Listen Up! The numbers support the recommendation for two new hospitals



Hugh Mackenzie
Huntsville Doppler

The Politics of Fear

I do not often write about the same subject two weeks in a row, but this week I am making an exception.

There has been a great deal of talk over the past few weeks about the recommendation of the Task Force appointed by Muskoka Algonquin Health Care (MAHC) which would see the eventual construction of two new hospitals in the District, one in Bracebridge and one in Huntsville. Many, but not all of these comments have been negative and most of those were based on information that, to put it as politely as possible, was inflammatory, scare mongering and not completely accurate.

We heard that the recommendations of the Task Force, if implemented, would result in crushing costs of over $200 million to people in Muskoka, that property tax rates would go sky-high, that the Provincial Government would never deliver on the proposal, that the recommendation for two new sites, now approved unanimously by the MAHC Board, was nothing more than a tactic by them to lure Huntsville into complacency while a new hospital was built only in Bracebridge, leaving North Muskoka in the lurch.  And so on.

Well, there is another side to that story. The research and recommendation of the MAHC Task Force paints a much different picture, especially in terms of cost to the local taxpayer. Here in a nutshell is what they have to say.
  • Renovation and needed expansion for the Bracebridge hospital would cost $285,973,400.
  • A new hospital site on new land in Bracebridge would cost $284,242,100.
  • Renovation and needed expansion for the Huntsville hospital would cost $284,149,000
  • Hospital replacement on current land in Huntsville would cost $295,889,600.
  • Based on the Ministry of Health formula, the total local share for two new hospitals is $129 million.
  • Current MAHC assets plus hospital Foundation fundraising would reduce the local requirement by $55 million to $74 million.

Here is the important part.

  • The remaining requirement for local taxpayers to shoulder is projected at $74,000,000.
  • The proposal is to raise this money, through a special levy over a defined period of fifteen years at a projected cost of $80 to $100 per year, per household in Muskoka.

Now, $80 to $100 a year per household, is not chicken feed. To some it would be a hardship.  But to me at least, it does put the question of affordability into a more reasonable perspective. It is also important to note that these numbers are not a bunch of fly-by-night calculations, thrown around by a group of people with no relative experience. The Task Force itself was made up primarily of Muskoka people with various expertise in areas of health care. There were blessedly few politicians. The Task force was also guided by consultants that had the confidence of the Ministry of Health and have a recognized expertise in estimating capital costs when it comes to hospital care. These people are not amateurs. They do know what they are talking about.

Second, the minute there is a more up to date, more technically advanced hospital in Bracebridge than there is in Huntsville, acute care services will begin to fall like dominos to South Muskoka. As I have said many times before, the number one priority in keeping two acute care hospitals in Muskoka, is to ensure that neither site is subordinate to the other. While renovation of the Huntsville hospital may be slightly less expensive, it will not keep us competitive and would make it more difficult to keep pace with the requirements and technology of an acute care facility over the next 50 years.

One argument I have heard more than once in recent days is that Huntsville does not need a new hospital. It is a fair comment, but here, in my view, is the reality.  First, if two hospitals remain in Muskoka it is next to inevitable that Bracebridge will get a new one. I have spent most of a lifetime involved in Muskoka politics, both from a business and an elected perspective. I know how effective Bracebridge has been in looking after what they consider to be their own interests. In this instance, they have again laid the groundwork, they have the clout and the connections, and they also have a substantive case to make for a new location. They will get a new hospital.

Now that MAHC has finally adopted an official position of equality between the two hospitals in Muskoka, I continue to believe that it is better to work with them, rather than against them. We are much better off on the inside, protecting our interests, than we would be fighting a proposal that will ultimately give us what we have been asking for.

We need to be at the table for a number of reasons.  Whatever the final outcome of the proposal that MAHC has endorsed, it is important to ensure that both South and North Muskoka are treated equally. It is also important to be there to resist any temptation to build one new hospital at a time. Under those circumstances, the chances of a second one following, would be in serious jeopardy.  We also need to be there, to ensure that acute services do not leak away from our hospital during the interim period. Further, we do not want to give the MAHC Board any excuse to depart from or water down their present commitment of equality between the two hospitals in Muskoka.

