Listen Up! Peace in our time….but goodbye Huntsville Hospital?

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Hugh Mackenzie Huntsville Doppler

Hugh Mackenzie
Huntsville Doppler

Last Monday, the Huntsville Hospital Retention Committee presented their recommendations for hospital care in Muskoka to a joint meeting of the Bracebridge and Huntsville Councils.  I was gobsmacked by what I heard came out of that meeting, first, because of what was proposed and second because it was approved unanimously by both Councils. I could only wonder how everyone got into the Kool-Aid!

Let me say at the outset, that with the exception of the few people I do not know, the majority of the members of the Retention Committee are friends of mine, folks of exceptional ability whom I highly respect. However, I am still shaking my head at what they have come up with and they will not like what I have to say about it.

In essence, when you cut through all the power point slides, the recommendation is for two campuses of care in Muskoka offering different services. One would be for acute care such as surgery and obstetrics. Call it site A. The other would be for ambulatory services such as chemotherapy and long term care. Call that site B. Although both hospitals would retain an Emergency Department, by definition, one of the two communities would lose their acute care hospital. There is no way to spin that inevitable result under this scenario.

Unless it is me that is drinking the Kool-Aid, I believe this is almost precisely the model that the Hospital Board (MAHC) was promoting when our entire community rallied with demonstrations and petitions last year, demanding acute care hospitals in both Bracebridge and Huntsville and totally rejecting the very model that was proposed by the Retention Committee last week. It is partly because of this community reaction that MAHC subsequently recommended a single site hospital in Muskoka, another contentious proposal.

Pessimist that I am, when it comes to this debacle I have no doubt that Site A will be situated in Bracebridge and Huntsville will become Site B, the ambulatory centre. The Hay Report, consultants recently retained by MAHC, have already recommended that surgery and obstetrics be centered in Bracebridge. I could hardly blame Bracebridge Mayor Graydon Smith if he has already marked out the site they have committed to buy for a new hospital to accommodate these expanded services. Huntsville will not get a new hospital.

If Huntsville loses its acute care hospital, it will have a devastating effect on our economy and our health care. Doctors and other professionals will gravitate  toward the more active hospital centre. We would likely lose the Northern Ontario School of Medicine which came here only through enormous effort by Huntsville people including Dr. Roy Kirkpatrick and former Councillor Fran Coleman. Dr. David Mathies, a member of the Retention Committee, obviously did not agree with his colleagues either. In an interview with Doppler’s Tamara de la Vega, he laid out his concerns. You can see it by clicking here.  Doctors in our community do not see it the way the Retention Committee sees it and they made that very clear to members of the Retention Committee at a meeting on Thursday night. Some expressed the view that if the Committee’s recommendations went through, there would be no hospital here in five years.

In my view, Huntsville has been cleverly and strategically snookered. Where are the two mayors who so publicly stood, practically holding hands, swearing that they would never agree to any proposal that did not provide for a fully acute care hospital in both communities? Remember that? After the meeting last Monday, Mayor Smith should have gathered his Council together for a champagne celebration. They stand to get everything they wanted. MAHC, as well, should be dancing in the aisle. They are effectively off the hook whether the eventual outcome is the first option they considered or their final proposal for a single-site hospital. The LHIN is also off the hook. All they wanted was a proposal that the communities in Muskoka could support. Huntsville and Bracebridge Councils have given them a free ride on that.

So what the hell happened? How did we come full circle to a proposal that has the potential of leaving Huntsville with a second-rate hospital? Perhaps it is because, in this particular instance, we have been too cozy with Bracebridge who, in my view, through this whole process, while saying all the politically correct things, have also quite rightly been protecting their own interests and doing so effectively. Huntsville on the other hand, had opted for a cooperative model, which I believe has backfired.

The original intent of the Huntsville Hospital Retention Committee was for them to prepare a proposal to the MAHC Site Committee for a single hospital in Muskoka that would protect the interests of Huntsville. Their mandate evolved to other options however, which is understandable, but the focus was intended to remain on Huntsville. I found it interesting however, that the consultant who was on hand on Monday night to assist the Chair of the Retention Committee in the presentation was the consultant from Bracebridge and not the one hired and paid for by Huntsville. I cannot help but wonder how that is in the best interest of our community?

