Shirley Roebuck at OHC Hearings
Thursday, May 4

Is There Room in Ontario’s Health Care System for a Heart???

Small Community hospitals have always had close ties to their communities, and Sydenham Campus is no exception. People call it “our hospital” and flyers proclaim “we want our hospital back”!

People are emotional about the hospital. The Erie St. Clair LHIN and the provincial government state that the decisions they are making are not emotional, but rather based on facts and needs. They hire consultants and create panels to advise them of these facts and needs. Some experts are being dismissed, however: the members of communities all over the province. The communities are accused of being emotional and too close to the project. I would suggest to the LHIN and to Premier McGuinty that emotion is healthy, and that there are good reasons why communities are passionate about their local hospitals.

Friction between the community and the LHIN should not exist. We both believe that this community is in need of additional primary care programs. The LHIN is establishing a Primary Heath Care Task Group. An explanation of their function is 5 pages long. They are accountable to the LHIN, and the LHIN is accountable to the Premier. Our differences stem from our differing opinions. The LHIN believes that Emergency Rooms support primary care and we believe that our hospital is the heart of community health care and should be supported by primary care programs. ER’s are often the patient’s first point of access to the health care system; the ER directs clients to the appropriate follow-up care.

Timely access to care is every Ontarians’ right. Small community hospitals and their ER’s are becoming expert in the stabilization and transport of critically ill clients. Rural EMS services are being upgraded; nurses and physicians are educating themselves in the necessary skills to help these clients. In 2006, the Canadian Association of Emergency Physicians (CAEP) spoke to the problem of overcrowding in ER’s, caused by too few acute care beds, and intensive care beds. In 2010, the CAEP spoke about the needs in rural health care. They made many recommendations to improve rural health care; there was no recommendation to downsize or close small community hospitals, just to improve them.

Locally the Sydenham campus has a large rural catchment area, servicing south Lambton County, the First Nations Walpole Island community, and northern Kent County. The priority for critically ill patients or trauma victims is access to emergency care, well within the “Golden Hour”, a term used by health care professionals to that first all important hour, after an incident, to ensure good outcomes to potentially fatal situations. Every nurse work works in the ER can tell you about cases like these, where the Sydenham team received, stabilized and transported critically ill /injured patients, resulting in good outcomes, which means survival, and a return to their lives.

One reason that the LHIN and CKHA is looking at changing the Sydenham ER into an Urgent Care Centre is overcrowding, The LHIN speaks about “having the right place, right treatment, at the right time”. The CAEP recently spoke again (2010) about overcrowding and stated that overcrowding is a systems problems and is the result of inadequate acute care beds and Intensive Care beds. They said that ER’s deal very efficiently with non-urgent patients; scientific literature does not support that ER’s are clogged by non-urgent clients. Finally the CAEP notes that the solution for overcrowding in ER’s is restoration of reduced bed capacity and urges the government to rectify their mistake. The Ottawa Sun, 2010-02-27, reported on the growing crisis in Ottawa, where 2 out of 3 hospitals cancelled surgeries due to lack of beds. There are reportedly many elderly clients in hospital beds awaiting a nursing home bed as well as an outbreak in gastrointestinal symptoms; the backup in discharging patients has led to 14 out of 20 ER stretchers filled with patients waiting for a hospital bed.

To bring this problem into local focus, we only need to look at developments at the Sydenham campus; the acute care, medicine unit was closed, with 5 beds left on the continuing care unit for admissions. There has recently been a severe lack of beds at the Chatham campus of CKHA, leading to admissions of active patients into Continuing Care beds at Sydenham. This is a patient safety issue, as this unit does not hold the correct staffing mix or numbers to take on patient loads with unsure patient outcomes. As concerning, is the use of the “time consideration” or “critical by-pass” practice. This is something that an ER will do, when they have no more capacity to accept patients other than critically ill patients. A recent article in the Chatham Daily News stated that on average the Chatham ER has been on time consideration 3 times per month, or 36 times a year. In reality, the Chatham ER has gone on by-pass 33 times since September, 2009. That translates to more than 5 times a month. Patients are waiting in ER for an admission bed to come available, causing over crowding and longer patient wait times.

The Registered Nurses Association of Ontario (RNAO) has recently created a challenge for Ontario’s Political Parties, which they shared with a group of politicians, in January, 2010.The RNAO, Ontario’s registered nurses professional body lists many priorities for health care. They speak in favor of proper funding to small community hospitals, and to keep the small hospitals a vital part of Ontario’s Health Care system. I enclose a copy of this report for you, as the priorities are too lengthy to discuss at this forum.

Many will point to the poor economy, and say that Ontarians cannot afford to pay anything more. The Liberal MPP’s are fond of telling the public how much money is already being spent. The facts reveal how much less money is spent in Ontario than the other provinces. We believe that more money is not needed. The present funding should ensure the continued existence of small community hospitals, if the spending were directed at patient care. The Toronto Sun, 2010-02-18, reported that dramatic jump in six-figure salaries at several LHIN’s in the province. The article quotes Tim Hudak, the provincial Tory leader, saying that the LHIN’s bureaucrats, middle managers and Liberal–friendly consultants are getting rich. Mr. Hudak also said that it was well known that Dalton McGuinty was pulling the LHIN’s strings from behind the scenes. The CBC reported on 2009-10-07, that the provincial auditors report “castrated the government and the senior management of e-Health for wasting nearly $1 billion dollars of tax-payers’ money over the past decade in a failed attempted to create an electronic health record system.” The NDP has also been very vocal about the mis-management of health care dollars, and is a leading supporter of public health care, and the retention of small community hospitals and ER’s.

In closing, I would like to thank the Ontario Health Coalition’s panelists for coming to Wallaceburg. We have been trying to tell our story for well over a year. Our communities wishes you only good luck and good health, but if tonight any of you feel unwell, go see the ER team at Sydenham Campus. They are the HEART of our healthcare.