It’s been a long tumultuous journey, beginning in 2012, and now finally, MAHC has abandoned their flawed 2015 single-site hospital decision. I have been outspoken on this matter, serving first on the MAHC board for 2 years (immediately following the original 2015 decision), and then for the last year as an advocate speaking out for the community’s wishes.
It is prudent now to reflect on what happened, with a focus on things learned, and more importantly, what should change going forward so things don’t go off the rails again. The people won this battle, but the war for our hospital’s future continues.
Let’s recap. The original MAHC board decision to combine the two hospitals into a single-site disregarded the voices of most of the community, medical practitioners/physicians, and political leaders at municipal, provincial and federal levels. It took over 3 years to correct, but not without significant ramifications:
- valuable time lost – delay in getting into the provincial funding queue for much needed infrastructure improvements and upgrades;
- community uncertainty – negatively impacting hospital foundations and creating a drag on businesses and growth;
- and cost.
So, what was learned and what should change?
First, for the MAHC board. They didn’t listen to the community 3 years ago. Thankfully, they got the decision right this time, but were pushed there by the community, and it took far too long. Oddly, their most recent report (Stage 1A Decision Support report) highlighted two new key factors: 1) a Land Use Planning report and 2) community support now viewed as critical. Neither of these factors should have been new. The District told MAHC in 2014 that a centrally located greenfield site was a non-starter from a land use planning perspective (MAHC even acknowledged that position here) and previous thinking that community support was non-critical is hard to fathom.
Reportedly, this latest MAHC board decision was not unanimous, and it was made in a closed session. This is a concerning pattern as MAHC holds far too many critical board decisions out of public scrutiny. Further, the board is self-selecting, geographically imbalanced and unaccountable to the communities it serves, which leads to mistrust and mistakes. They need to acknowledge these flaws and move quickly to fix them.
Second, for the new Ontario government. Ontario’s hospital planning & funding processes and supporting bureaucracy is broken. Starting with community unaccountable hospital boards, running through ineffective and costly LHINs, and ending in a highly bureaucratic Ministry of Health & LT Care. Throughout all these layers, far too many highly priced consultants. MAHC just spent 6.5 years and multiple millions of dollars to arrive at a decision obvious to the community, yet we’re only part-way through the 1st of 5 planning stages. Hospital capital planning shouldn’t take decades to complete. The result is wasted tax dollars, long delays and community churn/disruption. Worse, we see continual service consolidations into larger urban centers, justified under dubious efficiency and cost-saving rationale. Politics far too often influences healthcare policy and funding decisions, mostly to the detriment of communities like ours.
Doug Ford won on streamlining government, accountability, respecting tax dollars and fairness. He now needs to follow through on his promises. What better place to begin than fixing the highly flawed hospital governance, capital planning and funding policies/practices. Over to our new Minister of Health, Christine Elliott!
Lastly, for the community. If not for a small core of outspoken and committed activists, medical practitioners and a few engaged political leaders, this 2-site decision would not have happened.
Their sustained efforts educated, energized, and mobilized the community. So, democracy worked, and the people scored a major win. Still, much remains to be done.
The next step (Stage 1B) is where site designs, locations and costs are defined. The high cost arising out of the total “new build approach” remains concerning. Once again, this approach drove costs into the $500 Million range (with a local share in the $140M range). As I, and others have pointed out previously, it’s unnecessary, unreasonable and unaffordable given our community statistics and hospital ages. It’s also out-of-line with other comparable hospital projects. Neither the Provincial nor Municipal governments are likely to approve such a large ask. If this thinking by MAHC and their advisors continues, the planning process will once again be unnecessarily bogged down.
The community must stay vigilant and engaged. Many of the same MAHC, LHIN & Ministry players that have been deaf or indifferent to the voice of the people remain in place. We now have the long overdue change at the provincial level. Although we had support from some of the mayors (Huntsville mayor, Scott Aitchison, in particular, for his unwavering support), too many locally elected officials were reluctant to speak out while the community rose up. Let’s hold them to account as well in the upcoming fall municipal elections.
By: Dave Wilkin, (former) MAHC board director, retired banking & IT executive, CAHHMA member
COMMUNITY ADVOCATES FOR HOSPITALS AND HEALTHCARE FOR MUSKOKA AND AREA (CAHHMA)
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