Huntsville Doppler
The cynic in me
I guess I am the resident cynic when it comes to the hospital situation in Muskoka. Some have even called me paranoid in that regard. I will accept that, if I turn out to be wrong. Nothing would make me happier. But sadly, I am still from Missouri when it comes to believing that the movers and shakers at Muskoka Algonquin Healthcare (MAHC) are truly dedicated to two acute-care hospitals in Muskoka, perhaps with different services, but of equal strength and neither site subordinate to the other. My gut tells me that, first, that is impossible to achieve, and, second, that their number one goal is still to build a new hospital facility in Bracebridge and Huntsville will get what’s left over. Inevitably, that will, in time, lead to a single-site, acute-care hospital in Muskoka.
I am well aware that MAHC is working hard to assure the community that the goal is two acute-care facilities in Muskoka, but a careful review of the data that the Capital Plan Development Task Force has been producing shows that there are serious and perhaps insurmountable financial challenges ahead. I continue to fear that the time will come when they shake their collective heads and say, “Oh well, we tried, but we just can’t make two fully acute care hospitals work.”
You may recall that a couple of years ago there was a proposal on the table for two hospitals. Site A would be a fully acute-care hospital and site B would revert to ambulatory and long-term care, with both sites having emergency facilities. That was taken off the table. But my fear is that when we get down to the short strokes, especially with the much- needed new facility for Fairvern going full speed ahead on the Huntsville Hospital site, that’s exactly where we will end up. And cynic or not, in spite of the optics, that is where I believe at least some of the members of the MAHC board and staff, have always intended to end up.
I cannot forget that a year or so ago, Phil Matthews, who is now chair of the board at MAHC, appeared before Muskoka District Council to ask for a huge bundle of money to be put aside for one new hospital facility. We know that won’t be Huntsville. And now, there is another sign that disturbs me and that is the recent announcement by Mr. Matthews of an appointment of a new chief of staff.
There has been an acting chief of staff at MAHC for the past two years, who has said there should be only one door for surgery in Muskoka and that door is Bracebridge. Shortly after that appointment, Dr. Roy Kirkpatrick, a Huntsville surgeon, applied for the permanent position as chief of staff. He is eminently qualified with credentials and experience coming out his ears. He has been acclaimed for his work both locally and internationally. MAHC kept him on the hook for more than a year and then turned him down flat. In my view it was because he did not fit the board’s profile. He is not a “yes” man.
Now the new chief of staff is to be Dr. Khaled Abdel-Razek. He is an obstetrician and gynaecologist who lives and practices in Orillia. My understanding is he intends to continue to live in Orillia and will continue as surgical program medical director for Soldiers’ Memorial Hospital. He was also granted privileges at MAHC in 2013, working primarily out of Bracebridge when he is in Muskoka. Dr. Abdel-Razek is certainly a highly qualified physician, but it is hard to believe that after two years, MAHC could not have found a suitable candidate for the $150,000 appointment as chief of staff who actually lives and practices full time in our catchment area of Muskoka and East Parry Sound. It begs the question why?
The cynic in me remembers previous efforts to move obstetrics out of Huntsville and causes me to ask if, with an obstetrician as part of the senior MAHC staff, we are now going to hear that there should be only one door for obstetrics in Muskoka? And the really cynical part of me wonders if that will require more obstetric and surgical space that cannot be accommodated at the current Bracebridge hospital site and, hence, a new facility there.
I know my Bracebridge friends get frustrated with me when I write like this. Believe me, I want them to have the best hospital facility possible there. I just do not want to see it happen at the expense of Huntsville, where not only our health care would be compromised but also our economy. And I do believe there are people currently at MAHC who would be quite prepared to allow that to happen.
The real problem, as I see it, is the MAHC board which, in my view, is incestuous. It effectively appoints itself, kicks out those that do not walk the party line and even tightly controls who is entitled to vote at an annual meeting. There is no effective input from the community at-large and no way to ensure that the Board is fairly balanced. The movers and shakers at MAHC call the shots. I believe it is time to open the whole process up so that Huntsville, Bracebridge and East Parry Sound residents decide who will represent them on the hospital board and not a closed group of individuals with their own agenda.
Doug Ford has shown that he can make changes with the stroke of a pen. Maybe someone should talk to him.
Hugh Mackenzie
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John Boysen says
Keep being a cynic for our hospital! How do we open the positions on the board in a transparent way for emminent people who live and work in H’ville?
