Yes. Is this whole concept, recommended by the Task Force a non- starter? Maybe and maybe not. Certainly, Councillor Withey thinks so. But others, many others, are not so sure.

I do believe that Tim Withey has the best interests of Huntsville at heart. But I also believe his strategy is dead wrong. If there is an opportunity to work with each other, rather than against each other, that is what we should do and that is what we are being offered.

It is an unkept secret that Councillor Withey plans to run for Mayor, if Scott Aitchison is elected as our member of Parliament. It is becoming equally clear that he plans to use the hospital issue as his platform.

But the interests of Huntsville come first and that is why it is important that we keep our eyes wide open, but also, not to work against those who claim to support what we want.

To do so, would simply be throwing out the baby with the bath water.

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23 Comments

  1. It is not always feasible to renovate. As former chair of social services at the District when the Pines was redeveloped. Committee took a serious look renovating, the costing was more than a new build. So we built a new Pines. Don’t throw the baby out with the bath water just yet.

  2. Tammy McAughey on

    There appears to be far too many maybe’s and maybe nots for someone with a definite opinion.
    Maybe Tim Withey is correct, maybe he’s not. Maybe the Task Force’s recommendation will be more cost efficient, maybe it won’t. You made it clear in your opinion however, that a single site (in Bracebridge) would be the most cost effective. Perhaps, perhaps not. Regardless, it WILL NOT be beneficial for those of us in the catchment areas (EPS and Almaguin) that rely on Huntsville Hospital.

    Maybe we need a mayor like Tim Withey who will advocate for the people today and for the future. Hugh, you mentioned nothing about the impact of the costs on the taxpayers of Muskoka in years to come if 2 brand new hospitals are built. There is absolutely no way we can depend on governments to subsidize the local share!

  3. Sven Miglin: Former MAHC Board Chair on

    Hugh, as a dear friend it pains me to say that you’ve got it wrong.

    Unlike you, I haven’t seen the full report but understand that the total cost will be nearly $600 million. The Province of Ontario can NOT afford and will NOT commit to spending that large a sum on hospital redevelopment in a community the size of Muskoka.

    The resulting local share will be about $140 million. The only way to raise that kind of money is through the District tax levy. Many property owners already find their property tax bill too high. Should the District assume such a large debt load, other projects such as water & sewer, roads, affordable housing, etc. will all be severely impacted.

    Councillor Withey is right when he questions the wisdom of such a plan.

  4. Hugh:
    You are exactly right. Thank-you.

    There will be plenty of time down the road for the Ministry and we the public to analyze and critique the specifics of a final proposal; long before any final decisions are made by the Province. For now, sit back and be relieved, and grateful, that the Task Force made the decision it did; or, better yet, loudly support it and stronngly urge MAHC to accept it. It has taken a lot of time and effort by a dedicated few to get to this point. This is not the time to upset the apple cart ….for personal political reasons, or at all.

  5. Jim Logagianes on

    I commend Hugh for trying to diffuse a difficult situation that we as a community are facing. But Tim is right to be wary of the overall cost of this proposal and bring it to our attention. Can Huntsville afford to ignore the cost of the proposal being put forth? Or are we all going to consider moving when the cost of living in Muskoka escalates exponentially?

    • Agreed, Jim. I respect Hugh’s point of view, but I also think that Tim Withey was right to speak up before the ball gets kicked into the Health Ministry bureaucracy. Does anyone really think that the Ministry will approve a $600 million proposition for such a small population, in these days of budgetary constraint? With all the bureaucratic back and forth that such a giant ask would entail, we would be fortunate to have ANY new hospital up and running in 25 years! And we need an upgrade to our facility NOW. Some areas of the current hospital are quite shabby, not to mention, inefficient. Are we supposed to wait another couple of decades for a pie-in-the-sky hospital, while the current facilities’ deficiencies go unaddressed? Does MAHC care about this issue?

      There are three sets of stakeholders here: 1) the customers (the patients who consume the medical services) 2) the workers (the staff who provide the services) and 3) the stockholders/owners of the enterprise. The owners are we, the TAXPAYERS, since we are ultimately the ones who will be picking up the tab for many years to come.

