‘WE LET THEM BE HEARD.’ SOUTH MUSKOKA BUYS TIME WITH SPIRITED OFFENSIVE ON TWO HOSPITALS MODEL

Mark Clairmont | MuskokaTODAY.com

BRACEBRIDGE — Ten minutes into the meeting MAHC laid its cards on the table when CEO and president Cheryl Harrison said the province told them “Muskoka was fortunate” a few years ago just to keep two hospitals.

A-hundred-and-10 minutes later MPP Graydon Smith doubled down — braking his own cone of silence — saying “we’re blessed and fortunate to be in the position we’re in” because Premier Doug Ford “cares about this area.”

That was the first of the night’s comments that drew guffaws from the crowd.

Smith told me later he thought it was important to speak up now because “the time element is important. It gives everyone a chance to draw a breath on both sides — ‘what have we heard.’”

In between, bargaining chips were strewn across the table and scattered over the Sportsplex floor in a community “engagement” boxing match observed under the guise of Marquees of Queensberry Rules.

Not surprisingly a lot is at stake — least of all $1 billion in capital construction next decade and a trillion dollars the following half century to operate “equal” or “unequal” halves.

Beneath banners depicting the history of the Bracebridge hanging over and looking down on them, the 300+ seated — and couple dozen standing including Smith — the much anticipated showdown went back and forth on the merits (MAHC) and the drawbacks (rest of the crowd) of the Made-in-Muskoka health care model.

Indicative of the mood, it started with Harrison failing to receive the courtesy of even               token applause for her calm 40-minute opening remarks, which explained in greater detail the gist of what some — but not all — previously knew about MAHC’s proposed model that severs services more with a hatchet than scalpel.

Mayor Rick Mahoney — who oddly was given a microphone platform to address the meeting as the Q&A began — seemed to have turned coat in the past few days since the Huntsville meeting where he was more on the fence and then willing to give the benefit of the doubt to hospital officials, saying then he wanted to make sure his constituents were heard.

Tonight he was more adamant in telling MAHC their proposal “misses the mark on a lot of areas. … There’s far too much at stake.”

And he wanted to make sure all his residents got their say.

But hundreds were left standing out in the cold literally and figuratively. Many didn’t even bother trying to get in when they found the community room full at 6:05 p.m. just minutes after the doors opened prompting a long line-up to form out front in a dream of getting in and getting a say. Undeterred many of them still debated the pros and cons huddled together.

Ironically, MAHC heard them banging on the windows and horns honking outside, and is now considering another meeting a different night in Bracebridge to allow those disenfranchised their right to speak.

The board certainly got what was coming to them, based on south Muskoka community brickbats they’d received in previous meetings and in a huge public hue and cry the past week across all south platforms.

Opposition here was swift, firm — and on balance disquietingly polite, if that makes any sense — as the board and staff had to have expected with most of those comments, statements and questions oft repeated last week.

All of which fairly bore repeating.

Though Harrison reiterated (as in Gravenhurst and Huntsville) she wished she’d had more opportunity for feedback by her and staff. Again proving the unwieldy format of pass-the-mic is unworkable and undemocratic. Only once or twice they have to pull the plug or tell someone to “sit down.” That last time it was George Chen, of Royale Muskoka.

MPP Graydon Smith breaks his silence on hospitals debate, urges both sides to take breath.

Dozens of arms shot up across the room to speak negatively as the interrogation began.

Most were thoughtful, direct and spoken they said framed their in the spirit of community-mindedness and building. But there was one small “boo” 16 minutes in.

Harrison said both hospitals will still have an ‘H’ on them, which drew more laughter.

“Babies” gave birth to another hot topic — the loss of obstetrics in Bracebridge.

Dr. Khaled Abdel-Razek said with only 87 kids born at South Muskoka last year and 180 at Huntsville it makes sense to move the OB north.

Harrison remained steadfast in defending the Stroke Centre at HDMH, citing a provincial mandate related to Central Ontario geography. Thus plans for the MRI there next year.

She said MAHC had looked at other comparative models and the new one is the best fit moving forward for “one hospital with two sites.”

Although her continued reference to “future” hip and knee and orthopaedic services wreaks of a Hail Mary attempt.

Both sides had handouts for walk-ins arguing their cases.

