Ring around the Rosie
It was quite the circus at District Council last week when a motion was presented to endorse the motion from the joint meeting of the Bracebridge and Huntsville councillors, recommending two campuses of care in Muskoka, one for acute care and the other for ambulatory care, but with an emergency department at both sites. A number of councillors were not prepared to endorse the recommendations so an amendment was offered by Lake of Bays Mayor Bob Young to receive the report, rather than endorse it.
Enter Bracebridge Mayor Graydon Smith. He didn’t like that amendment, so he asked for a short recess to see if a compromise could be worked out. Following that, the original motion was amended to change the operative word in the motion from “endorse” to “support.” So now, the motion supported the Bracebridge/Huntsville initiative rather than endorsing it. Damned if I know the difference but it was a clever move on the part of Mayor Smith.
The amended motion passed eighteen to one with only Huntsville Deputy Mayor Karin Terziano voting against it. Some councillors, who could not vote for a motion endorsing the Bracebridge\Huntsville motion, which would recommend only one fully acute care hospital in Muskoka, felt that the amended motion allowed them to support the work of the Retention Committee, without actually endorsing their recommendations. As one of these councillors said, “So the resolution supported and thanked the work of the working committee but did not endorse their recommendations.” That may well be what they believed but I am not at all sure that is what the motion actually says in plain words. I am sure that Mayor Smith and other councillors came away believing that they had a motion from District Government supporting the recommendations of the Bracebridge/Huntsville Councils.
Not all Councils in Muskoka and East Parry Sound agreed with the Bracebridge/Huntsville proposal. Perry Township Council was disappointed that Huntsville did not provide consultation to the northern municipalities in their catchment area. They believed that the proposal, as it was presented, appeared to be very similar to what was circulated and rallied against over a year ago. And they were concerned that this would eventually result in the closure of the Huntsville Hospital as an acute care facility within a few years. Therefore Perry Council did not pass a motion to support it. The Reeve of Burk’s Falls has also voiced similar reservations and a number of other community groups and municipalities have expressed concern about the lack of consultation before the Bracebridge/Huntsville motion set a course for hospital care in Muskoka that came as an unhappy surprise to many people.
Physicians in North Muskoka are also very concerned about some, although not all, of the recommendations from the Retention Committee. In particular, they are concerned with the prospect of not having acute care services such as in-patient surgery in both hospitals. They believe that this would trigger a cascade of events that would quickly erode the core of acute care services at the non in-patient site and therefore that hospital would face the reality of running an emergency department with no trauma team or ability to deal with many types of emergency. They go on to say that the hospital without in-patient surgery will quickly deteriorate to one unable to support anything more than chronic care.
North Muskoka physicians expressed their views in a letter which they drafted to the Ontario Minister of Health, himself a physician, and which they hoped to be signed on behalf of all medical practitioners in Muskoka. Unfortunately that didn’t work as at a recent meeting, South Muskoka physicians apparently expressed strongly that Site A, the acute care hospital, should be in Bracebridge and in-patient surgery centered there. One insider told me that some of these physicians consider Huntsville a “ball and chain” particularly because they blocked a proposal to have a centralized pediatric care centre in Bracebridge. This does not bode well for any cooperative agreement between our two municipalities.
Some of the recommendations from the Retention Committee make a lot of sense. The boundaries of LHIN have to be changed to encompass all areas of the Muskoka East Parry Sound catchment area in a single LHIN. As well the funding model for Muskoka simply has to be changed. However, these are all changes that other Government agencies have to agree to and so far, there is nothing to suggest that they will. The only reality we know now is that Huntsville, Bracebridge and the District support a model for two hospitals but only one fully acute care campus in Muskoka. That remains unacceptable to many people.
I have been hearing from several sources that the Retention Committee has a number of exciting and innovative ideas up their sleeve to ensure effective hospital care in Huntsville and Mayor Aitchison also has told many that he has a plan. In a very short discussion with a member of the Retention Committee last week I was told that I had as much right to be misinformed as anyone else. Actually he hit the nail right on the head. If we are misinformed it is because we are not being at all informed. All we know now, is that the position of Council has changed recently from two acute care hospitals in Muskoka to a single acute care campus and a campus for ambulatory care. That may be the short game but it is all we have at the moment and it is not comforting. If there is a longer game afoot, that equally protects the interests of North and South Muskoka as well as East Parry Sound when it comes to hospital care, we need to hear it soon. The short game is not acceptable and if pursued, it will bring some reality to the last line of that old Nursery rhyme, Ring Around the Rosie, “Husha, Husha, we all fall down!”