      Contrary to what MAHC may imagine, they are NOT the owners and neither is the giant health bureaucracy of the Ministry of Health and Long Term Care. They are SUPPOSED to see themselves as public servants who enact the directions of the government. That government is ultimately backed up by WE the people because we, the citizenry are the ones who will be paying the TOTAL cost–there is no “free lunch”.

      We get a chance to vote for our government representatives but do we ever get to say “yay” or “nay” to the bureaucrats who sit in control of what is really OUR money? Instead, the bureaucrats throughout the health autocracy seem to be adhering to the “iron rule of bureaucracy” whose goal is to perpetuate the bureaucracy (and their fat salaries) rather than to serve the public.

      Since they have “no dog in this hunt” (i.e. they are NOT stakeholders) why should they dictate anything? It is a travesty beyond measuring that $500,000 of taxpayer money was spent hiring “consultants” recommended by the Ministry of Health, when even the simplest, and utterly inexpensive requests from staff get turned down?! With this $500,000 slap-in-the-face, does MAHC care about the morale of the staff at all? Do they care about the morale of the patients who are already depressed by their disease processes and then look around and get further discouragement from the shabbiness around them?

      Sign me:

      # disgusted-with-bureaucrats # we-need-a-taxpayer-revolt

  6. While I am amused at Mr. Mackenzie’s musings about my political future, I am truly shocked at his position with the hospital issue. This is an about face to his previously stated positions.
    Mr. Mackenzie may have forgotten that he was an ardent supporter of the non-confidence motion passed by the former council. Mr. Mackenzie apparently now has confidence that the MAHC Board has our best interest at heart.
    He also may have missed it but Councillor Dan Armour – a member of our health care community has come out with firm vocal support of my position. He wasn’t at the meeting when I had my “outburst”, or I’m sure he would have spoken up then as he has now.
    To be clear, I have always supported two hospitals for Muskoka. What I do not believe in is bankrupting our District with $140,000,000 in debt – not today – not in the future.
    As I have stated my fear is when MAHC finally gets to Stage 4 or 5, the province will step in and decree that this much money will not be spent for such a small population base.
    The Province allows hospitals significant discretion through many of the steps within the 6 step submission process to the ministry but ultimately will seriously question the capital costs to serve a small population such as in Muskoka. Then, the decision might be made for one site.
    By that time the Surgery Department in Huntsville will be completely gutted (a process that still continues today) and it will become obvious as to which town will win the local hospital lottery.
    This has nothing to do with a potential upcoming by-election but I will concede that healthcare should be part of every candidate’s platform in any election.

    • Tim, as I’ve indicated in former comments, I agree with you 100%. The new Tory regime at Queen’s Park grudgingly granted healthcare a 1% increase in their initial budget. Does that sound like a government which is interested in a program of profligate spending? (Education received a token 1% in the same budget: All other ministries were gutted.)
      .
      As I see it, the greatest benefit of renovating both hospitals is that it can be staged; hopefully at a rate satisfactory to both the Ministry and the taxpayers. It’s a sensible approach, and certainly the best that we can expect from a government elected on an austerity platform.

    • Thank you for standing up for us Tim and looking out for Huntsville. Thankfully you were the only one who had the guts to stand up for those of us living in Huntsville and North, and question MAHC which has proven in the past to not care one hoot about the people paying their salaries.

  7. I’m still wondering just why we need a new hospital at all I have had a stay in the Huntsville hospital and found it very good, Have had very little wait time in the E.R . when we had to go there and the staff was excellent. Now maybe in the summer things might get a bit more hectic but it’s been like that for years. Granted this hospital is getting a bit run down needs to be painted up and stuff but I’m not sure we need a complete new building. One thing for sure we do need both hospitals having just one is crazy there are to many people that rely on Huntsville from a long distance. I guess I shouldn’t worry don’t think i’ll ever see it competed anyway.

  8. Tim is right. $600M+ for 2 brand new hospitals in a community of 65K residents with a below average growth rate, replacing to averaged-aged Ontario hospitals is just dreaming. All this proposal will do is continue to add more delays to getting any improvements/upgrades. MAHC started this process in 2012, so it’s approaching 8 years and they’re still stuck in stage 1. Huntsville hasn’t seen a major reno/upgrade for almost 20 years. At this rate of progress (with this board), it is looking like another 15 years before anything gets built. Pathetic. This is totally unacceptable to the local residents and taxpayers.