Henk Rietveld says
Optics are everything. Unfortunately, perception is too often reality. The MAHC has failed to convince me, and I am sure, many others, of any agenda that supports what our people want. The lack of transparency, ill-timed announcements, etc., contribute to a “them and us” appearance. This does not inspire trust and confidence. Just ask Trudeau.
Well said, Hugh.
Lynn Crowder says
I agree with you Hugh. I believe as you do, there is a long range plan and that the deciders are playing the game of inclusion/exclusion, as well as working the strings of process in a fore gone conclusion.. It is sad to see. When they did not choose Dr. Kirkpatrick it was clear the writing was on the wall. Glad that I am not the only one to see it. A chief of staff, with no investment in my community ….that is not comforting in the least. I would be curious to know where the people who sit on this board live too? Because I live in Port Sydney it makes no difference to me. I have to travel either way. But having travelled regularly from Bracebridge to Huntsville. It is not a quick drive. Nor is the drive from Algonquin Park to Bracebridge. Besides, the last I heard, the community decided, that we needed both. It is a shorter ride from Orillia to Barrie….with its big beautiful hospital….why should Orillia have a (new) hospital…can’t they go to Barrie? Ridiculous. Right? I agree with you Hugh. The people on this board are not paying attention to what the community decided. It is certainly not economical to have two hospitals. Important and pivotal decisions often are not about economics.
valerie corbett says
HUGH, thanks for the overview of this situation. I admit I haven`t been paying much attention until recently! I have some questions. 1, what are the duties of a “chief of staff”? 2, does it pay $150,000 for each hospital? 3, did Huntsville and Bracebridge each have a separate C of S up till now? Since the board has chosen the doctor from Orillia, will he fit the old adage “jack of all trades, master of none”? Why would a doctor with a successful OBGYN practice even consider applying for this “job”? Would appreciate some enlightenment Hugh!! Thanks in advance.
Tim Withey says
Well done Hugh, great piece. You are spot on with your assessment. This latest news should be met with high suspicion indeed. The fact that the individual picked is from out of town is the first issue. Especially when we had an overqualified candidate here in town with Dr. Kirkpatrick.
Dr. Kirkpatrick, by the way, has had a recent addition to his long resume of accolades. At the beginning of the year Roy was elected to the council of the Royal College of Physicians and Surgeons of Canada which regulates the specialists in the country. With this election he becomes the Chair of the Regional Advisory Council for Ontario and Nunavet. Probably still not good enough to get the Chief of Staff job.
So we have a new Chief of Staff who already preforms procedures at the Bracebridge site so will be predisposed to centralizing surgical services there. Moreover, Ms. Bubela’s recent article about having two MRI sites in Muskoka, which is absolutely outlandish, unnecessary and unaffordable, plays to Bracebridge’s advantage as well with this appointment. As any Ob-gyn knows, if there is trouble during a pregnancy you can’t x-ray a patient for obvious reasons. Any guess what you can do? That’s right – an MRI.
So this all speaks to the basis for Hugh’s article, namely how our hospital board is constituted. Currently, there is virtually zero accountability to the community. We need to force the province to step in and make the necessary changes to this system to rectify this. Interestingly, Soldiers Memorial Hospital in Orillia has a system of open elections for their board and include two seats for municipal representation, much like Huntsville’s used to be. As a new member of council I will advocate for a doubling down on the motion of non-confidence in this administration and board passed last spring, to push the province to act.
Ross Maund, former MAHC director says
Thank you for your excellent commentary Hugh. It is obvious that the MAHC board feels no regard or accountability to the consensus view of the community that they serve. It is a travesty that Dr. Kirkpatrick was not enthusiastically endorsed as the logical and superbly qualified COS for MAHC. The decision in many respects is yet another example of the ongoing disconnect between MAHC leadership and our community.
One might think that MAHC leadership would be astute enough to build trust in selecting a person that is highly regarded throughout Muskoka and within the medical community. Feels like ensuring that senior board leadership maintains control over the COS trumps good judgement. Given yet again another totally inappropriate decision by the MAHC board leadership should be a heads up to the community on the veracity of development information to date. Big question continues about MAHC board’s governance and accountabilities? A community hospital can not conduct itself as an island from the locale that they serve.
Ralph Cliff says
Very well stated Hugh.
