The recent news that the MAHC Board accepted the recommendation of the Task Force is good news indeed. The last three years of spin, public meetings where no questions from the floor were allowed, and misleading information are hopefully behind us. Gone too should be any suspicion or animosity between the municipalities over turf and ‘site A – B’ locations.
Unfortunately—not so fast on the last point.
But what of the intervening years? The bitter reality is that until there is a significant change in the funding formula MAHC is very likely to be in perpetual deficit hoping for annual bail outs from the Ministry while rationalizing and cutting services we rely on so badly.
Interim Chief of Staff says all surgery should happen in Bracebridge
Currently the interim Chief of Staff is still in place, the very Chief who said publically three years ago that all surgery must pass through one door—and that door is in Bracebridge! Obviously, this does not represent the delivery of good, safe medicine for the community that doesn’t have surgical services under its roof. Where’s the guarantee that the related professionals that support surgical services are going to remain in the town that wouldn’t have enough work on a daily basis to support an Emergency Department in case of situations where surgery is necessary? They may stick around for a while, but soon will head for greener pastures and full-time employment.
On this very point there is a current situation in Bracebridge that hasn’t received much attention in the public domain. Central to a full-time operational emergency department, along with surgical services, imaging and a lab, is the Intensive Care Unit (ICU). This is the place where critically-ill patients (stroke, heart attack) who show up at an Emergency Department are admitted, to be looked after by Physician Specialists and specifically trained nursing staff.
But … Bracebridge currently has one internist
The Huntsville site currently has four internists. Bracebridge, in contrast, has one, who commutes from Toronto. Three short years ago Bracebridge had three internists, two of which left without having replacements lined up. What is important here is the on-call schedule. In Huntsville, the four internists are each on call one week per month. In Bracebridge, the one internist is on call for seven days and the rest of the month is covered by expensive locums (temporarily hired guns from other hospitals) otherwise Emerg shifts have no internist back-up coverage. This is critically important because all of these services are intertwined and rely on each other to deliver the vast array of services attached to our Emergency Departments.
Plastic surgeon spending most of his time in Bracebridge
Last week Doppler ran an article about a new Plastic Surgeon in the area. The article said he was working in Huntsville. However, because of a broken piece of equipment in Huntsville—that’s been broken for three years—he is, in fact, spending a lot of his time operating out of Bracebridge. I asked the Huntsville Hospital Foundation office to direct my Business Cares donation to replacing this equipment and was told that it’s not even on the capital replacement list!
So what’s going on? What is the status of recruitment of new Internists to Bracebridge? Why are they looking to move surgical services to a site with this ongoing situation? The reality is that Bracebridge has to recruit three new internists and have them all arrive at the same time. Recruiting one at a time won’t work because they will likely be made to take on more on-call shifts than they want.
As Hugh Mackenzie’s last opinion piece points out, the push to build a brand new hospital in Bracebridge will be strong given the challenges with the current location. We all remember Mayor Graydon Smith offering up a prime piece of highway-accessible land in the middle of the one-site debate a couple of years ago.
But without the ability to recruit and keep physicians it won’t really matter. The interim Chief’s opinion of where surgical services should reside won’t matter much either but in the ongoing push to provide a balanced budget some of these moves may prove too attractive to the MAHC administration and board to ignore. Ironically, this was the reason for the push for one central site.
Unlike the proverbial baseball diamond in the cornfield, a brand new hospital is not a “Field of Dreams.” If you build it—they may not come.
Tim Withey is the former Vice Chair of the MAHC Board, and is currently on leave from the board of the LHIN (North Simcoe Muskoka Local Health Integration Network ) as he pursues a seat at the District table in the upcoming municipal election.