    • wendy j brown on

      I to disagree with replacing both hospitals. Our hospital was built with the plans to expand to fill the future needs when it was built in the 1970,s. So renovate and expand why waste that much money just because Bracebridge didn’t have the foresight to do that also years ago. I swear the people in the mahc should be let go and some people with common sense and a better touch with reality should be on the panel.

  9. I do not pretend to be an expert in the field of health care. I am just a simple engineer who tends to put politics aside and be guided by facts. As Yogi Berra once said, “It’s amazing what you can see just by looking”. So, when I was offered a tour of both hospitals last year, I took it. The Bracebridge Hospital is now 56 years old and Huntsville is 42 years old. While that may not seem old, health care today is vastly different than even 42 years ago. The need for new is more obvious in Bracebridge. But even though Huntsville is newer, there are many constraints to renovation. As I understand it, the additional cost for two new vs one new and one reno is about $100 million. That sounds like as lot but if the next hospital also lasts 42 years, that amounts to $2.4 million per year; small potatoes in the OHIP budget.

    But the kicker for me was when my family physician, whom I trust with my life, told me that running a safe, clean and efficient hospital through 3 to 5 years of the disruption and dirt associated with renovation is not something that patients, staff or visitors would be happy with.

    Regarding the local share; if we stopped arguing and started a special tax levy this year, we would have the money saved in the bank before construction started, and there would be no interest charge. The special levy would amount to around $10 per month for an average household in the catchment area. Homes with lower assessment would pay less. Bigger homes would pay more, but they can afford it. That compares with $27 per month for the Waste Management levy or $40 per month for a case of beer. That levy is a very good deal to get 2 state-of-the art hospitals in Muskoka for the next 50 years.

    At my age, I will probably never see either new hospital, but I am happy to pay the extra $10 per month. I think it’s time to support and thank the professionals and volunteers who have spent endless time and energy to get us to this point, all on top of doing their day jobs.

    • I disagree with your doc’s notion that renovation can not be “safe, clean and efficient”. I worked at a 500-bed hospital that was slowly renovating and adding to its existing plant. (The original building was built in the 1930s. by the way). As each floor/wing (three wings with 6 floors each) of the hospital was scheduled for complete stripping and renovating, it would be sealed off from the rest of the building. Each renovating section would have a chute installed for the stripped-out material to slide down to waiting dumpsters and a moveable steel stairway gave direct access to the construction workers. Of course, it required meticulous planning by the hospital administration after consulting with the various departments of nursing, housekeeping, central supply, etc. (who solicited suggestions from their staffs, in advance). The various department heads would often make suggestions for an improved plan which the administration would frequently incorporate. It was a completely consultative process that took about five years, start to finish. The result was a beautifully renovated hospital–including the building of a new surgical wing next to the Emergency Room on the ground floor. They elected to completely replace the surgical wing, since the previous location had been on the sixth floor of one of the wings and had presented a lot of problems with patient transportation to and from the O.R. because there was only one set of smallish elevators in that wing.

      Surely, if a project of that magnitude could be accomplished, in that amount of time, adding to and renovating the current Huntsville building should be a “piece of cake” for competent leadership.

      Likely, what should be done, is the building of a long-term care facility next to the current hospital building. Most nursing home patients do NOT need all the “high-tech bells and whistles” of a modern hospital and, should the need arise, an individual could be easily transported next door to the hospital (or to the hospice care facility already on the hospital grounds). With the resulting significantly decreased patient load in the hospital itself, sections needing the most TLC could be sealed-off and renovated. The biggest problem would be trying to add a second floor to the existing building, with all of the noise that would be involved. Perhaps a quicker, less expensive, and less disruptive, alternative would be to build a wood-frame, long-term facility on top of the existing hospital building, instead of next door. There is no reason why a wood frame building has to be less sturdy than a steel and brick building is. That addition could temporarily house acute care patients while the acute care wing is renovated. These are just “off-the-top-of-my-head” ideas and may not be practical but, at least an attempt needs to be made to do better with less. Instead of proposing a brand new build (which will quite likely fail) some innovations need to be pursued.