When they bring in an outsider as chief of staff
and ignore our own qualified doctors its obvious
which way our hospitals are headed.
We know which way the directors are headed!
Hugh Mackenzie says
Hi Val: I can answer some of your questions. The Chief of Staff is the Head Medical Officer at MAHC. He reports to the Board and is responsible for Standard of Care and other medical matters. His $150,000 salary covers both hospital sites. Huntsville and Bracebridge have had a common Chief of staff since the two hospitals amalgamated. I could only speculate on your other questions and I have done enough of that in my column!
Susan Vtech says
They did not choose a local doctor for the position.
Perhaps we are looking at the question from the wrong angle.
Maybe knowing what its like working with the hospital board
none of the local doctors wanted the position/headache?
Maybe its time to replace the entire board including the leadership?
Just a thought.
Rob Millman says
As you know, Hugh, the standard operating procedure (pun intended) is for the Board’s Nominating Committee to vet the candidates who apply, and select however many new Directors are required. They are presented to the Board as a whole, and generally confirmed. This Board has one employee (usually the Executive Director; possibly the Chief of Staff, in this instance). The Board has the entire community it represents as its employer.
.
When I was a Director for Fairvern, however, I was elected by community members (who belonged to some hospital cabal). Did they pay a token membership fee? Did they know the secret handshake/oath? It was never clear to me: in fact, this very lack of transparency seemed to be part of the mystique.
.
I certainly have no qualms about the standard procedure viewed in a vacuum. But this is anything but a vacuum; with two communities wanting the best for their citizens, and a Board that spins on its axis more than a weather-vane in a hurricane.
valerie g corbett says
Thanks Hugh!!!
Kathryn Henderson says
It’s about time this received more attention. It is just ridiculous to hire someone from out of town when we have a perfect candidate right here. What happened to SHOP MUSKOKA????????? I guess that only applies to us peasants. I said this a while ago more than once that the board won’t hire Dr. Kirkpatrick because he will do a proper job and would not be influenced wrongly by the board. If I was Dr. Kirkpatrick I would Not take the job now even if they begged me. Maybe we should move to Orillia. We will be able to talk to our Huntsville Chief of Staff there. Just plain politics and bullsh*t. I have about had enough of this. BOO to You a-holes running the show.
Charles Wilson says
Not sure the problem can be resolved by appointment of different people to the 12-member board. Surely it’s the district funding cutbacks from Queens Park which need addressing?
These cutbacks have, according the Board’s chairman, resulted in:
Single sited chemotherapy, ophthalmology and bone densitometry;
Closed 10 acute care beds, then added 5 beds;
Removed eight Complex Continuing Care beds from the regional CCC program;
Moved 12 interim long-term care beds to the community as they do not belong in a hospital;
Reduced 37.3 full-time equivalent positions.
Laid off seven PSW’s then recalled them into other positions at MAHC as work became available.
Queens Park has a problem: it has as its boss an ideologue; a man who gets elected by spouting off ideas which appeal to the 40 per cent who vote for him in the 905’s etc but aren’t really capable of being instituted without disrupting essential services. Dog whistle politics.
People elected for this particular virtue cannot actually provide leadership in the true sense of the word what they can do are providing divisive often faux political issues which may appeal to their base but don’t actually have any legs. Sooner or later their own lack of access to real political solutions becomes methods of forcing others to accept their non-solutions. This leads to conflict and, in the 20th century, we saw where that took us all.
Canadians, normally fair rational voters who try very hard to look out for everyone in their community while at the same time keeping taxes down, are seeing our health care in the crosshairs of this debate. Modern health care is becoming more and more centralised because centralization, according to the model currently in favor by the people who control it at the centre, delivers better care to more and less expensively.
The conflict is as old as national health care itself. It is the Beveridge model vs. the Bismarck model. Canada under the impetus of Mr Douglas attempted to institute the Beveridge modern but to leave Dr, choice to the patient. It sort of worked in the 1960’s when medical autonomy was still a thing. But today, when the primary asset a GP has is his or her rolodex access to specialists, it makes little sense.
Frankly the board could be composed entirely of our own uncles and aunts and we still wouldn’t have a scintilla of increased autonomy.
Queens Park is centrist in its approaches to all government functions. It is operating much the same way as local maharajahs operated under colonial British rule in India and its not going to end in tears, the tears are real they are now and, unlike the other big wet in the news this week, they aren’t about to recede.