by Michael Erskine
LITTLE CURRENT—The board of the Manitoulin Health Centre may have learned that the corporation is in good financial health during its recent annual general meeting, but the elephant in the room lay tucked behind the comments of hospital CEO Derek Graham regarding provincial realignment efforts.
Coupled with the general focus of the Drummond Report on service delivery through service clusters in larger urban areas, the threat to local health care and small community hospitals appears to be more than just idle worry.
“Tomorrow will redoubtably bring difficult challenges,” Mr. Graham reported. “Healthcare budgets will continue to come under the microscope and funding will not grow as it has in the past. In fact, it is likely that our global budgets may be frozen for some time to come. However, there is a solid and committed team in place at the Manitoulin Health Centre and this will be the basis from which we shall meet these challenges. We shall continue to provide compassionate care, close to home,” he said in the conclusion of his report, drawing attention to the verbal focus on the restructuring efforts of the Northeast Local Integrated Health Network (NE LHIN) and two recently publicized reports on those efforts in other Northeastern Ontario catchment areas.
“There is some interesting reading in the proposed realignment plans for Cochrane and Temiskaming Districts,” said Mr. Graham.
The reports in question were released following a lengthy community and stakeholder consultation process in both regions. Some 250 representations were made during the engagement sessions held by the NE LHIN in Englehart, Kirkland Lake and Temiskaming Shores during March of 2012, while there were 13 such sessions held in June for communities including Hearst, Kapuskasing, Smooth Rock Falls, Cochrane, Iroquois Falls, Matheson, Timmins and Chapleau where some 650 residents came out.
The rationale of the Cochrane exercise was “to create a less fragmented and more patient-focused continuum of care and realign the current 45 NE LHIN-funded health service providers in the Cochrane Hub into clusters or regional provider networks, as appropriate.” A graphic in the report shows the 45 health service providers currently operating in that district rationalized into 20 agencies by 2014.
Similar objectives can be read into the NE LIHN report for Temiskaming District.
The facts outlined in the report range from bleakly stark demographics, as the population is declining across the Northeast, down 13 percent in the Cochrane District, while it is up 20 percent in southern Ontario; disturbing inefficiencies, such as noting that 100 of that district’s 426 beds have no patients in them on any given day; and the statement that fully 25 percent of the cost of hospital budgets in the district are eaten up by administrative and support services. Another disturbing commonality is that existing hospitals are part of a crumbling infrastructure problem facing communities across the Northern and rural regions of the province.
The general conclusions of each report indicates a rationalization of administrative functions in health delivery and a better focus on appropriate levels and types of care.
“The LHINs do not have the legislative authority to make many of these decisions (to rationalize services),” said Mr. Graham. “Only the Ministry of Health can force this framework plan. We will have to see in what form this gets adopted here. I have started to dialogue with other CEOs on that.”