Since Monday, I have felt somewhat alone in the wilderness in thinking that the proposal presented to the joint Council Meeting was a very bad deal for Huntsville. I was surprised at the mild audience reaction at the presentation and the complacent comments I have heard since. However, since Dr. Mathies has spoken out, others have too and I am told there are efforts underway to mobilize the community once again. We are going to need that.

One issue that has been dealt with through all of theses deliberations is what appears to be a reality that two fully equipped acute care hospitals in Muskoka cannot be financially supported and will never be approved. If that is indeed the reality, then I would support the concept of a single-site hospital equally accessible to all of Muskoka before I would support a proposal that would effectively subordinate one community to the other. We cannot allow that.

 

26 Comments

    • Huntsville does not have to sacrifice in this! There’s the original plan to build a new state of the art hospital within the town of Huntsville municipal area. Great for the taxpayers of Huntsville and pretty darn good for all the other areas around us.

  1. Darrell Secord on

    I have been watching this saga from afar for sometime with great interest. I’m not really sure why the public would want to travel farther for services than they do currently. I was looking forward to moving back to my hometown of Huntsville……. But with the proposal to decrease needed hospital services I am reconsidering. Any solution that limits health care in either town should not be considered acceptable.

  2. A good article Hugh. I have the feeling we’re dealing with the old shell game, if you keep moving the shells around and around one loses track of the nut. We’ve lost track.

  3. It seems to me that some of the hospital debate misses a key element. We have great doctors and staff, but the reality is that we have two undersized rural hospitals that are struggling mightily with the cost of the infrastructure required for the level of care that we should expect in the 21st century. We already drive to Barrie or Toronto for advanced specialized care. Many also drive south for shopping, car dealerships, airports and vacations, sporting events, etc. Personally I wouldn’t mind driving to Bracebridge for a surgery if it means a bigger, better-equipped hospital with more specialized surgeons (or whatever). What I am most interested in having locally is an Emergency Department, for the obvious reason. Hospitals are an emotional topic, but I don’t think it’s as simple or one-sided as some pretend.

    • Brian, I agree with you, up to a point. Where you lose me is location. Why Bracebridge? People from Gravenhurst would have the choice of 2 hospitals, but what about people living north of Huntsville? Have one hospital for surgery by all means, but it should be located in Huntsville

      • I would also favour Huntsville as the site: the point I am making is that I can see advantages to one site with the scale for more services. Sometimes a pair of convenience stores is fine, but sometimes bringing in a full-scale supermarket is even better.

    • The problem with your logic Brian is it misses the point of what’s required to operate an Emergency Department. You can’t have an ED without surgical back-up on site, this is a hard and fast rule. So if you move all of the elective surgery from one site eventually there won’t be enough work for the surgeons and anesthesiologists at the other. They will eventually retire or move away to where there’s more work and then your ED department closes. You cannot force a doctor to practice where they don’t want to because they can’t make as much money as they can elsewhere.
      You are correct when you state that we shouldn’t expect all specialized care here, but I don’t think that’s part of the current discussion.
      So you are right it is not simple or one-sided. There is a very real domino effect once you start single-siting services, particularly when the service has an emergency component to it, like obstetrics, for example.

  4. What happened to the proposal to have 1 hospital located in Port Sydney?
    Perhaps the better Huntsville strategy was to agree to a 1 hospital solution as MAHC and others recommended, and support the Port Sydney location. 1/2 of a good loaf would have been better than none.

    • Dave, the one site in Port Sydney does not have the support of the Province, District or local Municipalities. There is no appetite to put a new hospital in a ‘greenfield’ site where there isn’t any infrastructure currently. It’s too expensive and would effect the economies of the two adjacent towns where the infrastructure already exists.

  5. I agree Hugh…..this seems like the same proposal that was so roundly denounced a few short months ago. Obviously, the mayors and council see it differently now and I’ll be very interested to hear the how and why of the turn-around.