Alternative Level of Care got a fair bit of time. But Al Clark, of Bracebridge, couldn’t articulate his call for more LTC facilities to offset the load and he failed to gain much traction in calling on the audience to overturn the board.

“Who thought we could afford $1 billion?” The audience didn’t understand him and shouted him down. Mahoney even had to stand up and try to focus Clark to no avail.

Harrison said she had to “stress” the status quo doesn’t work.

Now that drew opposition from doubting doctors and nurses who shouted the comment down.

Harrison said January last was the original date for MAHC to submit its proposal to the Ministry of Health — who she said has told them “‘you have a good model.’ They will work with us.”

But she said the hospitals are willing to “take time” to get it right.

It depends on when they can get two opposing solutions together.

That appears certain to be spring at the earliest and fall if necessary she seemed to concede.

Another MAHC rep admitted “changes are being made” now.

Asked after what he thought of the meeting, “the Bee Guy” Jim Smith said “it was right full of you know what. It’s the government telling us what we have to do by their standards. But they sometimes don’t know what they’re talking about.”

It was sentiment shared by more than one attendee as they shuffled out into a cool Tuesday night at 9 p.m. with no solution in sight

Dr. Rohit Gupta, of Bracebridge, who penned the open letter by doctors, said he “hoped” officials heard the message.

“We certainly hope so. But we feel that they are just doing a formality and telling us during the meeting they are doing their due diligence.

“But we feel it’s a done deal and they don’t want to listen to us. We hope they listen to us.”

He said a planned meeting with doctors February 20 was a surprise to him today.

Does it open talks toward bridging the gap and a single solution?

“I have no idea yet. We haven’t got any email yet. They just told us today. So we’ll see what they want to say.

“They already know our stance. So I’m not really sure — there were 41 who wrote the letter. That’s all the physicians. So calling this meeting is going to make any difference? I’m not sure. We’ve already said everything.”

Nurses got a lot of love — with many of them on hand.

Erin Ariss, president of Ontario Nurses’ Association, came to say MAHC has cut the nursing staff.

“Nurses say ‘no’ to this plan. They’re putting their needs first and yours last,” she said of the overall plan.

“This community is powerful and the ONA is not giving up.”

Gravenhurst councillor Penny Varney, a retired nurse, supported her fellow colleagues and urged south Muskoka and Bracebridge not to give up the “fight.”

Or risk being like Gravenhurst she said that lost the Muskoka Centre and Ontario Fire College without provincial support.

That statement drew resounding applause.

Someone said “the community won’t be the same until there are two equal hospitals.”

Another asked how the 250 consulted in focus groups came up with the latest model when hundreds more this week and last oppose what’s proposed.

Abdel-Razek attempted to placate opponents by claiming that with south Muskoka the surgical centre would have 9,700 operations compared to 800 in Huntsville and that the Bracebridge site will have a larger physical footprint.

And that typically of the 25,000 people who present to emergency, only 8 per cent — or 1,200 — are admitted to hospital beds.

The meeting was almost hijacked when the subject of the Royale Muskoka property came up a couple of times. It was once MAHC’s “preferred site.”

Philip Wah, company CFO, was given a good five minutes to make his case about offering land and money only to be rebuffed. It’s a long story in which MAHC’s Alasdair Smith refuted that, saying its lands were considered too late but after analysis didn’t meet requirements.

It’s a long story, which at this point isn’t returning until MAHC ventures back down that road or is forced to. Wah, however, persisted in citing time frames that seemed to suggest hospital moves were executed that didn’t line up with exactly when decisions were made.

Wah concluded that if there are only going to be “18 beds,” why not keep the existing SMMH site?

Rick Stuthers asked if the board would “say no to a bad plan that lacks community support.” MAHC officials didn’t respond.

A Burk’s Falls woman was “irked” she’d have to drive to Bracebridge for surgery and wanted a “guarantee” the hospital in Huntsville would have emergency surgeons.

She was told it would 24/7.

Mark Robson, who said he had a health industry background, blamed part of the problem on “hurting” ALC beds. Solving that, he said, would help by creating more LTC facilities, which got an “Amen” from Clark.

Harrison said it’s not easy finding the right homes for those 30 per cent of patients in hospital needing home or LTC care after being rehabilitated.

“It’s not about the (number of) beds, it’s the use of them,” replied Harrison.

