{"id":67167,"date":"2019-05-23T05:11:42","date_gmt":"2019-05-23T09:11:42","guid":{"rendered":"https:\/\/huntsville.dopperonline.ca\/?p=67167"},"modified":"2019-05-22T20:13:20","modified_gmt":"2019-05-23T00:13:20","slug":"a-balanced-and-phased-renovation-expansion-of-existing-hospital-facilities-is-the-best-way-to-proceed","status":"publish","type":"post","link":"https:\/\/doppleronline.ca\/huntsville\/a-balanced-and-phased-renovation-expansion-of-existing-hospital-facilities-is-the-best-way-to-proceed\/","title":{"rendered":"A balanced and phased renovation\/expansion of existing hospital facilities is the best way to proceed"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><strong>Is MAHC off-track again?<\/strong><br \/>\n<strong>By Ross Maund and Dave Wilkin<\/strong><\/p>\n<p>On April 29 the Muskoka Algonquin Healthcare (MAHC) Capital Plan Development Task Force published an <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.mahc.ca\/en\/about-mahc\/resources\/Future-Planning-docs\/Task-Force-Updates\/MAHC-Capital-Plan-Development-Task-Force-Update-28-April-29-19.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">Engagement Feedback Summary<\/a><\/span> of feedback provided by those who attended their March community information sessions on the hospital redevelopment options under consideration. As a reminder they are:<\/p>\n<ul>\n<li>three options for South Muskoka Memorial Hospital (SMMH) &#8211; 1. renovate existing\/expand; 2. new hospital on existing site; 3. new hospital on new \u2018greenfield\u2019 site.<\/li>\n<li>two options for Huntsville District Memorial Hospital (HDMH) &#8211; 1. renovate existing\/expand; 2. new hospital on existing site.<\/li>\n<\/ul>\n<p>We have previously <span style=\"text-decoration: underline;\"><a href=\"https:\/\/doppleronline.ca\/huntsville\/all-candidates-forum-huntsville-candidates-weigh-in-on-healthcare-and-future-hospital-debt\/\" target=\"_blank\" rel=\"noopener noreferrer\">written about this important topic<\/a><\/span>, and we find the latest survey results and their interpretation concerning. The survey garnered just 140 responses and showed some preference for new-build options, most obvious in the greenfield-site option for SMMH.<\/p>\n<div style=\"float: left; margin-right: 14px;\"><strong><broadstreet-zone zone-id=\"45658\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone><\/strong><\/div>\n<p>Subsequently, the Task Force determined the feedback showed \u201c<em>generally all options seem reasonable and meet the needs for future hospital care<\/em>\u201d. Our primary concern is that when the likely $110 to $120 million local-share cost is included, <strong>all<\/strong> the options fall into the $450 \u2013 $500 million total cost range. This was not made clear in the survey, (and with just 140 responses, the survey results are statistically invalid). Additionally, given the minimal differences in cost of the options, it\u2019s no surprise that a preference for new builds exist. Who wouldn\u2019t want a new house if it costs about the same as a renovation?<\/p>\n<p>The problem is obvious. This capital spend will create a local share burden to residents, businesses and foundations in the $110 &#8211; $120 million range, and constitute the largest single debt in the history of Muskoka. The resulting debt would significantly escalate ratepayer taxes for decades. Some may see spinoff benefits in large capital-intensive projects in their areas, but a half billion-dollar total cost is not aligned with the best interests of local ratepayers or the financial reality of our province today.<\/p>\n<p>Ontario carries a <span style=\"text-decoration: underline;\"><a href=\"https:\/\/occ.ca\/wp-content\/uploads\/2019-Debt-Report.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">gross debt of ~$348 billion<\/a><\/span>, constituting one of the world\u2019s worst sub-national debts. In 2018 the deficit reached $18 billion and the provincial government forecasts multi-billion-dollar deficits out to 2022 (that\u2019s assuming no recession, of course). The 2019 provincial budget allocates <span style=\"text-decoration: underline;\"><a href=\"http:\/\/budget.ontario.ca\/2019\/contents.html\" target=\"_blank\" rel=\"noopener noreferrer\">$17 billion over the next 10 years<\/a><\/span> for hospital infrastructure capital spending, a slight decrease. With 60 <em>major<\/em> hospital projects currently in the works, competition for this limited capital will be fierce.<\/p>\n<div style=\"float: left; margin-right: 14px;\"><strong><broadstreet-zone zone-id=\"45658\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone><\/strong><\/div>\n<p>The Task Force option-selection <em>decision-criteria<\/em> has not been published, however their recently published seven guiding principles overlooks what are arguably some of the most important considerations: equitable, affordable and reasonable. There is only one vague sub-point that is even related: \u201c<em>spaces that appropriately balance cost with need<\/em>\u201d under the Facilitates Operational Excellence Principle. We can\u2019t see how these principles meaningfully separate the various design options being considered. We\u2019ll have to see if the criteria are any better.<\/p>\n<p>By most measures, including demographics, growth rates, and scale, the costs of any of the options, as currently structured, are out-of-line. Today\u2019s financial climate demands that major development projects be grounded in financial reality. Expecting much more than what is necessary, affordable or fair (with-respect-to other provincial capital projects) is flawed. This approach only leads to more delays in getting <em>any<\/em> capital approved for our much-needed infrastructure upgrades, and further undermines credibility. We are now seven years into capital planning yet remain in only Stage 1 of 5 stages.<\/p>\n<p>A balanced and phased renovation\/expansion of existing facilities, as needed, is the only viable option and approach today. It is cost-effective, fastest to bring online, creates the lowest local-share cost and aligns with the fiscal realities of Ontario for the foreseeable future.<\/p>\n<p><em>Ross Maund and Dave Wilkin are business executives and former MAHC board directors<\/em><\/p>\n<p style=\"text-align: center;\"><strong>Don\u2019t miss out on Doppler! Sign up for our free newsletter <\/strong><span style=\"text-decoration: underline;\"><a href=\"https:\/\/doppleronline.ca\/huntsville\/dont-miss-out-on-doppler\/\"><strong>here<\/strong><\/a><strong>.<\/strong><\/span><\/p>\n<p style=\"text-align: center;\"><strong><broadstreet-zone zone-id=\"45657\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The latest survey results and their interpretation are concerning. The survey garnered just 140 responses and showed some preference for new-build options, most obvious in the greenfield-site option for SMMH.<\/p>\n","protected":false},"author":13,"featured_media":62613,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5],"tags":[26,205],"class_list":["post-67167","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-commentary","tag-breaking","tag-mahc"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v25.8 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>A balanced and phased renovation\/expansion of existing hospital facilities is the best way to proceed<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/doppleronline.ca\/huntsville\/a-balanced-and-phased-renovation-expansion-of-existing-hospital-facilities-is-the-best-way-to-proceed\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"A balanced and phased renovation\/expansion of existing hospital facilities is the best way to proceed\" \/>\n<meta property=\"og:description\" content=\"The latest survey results and their interpretation are concerning. 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