    A few problems with this proposal is that while two sites as they’ve been proposed may work in the beginning, but I fear it that it wouldn’t last.

    Doctors will go where the surgical services are and emergency patients will bypass Huntsville and go straight to Bracebridge (or the other way round) because surgical services go hand in hand with an effective ER. Once that happens it will become obvious that the second emergency isn’t well utilized and one of the towns will be downgraded to a walk-in clinic with shortened hours.

    With an aging population the lack of a hospital at least as good as we have currently could have a tremendously negative effect on people wanting to stay in Huntsville or – as one potential resident has stated here – move here in the first place.

  6. I agree with you, Hugh. Thank-you for speaking “truth to power”. We have been duped. After all the jargon and babble-gab, we are right back where we started. Site A will be an acute-care hospital (with surgery and obstetrics) and Site B will be a non-acute health-care facility (with geriatrics and rehabilitation and some clinics). Ambulances will bypass site B with all seriously injured or ill patients and it won’t be long before we won’t be able to justify keeping site B’s emergency room doors open after-hours. It will become a walk-in clinic with “stabilize and ship” capacity only. All the chatter at the council meeting about health hubs and health care campuses were little more than a diversion to fool the community into thinking that this is an issue that is too complicated for them to understand. We cannot assume that the LHIN and government would not approve a new, single-site regional acute-care hospital until we ask. If all stake-holders were in agreement, I think they would approve it. There is infrastructure money to be had and with all resources targeted toward the one goal including fund-raising on the part of several communities, it could be done.

  7. The question needs to be asked, as a community with superior health care services and a committed medical staff. Are we prepared to stand by and watch medical services diminish ?
    I certainly hope not.

  8. One thing that stands out to me is that when you travel Hwy 11 north and notice the population numbers, they increase as you go north. Huntsville is the major town by population and when you add the near north or south Parry Sound into that catchment area it should be obvious that if there is going to be a Site A and Site B, Huntsville must be Site A. As well, When you factor in Algonquin Park and areas like Dorset, Bracebridge makes no sense . A few minor twigs to the infrastructure, already planned, will ease access to the Huntsville Campus without causing any interruptions and we all know that there is room to expand on the “Campus Property”, already owned by MAHC in Huntsville while there is little room to do so in Bracebridge. This shouldn’t be such a difficult decision to make. Those of us living north of Huntsville are once again being ignored.

  9. Linda M. Kelly on

    Thank you, Hugh, for your poignant letter.
    Thank you, Jean Bagshaw, for your precisely accurate description of the big smoke-screen we were treated to last Monday. Health Care Hubs? Health Care Campuses? Please define a ‘Campus of Care’, if you will…
    Throughout the meeting, I wanted someone to define those 2 terms, but they did not.
    Site A / Site B…. As Mr. Murdoch said, it’s looking more and more like a big shell game, and we’ve lost track of the nut! Once again huge amounts of our money are being paid for some nice, well-educated, well-spoken experts to tell hard-working, honest, educated Huntsville citizens what will be best For us. Well done, but questions remain…
    God Bless Dr. David Allen. He proposed a single-site between these two towns, some 20+ years ago, does anyone acknowledge that? Real estate may have been more affordable then. He had the common sense and foresight to envision the future of Muskoka. A surgeon who dedicated most of his life to the people here !!!! Long before the ‘Amalgamation’.
    What of the many childrens’ camps, golf resorts, fair grounds, camps like Olympia located in the very rural areas around Huntsville, whose numbers swell to thousands during the summer months? What of the rural towns like Kearney, Emsdale, Novar, Burk’s Falls, Dwight, et al? And what about just the many lake-cottagers who come every summer.
    When an accident happens, God forbid, will it be acceptable to take the extra half-hour drive to Bracebridge because the experts say this is the most ‘cost-effective for our Communities’?? When a woman goes into labour, and perhaps the baby is in distress, will it be acceptable to ship her 30 min. to where there is a surgeon? How about a chain-saw accident? Head injury? Stroke? Drowning? To lose Huntsville’s emergency services is just unthinkable.
    In my opinion, we cannot afford to lose the wonderful surgeons we have in Huntsville, nor can we lose our Internal Medicine team. Same for Bracebridge.
    This should not be a struggle, between Huntsville and Bracebridge. That is absolutely ridiculous. This is about the safety and well-being of all people in both communities.
    The amalgamation of these 2 hospitals should NOT force us into any decisions that will jeopardize any people. Money should not out-weigh common sense and love for our fellow human beings.
    Please speak out, and stop this travesty.