She added on the subject of sick patients who require even more care than MAHC’s two sites and ICUs can provide that they are regularly transferred to Orillia, Barrie and the GTA. A stat one ICU doctor disputed saying he’d only referred two.

Real estate agent Mary Gauthier expressed concerns about what the public believed last summer to be “two equal hospitals.”

She called the outcome a “bait and switch” that will hurt housing prospects and community growth.

Her main concern was about SMMH’s new location and wants the Royale Muskoka site reconsidered.

She called the outcome of the chosen  site at 300 Pine Street “a huge mistake,” after the town purchased it for from Fowler’s Construction for $1.6 million.

The land at 1975 Muskoka Beach Road, is in her opinion, the better location that would allow future growth nearby.

“Let Huntsville keep what it’s got and let Bracebridge have the bigger hospital.”

Kruger blamed government under funding.

Dr. Bill Caughey, a respected retired physician, said SMMH used to be “happy place” when he worked there.

But he said it is losing doctors and nurses for various reasons and will continue to do so if the new model is adopted.

His comments followed serious allegations about staff “gag” orders and “reprimands” for speaking out about model details.

Someone claimed SMMH has a “toxic work environment. Nobody is going to come to work in a toxic work environment.”

Dr. Tom Irvine, of Gravenhurst, found the meeting “interesting.”

He said he gets that the Stroke Centre needs to be in Huntsville — “it’s an Ontario thing. “But I think because the Stroke Centre is there they think the larger hospital has to be there. When I think it should be in the geographic centre, which is just north of Bracebridge (Hwy. 117) about the MNR. The Stroke Centre can still be Huntsville in the smaller hospital as long as they have an MRI. And that’s OK.”

He said he was “glad to hear Dr. Gupta and Bill Caughey speak.”

Because he was asked to make sure the doctors really represented themselves.

“And I’m glad that happened.”

District of Muskoka Chair Jeff Leeman said the two hospitals “can be equal, but not the same if that makes sense. I don’t think you can duplicate everything. I don’t think the system works that way anymore. The problem is you can’t staff two small duplicates of everything.

“But, and here’s where I think they’ve gone out of balance and why I don’t think it’s equal. This model has concentrated all the inpatient care in Huntsville and all the ambulatory care in Bracebridge. And there’s got to be a better balance because people are saying I’m going to be going to Orillia or Barrie,” said the former Barrie mayor. “And I’m not going to go up to Huntsville. And I want to know my hospital’s going to be there for me if I need to go in.

“An so when the physicians are saying you haven’t got this right, it is important for the hospital to sit down and listen and work out a better model. I don’t think for a moment they’re going to be able to duplicate everything. And I do think there’s going to have to be some specialization.”

Leeman said he had a meeting with the deputy premier Sylvia Jones who he told $225 million would be hard to raise in the Local Share. And we were told that’s the formula for everyone around the province with 51 hospitals projects across Ontario.

“My take is we shouldn’t be hurrying this and if the board has to say to the province you’ve got to let us take some time to work with our doctors and nurses. I don’t know if they can get more money or the Local Share could be anymore. But I will say that this model clearly doesn’t work for south Muskoka. And so they need to go back and hear people and come back with a better model.”

The district chair said he’s aware of the Ontario Health Premium, but he’s not sure everyone would be willing to ante up a few more bucks locally and provincially to cover soaring contruction and operating costs.

He said the reason the district committed $84 million is because hospitals are the top of the list.

“So what I heard tonight I’m not surprised people are upset.”

Board chair Mo Miller said after she wanted to “cry.”

Harrison said: “I think people just wanted to be heard and that’s what doing this now is about. We let them be heard and we’ll come back. Listen, we’re trying to follow a schedule. And if it works it works and if it doesn’t and we need more time just like Graydon said.

Is fall an option?

“You know what, I think if we just need to keep up with the engagement till we’ve got people who are feeling comfortable with where we are going. And you know what, if that’s six months, eight months, it’s the will of the people that want to have their hospitals.

“We just need to keep up the engagement.”

Already a coalition of opposition groups have formed led by Bruce Kruger, Phylis Ingram, Dan Waters and doctors to further inform the process and fight for their hospital.

Waters said he’s already got more than 1,000 signatures on his petition to stop the model.

He said he will give Smith the first right of refusal to present it to the legislature.

“If not I’ve got three other parties I can go to.”

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