Muskoka Algonquin Healthcare (MAHC) recently published the survey results in a report for its Hospital Redevelopment Plan & Taskforce (here is the link to that report). There are some very important messages to be derived from it.
Some top-level points of interest:
- 2183 responses were received over seven weeks
- respondent models (multiple choices were permitted) “supported”: 69 per cent for “Two Sites (not status quo)”, 13 per cent for “Two ites (One Outpatient/One Inpatient)” and 18 per cent for “One Site (centrally located)”
- a table of five “Likes” & “Dislikes” for each model
- key important criteria from responders included: reasonableness of travel time, meeting infection/safety requirements, retaining staff and physicians and accommodating future growth/change
As we called out in a previous commentary, the survey was clearly skewed against the option of maintaining what we currently have, two acute care hospitals, by stating it would mean continuation of single-siting of medical services for the sole purpose of cost cutting.
One concludes the survey was not so much about presenting full-option preferences to the community as it was about responding to pre-decided MAHC models. There are other signs of bias in the report, such as placing the feedback comment “funding formula is flawed” under the “dislike” column for only the Two-Sites model. The funding formula is a known issue facing MAHC today (identified by the government, for resolution), and until resolved, continues to be a problem regardless of the selected future model. Additionally, why were there no tabulated statistics published along with the Likes & Dislikes? Surely some were more frequently called out than others, and therefore, more important to the community.
Despite the skewing and flaws, it is still abundantly clear that the community expectations are for the two existing acute care hospitals to be retained. Surprisingly, this clear message wasn’t even mentioned in the report, and worse, it was discounted, by stating: “It is recognized that this lack of clarity created some confusion, and the feedback received was not informed feedback rather largely opinions.” Dismissing the result in this way is not only wrong, it is insulting to those who responded to the survey, clearly implying that they don’t know what is important to them, and they are “uninformed”. This also seems to justify MAHC’s position on the need for yet more surveys in 2018.
All this leads to a key question: Has the community consensus changed, or does it confirm that the MAHC board’s first decision back in May ‘15 was flawed, because of not hearing or respecting the expectations of the community they serve? We believe the community’s preference has been very consistent all along.
Interestingly, signs are emerging suggesting the Planning Taskforce may now be leaning towards the “Two Sites (not status quo)” model. If true, what are the possibilities/probabilities of a MAHC pivot from its previous position? Following community resistance to its first decision, there was significant discussion about an A & B site solution for Muskoka. This solution has a site A providing full acute care hospital services, and a site B focusing on (potentially) urgent care, longer-term care and some outpatient services. In other words, one hospital (possibly new?) would be ‘designated’ the full-service, acute-care facility and the other would become a diminished facility over time, lacking acute-care services, against the wishes of site B’s community. This is essentially the “One Outpatient/One Inpatient” model, clearly rejected in the survey.
Over the coming months, it will be important for communities to monitor and fully understand the implications associated with the deliberations of the Planning Taskforce. It will likewise be important that the community require MAHC to spend time in public consultation (listening vs. talking), to be fully transparent with all information of the Taskforce meetings (vs. minimalist updates currently being posted) and not to rush to conclusions unaligned with the community stakeholders’ consensus and expectations. Given their previous significant decision misstep, the MAHC board needs to get the process (including collaboration, and community support, etc.) right, and soon. We understand the Taskforce completion target has again moved out, now sitting in September 2018. The longer this uncertainty persists, the greater the negative impact to the community (business and community growth, hospital staffing, donations etc.).
All community members need to remain attuned to these issues during the months ahead, and ensure their interests and needs are being met.
Submitted by Dave Wilkin, (former) MAHC director, retired bank and IT executive and Ross Maund, (former) MAHC director, and career health services corporate executive.
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