  10. Hi Hugh – These recent events remind of a time in the mid 1980s when Ontario Hydro decided to build a Super Station in Bracebridge and close the Huntsville location, which by the way Huntsville served the area almost to Powassan. Representatives from Gravenhurst, Bracebridge and Huntsville were invited to go to Toronto to speak with representatives on Ontario Hydro. I, along with 2 Hydro workers, travelled to Toronto to attend the meeting. Well, it turned out that we were to make a presentation to the Ontario Hydro Board of Directors. What a surprise!!! Not for Bracebridge and Gravenhurst reps for they were fully forewarned and prepared. Once we were introduced we were asked which order we would like to speak. I quickly suggested that alphabetical would be fine with me…..giving Huntsville the last say….and allowing time to prepare some notes. The other towns presented well prepared overhead presentations supporting a Super Station at Bracebridge. We, Huntsville, decided to detail a sample day for a worker getting up and driving to Bracebridge to get the truck at 8:00 AM , preparing the tools for the day’s work and then driving to north of South River to work for the day…..with a couple of coffee breaks, lunch and the leaving for the trip back to Bracebridge to arrive at 4:30 PM we illustrated that the actual working time was not very significant….not very efficient!!!!! Well, a couple of months later it was announced that the Huntsville office would remain open, but they would increase the size of the Bracebridge office. Fortunately the local staffs that operate Ontario Hydro understand how to best serve the area, for over the last 30 years one can easily see that the Huntsville office has grown successfully as “Muskoka TS.” One just has to witness the activity at the Station across from the OPP on Ravenscliff Road to see the successful need for a Huntsvile site, while the Super Station never materialized in Bracebridge. The same will be true for the Hospital over the next 30 years, especially with the expected growth of Huntsville, along with Deerhurst and the area north of Novar.

  11. June and Tom Banks on

    We spent some time in Huntsvilie hospital last week, as my husband had pneumonia, and it may be old and getting a little worn, but the care of the doctors, nurses, and all the rest of the staff was wonderful. We need our local hospital, we are an ageing community and many people have no way to travel longer distances to get the care they need.

  12. I have not been shy, Hugh, about commenting when I disagree with you. In fairness then, I wholeheartedly support your views, with which I agree completely.

    Many respondents to your article have already expressed more eloquently than I possibly could, historical, financial, and logical reasons for either a one-site solution; or for Huntsville to be Hospital A. The latter would be totally counter-productive: It would destroy a very rare joint agreement between the towns, since Bracebridge was awarded the District government in 1972.

    Far too many external, financial and internal, personnel resources have been expended to date. It is well past time to simply choose a location for a new hospital; central to the summer population to be serviced. If that location is not serviced, so be it. There could hardly be a better time for infrastructure expenditure, with the Trudeau government rolling out $10 M a year for the next three years. Let the south have their transportation infrastructure monies: We have identified a more pressing alternative need for our LHIN. Not only would all the savings incumbent in an amalgamation accrue, but the two hospitals would no longer be in a widget-counting competition to acquire scarce financial resources from the province.