There is nothing to be gained by being frightened by the proposal that has been adopted by  Muskoka Algonquin Health Care. There is potentially, much to lose by starting a war. There will always be sceptics, there will always be problems, and there are miles to go before a firm direction for future hospital care in Muskoka is cast in stone. But, as long as there is a commitment to equality between North and South Muskoka, we can do better by working together.

I have had enough of the politics of fear simply by following the federal election. We do not need them here in Huntsville.

You may also be interested in reading Terziano in support of task force’s recommendation of two new hospitals and MAHC Board endorses recommendation for two new hospital builds.

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  1. Very good Hugh you do make a lot of sense I was one of the people asking just why we needed a new hospital in Huntsville . And now I’m wondering if we do get a new one just how much better off we will be in terms of acute care. Will we still have to go south for heart surgery and all the special things just as we do now or will we try and get the specialists to come to town. Last winter my wife had to go to New Market for heart surgery will this kind of thing be possible in a new hospital. I’m just wondering just how much better off we will be with a complete new hospital.

  2. Remember all of this is 15-20 years in the future.
    The figures will probably be 10X those amounts.
    What is built will depend on the government in power in the future.
    I probably won’t be here to see the outcome, but I can see one hospital
    built in the middle of nowhere on swamp land owned by some friend of a friend.
    It’s nice to dream and I do pray that the outcome is two hospitals. The need is there.
    Maybe in time our population will increase enough so that our votes mean something.

  3. What i dont understand is what was the point when the hospital was built to design it so it could be added onto easily and now its a sin to even think of that? Also if you have ever seen a union job come in anywhere near the amount that was quoted it would be very rare and i could say nigh onto impossible. We here in Huntsville apparently have the extra land and the hospital that can be retrofitted why cant we do that for alot less. You say 80 to 100 dollars per person well i dont think thats anything like accurate and think of the low income people and the seniors who 80 to 100 dollars even stretched over a year is quite a bit of money. I think the kindness of the more well off people who have donated money to the hospital is wonderful, makes me wonder what there opinions are on this whole fiasco.

    • To be clear, the people asked for 2 acute care facilities, NOT two brand new hospitals. People who are in opposition of your opinion are deemed “inflammatory” and have “fear based” facts, but I disagree.

      The Task Force is made up of professionals, however we cannot haphazardly dismiss what the other experts with direct experience in healthcare issues have to say either. They are not “a group of people with no relative experience” nor are they “amateurs” as you would like the public to believe.

      Further, if I am correct your figures ($80-$100 / household) are based on 2019 costs and NOT 2026 costs making the initial tax levy (and cost to build) far lower than actually projected. I find this very misleading to the public.

      People are concerned and rightfully so. If the province says no to 2 new hospitals, but approves one, there’s a very good chance Huntsville Hospital will be lost. There’s no need to sugarcoat that very real possibility. Upgrading/ expanding both current hospitals would perhaps remove that option which I’m sure “some” experts would agree.

      On a final note, there are far more people who oppose 2 new hospitals (Hugh you said so yourself) than those who are in favor of it. That in itself should say something, but no one is Listening to the People.

  4. This entire discussion sickens me. We have all seen your quoted financials before, Hugh; right down to the $80 per annum over 15 years. But this is not your grandfather’s healthcare system: with the Tories’ continued austerity program, the concept of two new hospitals is unsupportable. I’m tired of crying in the wilderness about all the additional costs accruing to a new Bracebridge hospital which have been assiduously (and politically) ignored. Suffice it to say, that they are substantial.
    Ms. Tebby’s points are all extremely well taken. Two brand new hospitals, 20 minutes apart, to support an insignificant population, is just not on. If we propose to build out in Bracebridge, and up in Huntsville, I would think the new figures are highly likely to be acceptable to the province. This hodgepodge is likely to elicit one of 3 responses: 1) wait another 5 years (until after the next election); 2) only build the new hospital in Bracebridge; or 3) revisit the “brownfield” property in Port Sydney as a mutual site.
    As they say in the stock market: the bulls get some, the bears get some, but the pigs get nothing. An over-ask is destined for failure.