    • With all due respect, Mr. Holland, if there is going to be a special levy for healthcare in Muskoka, it needs to be for long term care. Please follow this link:

      https://www.theglobeandmail.com/investing/personal-finance/retirement/article-with-baby-boomers-aging-the-cost-of-long-term-care-is-set-to-triple/?utm_medium=40digest.intl.carousel&utm_source=email&utm_content=&utm_campaign=campaign

      The DIstrict is already responsible for the Pines in Bracebridge and we are hopefully going to have a new 160 bed long term care facility in Huntsville in the near future. Dealing with this issue head on will immediately help with the ALC (alternative level of care) patients that are contributing to ‘hallway medicine’ today in our hospitals and will only get worse in the future. If we are going to increase taxes for our local healthcare, the issue of elder care is far more important, in my opinion, than two brand new hospitals that we can’t afford.

      • Good article, Tim. Many have spoken about this need for the increasing level of care required for the elderly. If one lives long enough, one is almost guaranteed to become disabled–either physically or mentally, or both. The risk of stroke and dementia increases dramatically after 85–two major causes of disability. Modern medicine has extended life but unless it is healthy and able life, it will need a much bigger commitment to long term care.

        In times past, most people died in their 60s or younger–typically, before they had lived long enough to become disabled. The major causes of death were infectious disease, war and the famine that always accompanies war. We are fortunate to be living in a time when infectious disease has diminished greatly and the ancient scourge of war and famine do not threaten us much anymore.

        Prussia launched its first old age benefits in the late 19th century and selected age 65 as the point where a Prussian citizen would receive a government pension. One might wonder why that age was chosen. As the story goes, Prussian Minister President, Otto Von Bismarck asked one of his aides, by what age had the vast majority of individuals already died. The aide went off and checked whatever statistics were available and told Bismarck that that age appeared to be 65. At that time, few Prussians lived beyond that age. Bismarck then ordered that 65 would be the age to begin receiving benefits.

        Not so today, when many live decades longer, with increasing frailty.

  10. WOW! Folks .. just a simple thought .. you get what you pay for and renovations will never be able to supply the health requirements … now and … in the future for ALL of Muskoka! No matter how to you want to slice it and dice it is still … same old … same old, same footprints, same old infrastructure etc etc and same old problems now and in the future. We need to get over ‘the location’ .. the emotion of our site/location protection and think and react outside the box. The future is now and to stay with the same ideas and support for 2 hospitals is wrong no matter where you live. We … ‘all of Muskoka’ need to face the reality .. we can not support 2 hospitals ..long term , it is too expensive! It’s time to CHANGE and get the show on the road for ONE new hospital! Otherwise we will go to the back of the line for any government support .. like we have been for the last 20 + years . We need to face the reality, expense, our population size, ,, etc etc for 2 new hospitals .. it is not going to happen … and … we ALL lose if we continue down this road!

  11. Mary Flavelle on

    Has anyone considered using the west end of the hospital for what it was intended. ?? Patient beds!!!! There is a new facility being built close by. Why can’t the existing facilities that are now in the west wing
    be included in a wing of Fairvern?
    It seems to me nobody is really thinking of the taxpayer.
    This way it would be a lot less disruption at the hospital.

    Food for thought…….

  12. Tammy McAughey on

    I would like to address the above statement – “renovations will never be able to supply the health requirements…” I disagree given Huntsville was designed so that it could be expanded upon. I believe the same holds true for Bracebridge and neither is to the point where demolition is needed!

    I’ve been in 2 hospitals this past year (both much older than the 2 in our region) that have been updated as well as renovated and, those hospitals meet every requirement as acute care facilities. Fix what is broken but don’t waste what is not.

  13. Ross Maund and I have addressed the question of affordability of this size of ask in previous articles (and on Cogeco’s Muskoka Matters show). To recap a key fact pertaining to today’s fiscal reality. If every one of the roughly 230 Ontario hospital sites (~135 hospital corps) was completely replaced/rebuilt to the latest standards (like is being recommended here) the total capital cost would exceed $80 billion. The Ontario government’s annual hospital infrastructure capital budget is about 1.7B $, so it would need to rise by a factor of 4 or more to cover the costs. We are in good economic times, and the coming years are likely to be much more challenging for higher spending.
    What this task force is recommending is not going to happen. Perhaps the thinking is to ask for the moon, and settle for some lower cost option? Problem is that it all adds more delays, and more wasted money on pricey consultants.

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