  13. I can’t resist adding just a few more points to the discussion.
    In my opinion, the Councils and the Hospital Retention Committee are voluntarily giving away a golden opportunity to have a new, centrally located, single-site hospital.
    Their Site A/SiteB proposal is like putting patches on the knees of a thread-bare pair of pants…the holes are covered but the fabric will soon disintegrate. By the time this proposal is implemented, technology will be so much more advanced that we will once again be having to address severe limitations to what we have just finished retro-fitting/expanding.
    If the government isn’t making sufficient funds available to maintain two buildings now, what makes us think that there will be sufficient funds for two buildings in the future? And when the funding is limited, to which site do we think the money will go? Not Site B!
    Business has said that it would be difficult to conduct business without a hospital. Well, with this proposal, if your community gets Site B, you won’t have an acute-care hospital, you will have a non-acute health-related facility.
    There is concern that development will be drawn to the single-site location and away from the existing towns, but I don’t believe that this will be a major problem. As long as there is an accessible state-of-the-art acute care hospital that is centrally located, all communities will thrive. Yes, we would have to keep roads cleared and ensure alternative routes and modes of transportation, but this can be done.
    It would be wise for the Councils and the Hospital Retention Committee to listen to the physicians, the hospital board and the hospital administration.

  14. The problem, Jean, is that a single site model is not supported by any planning department at any level of government, from the Province on down. The District will not allow a new facility on a greenfield at the expense of two existing urbanized towns that are already supported with existing infrastructure. It’s not only the cost of a new building, it’s the services it requires to run. It is simply too expensive.

    You state the government isn’t spending the money to maintain buildings now, but they never were. The money donated to the foundations can be used for this. Just like we saw for the Emergency Department in Huntsville recently.

    The problem is the funding formula we are forced to live under. The Ministry of Health knows it’s the problem too but the cupboard is bare. Foundation money cannot be used for operations so we are forced to look at rationalizing services to one site or another, but that may not even solve the problem.

    We are stuck between a rock and a hard place because rationalization can lead to the eventual loss of an Emergency Department as doctors move away to a more stable environment to practice in.

  15. So to add another piece of information to the conversation. I had a chance conversation with the internist on call at 3pm on Sunday, January 10. He informed me that he hadn’t had a chance to sit down all day so far. The ICU in Huntsville was so full that there were ICU patients admitted to Emergency Department beds. The ICU in South Muskoka Hospital was full as well. No beds available. This was a Sunday afternoon in January, not the middle of July!! I asked him if it was visitors or tourists in our ICU beds and he replied that it was all local citizens. So rationalizing services and cutting beds does not stop the fact that people are still showing up to the doors of our hospitals who are seriously ill that need medical help in a timely manner.
    We need to let the Province hear loud and clear that the funding model for MAHC must change. All of these other plans an ideas are simply re-arranging the deck chairs on the Titanic, I’m afraid.

  16. I have no doubt that given the chance to have whatever we want, both towns would opt to have a new acute care hospital in each town. If this was an option, I’m sure that we would already have the plans drawn up.
    It has been stated that a single-site model is not supported at any level of government, however if that were the case, why did our hospital board recommend a single-site acute care hospital?
    I am assuming that they have done research and are basing their recommendation on a plausible plan.
    I know that the foundation supports capital expenditures (as opposed to operation expenses) so imagine how much more we would have to spend on capital expenses if both foundations lumped all of their resources and efforts toward one common goal.
    Infrastructure would be a challenge to be met, however there are new “green solutions” to address waste disposal issues provided there is sufficient land. Most medical waste is picked up and shipped to a specialized waste disposal facility. There is technology available for water purification. It would require professional input from those in the industry.
    There is lots to consider and we need a positive approach.

  17. Sorry Jean, with all due respect, but your assumption that the board and the administration did their research in choosing the single site model somewhere between the current sites is where you are misguided.
    They did not.
    In fact that is why Mayor Aitchison, Mayor Smith and other Mayors in attendance delegated to the LHIN Board last September, to simply state that none of the affected municipalities were effectively consulted anywhere along the way in the process. This is why the LHIN set up the task force to try and find a solution other than the single site plan.
    The District has publicly come out to state that policies are in place to not let a new greenfield hospital happen. It is simply not acceptable to any level of government, including the Province.
    Sorry to sound negative, but this is reality, plain and simple. To keep pretending that this option is still on the table is not productive and we should refocus energies for a solution that will actually work.

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