  5. The technologies and flow of operations in a state of the art hospital is vastly different than in hospitals that are 43 and 65 years old. Having spent 40 years planning and managing both renovations and new builds in an industry that changes something every year, I can tell you that degree of change is much better implemented in a new build. The external costs of disruption, extra cleaning and noise reduction over 3 to 5 years of renovation would be in the millions. Also, the existing buildings and land can be repurposed to generate substantial revenue that is not yet included.

    As for the local share, a $100 dollar per year special levy for an average assessment would turn out to be $50 (case of beer) for some and $200 (golf and dinner for two) for others. Totally doable. Whatever the final outcome there is no downside to starting that local share fund now. And starting it now is the best way to show community support for the MAHC task force recommendation. Community support is the first criteria the Ministry of Health will look at. Without community support, any proposal will not get past first base. We want two modern hospitals and that is what we got. It’s time to give strong support to the thousands of hours the task force has given voluntarily to this project. Where were all the naysayers when the task force was recruiting volunteers?

    So I after a great deal of thought and hours personally working the numbers, my experience tells me the the task force recommendation is the right one. Hugh Mackenzie brings a political perspective that I do not have, but we are on the same page on this topic.

  6. With all due respect to Hugh Holland, healthcare infrastructure redevelopment is not similar to the development of private sector industrial plants. I have been on both public and private industry infrastructure projects and the two in many respects have opposite characteristics, priorities and financials. The complexities, processes and financing of Canadian hospital redevelopment projects can not be reconciled through the lens of the private sector methodology (perhaps with the exception of 3P projects). A quick detailed review of Ontario hospital redevelopment projects over the past many years will eloquently demonstrate that MAHC’s Stage 1B announcement is dramatically not aligned financially with any like communities. The gross capital costs whether stated in 2019 $ or 2024 $ are staggering with a corresponding staggering local taxpayer share. Hiding from the reality of a Hanscomb (MAHC consultants)
    gross capital cost stated in 2024 $ is $705,818,700 in a community of 61,000 full time residents can not be denied. Likewise their estimated local taxpayer share of $180,573,200 should not be rationalized as the price of an evening out. Too many are not being forthright and leading the community into a project well beyond the affordability of Muskokans.

  7. If Hugh’s numbers are anywhere close to reality then i think a new Hospital would be a good choice.
    There comes a time when renovating costs more than building new and another factor to consider in Huntsville is that the land is available, serviced and essentially ready to use, right next to the existing hospital. These are all advantages.
    No disruption of service would occur as the old hospital could continue to operate as the new one is built next door. After the switch over, then the old hospital could be renovated maybe into a much needed long term care facility. It has a wonderful site, is solidly built and as noted, has been designed to be expanded upon. With no operational constraints to contend with this building could be renovated more efficiently than if it had to remain a working hospital.
    We could end up with a new hospital, a long term care facility and the doctors office complexes all in one area. This would be a good solution.

    Another point that could be made is to consider if all the town’s currently supported expenses actually are needed and if they are as important as the hospital? When you see all the town vehicles roaming about, all the various areas of expenditure, one has to wonder if maybe a few cuts here and there could be the town’s equivalent of that $80 to $100 per year per person that Hugh speaks of. Possibly a few less mowing jobs on parks, a few less new trucks, maybe find a contractor who can do some snow removal a little cheaper than the town….. there have to be savings out there and these could be put toward a hospital, at least for a few years. Just a thought as when you think about it what is more important than a good hospital? It only takes one visit to emergency to gain an appreciation of the value of a good hospital and we will all get to this point at some time in our lives!

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