Listen Up! The other shoe has dropped

Muskoka Algonquin Health Care (MACH) has certainly stirred things up this past week with their announcement of plans for future hospital care in Muskoka and East Parry Sound.

There can be no question that this proposal is different from that which was promised several years ago, and it is understandable that some people will have their noses out of joint. 

But it is also time for a reality check.  

Clearly, the plan approved by the MAHC Board and supported by the provincial government was for two fully equipped acute care hospitals in Muskoka. There were many at that time who predicted not only that this would not happen but also that it was not necessary. Time and circumstances have proven them right. 

The reality is that given a number of factors including spiraling construction costs, increased interest rates, updated building codes, and serious post-COVID pandemic staffing shortages, two fully equipped acute care hospitals within 20 miles of each other are not feasible and are simply not going to happen. If that was not evident when the original commitment was made, it certainly is now. We can be angry about that, and we can play the blame game, but it accomplishes nothing.

What we need to remember is that were it not for the herculean efforts of then Bracebridge and Huntsville Mayors Graydon Smith and Scott Aitchison, working together to ensure hospital sites in both North and South Muskoka, we would now be staring at a single-site solution that would have effectively disenfranchised one of these communities.

The direct result of that, even in the face of necessary changes to the original model in order to stay within the province’s financial commitment which remains in place, is that a two-site solution is still both possible and viable. 

In my view, we should stop thinking in terms of two hospitals to serve Muskoka and East Parry Sound and think instead of one hospital with two campuses. This is the corporate reality of Muskoka Algonquin Health Care as it is for a number of other hospitals in Ontario.

The latest proposal by MAHC for hospital care in Muskoka and East Parry Sound may not be perfect but it recognizes the reality of both costs and available funding, and it provides between the two campuses in Muskoka two sites with emergency and acute care facilities and an overall hospital facility that is state of the art in terms of equipment and services, with minimum duplication between the two campuses.

Over the years, I have been quite critical of the MAHC Board for the manner in which they handled discussions, proposals, and decisions related to hospital services in Muskoka and East Parry Sound.  But with the exception of some transparency and communication issues, I am not this time. Indeed, they needed the wisdom of Soloman to decide how to divide hospital services between the two campuses in a manner that ensures one is not subordinate to the other, as well as the courage to do what had to be done. 

And therein lies the rub. The manner in which MAHC decided to allocate services to the two campuses was primarily to differentiate between ambulatory and day surgeries and those that require more extensive in-hospital treatment.

I can see where people in South Muskoka would have difficulty believing that both hospital sites have been treated equally when one has 18 patient beds and the other 139 beds. But ambulatory, diagnostic, and day surgeries do not require nearly the number of beds that longer-term, in-hospital patients do. 

On the other hand, the Bracebridge campus will be busier, with patients throughout Muskoka and East Parry Sound coming there for outpatient diagnostic and day surgery, services of which there were many thousands last year. 

I find it interesting to note that at their public meeting in Huntsville recently, the MAHC Vice President, Corporate Services, and Chief Financial Officer, stated that the new hospital facility in Bracebridge would increase their total space from the 139,000 square feet they presently have, to 175,000 square feet, but to my knowledge, similar information about the Huntsville site has not been released.

For those who have not seen the MAHC media release, here is the gist of their proposal: “The Made in Muskoka Healthcare model concentrates day surgeries and other outpatient surgical procedures, as well as most outpatient exams such as non-urgent imaging, within a leading-edge Ambulatory and Surgical Centre on a new location in Bracebridge. The 24-7 emergency Department activity would be supported by full diagnostic and medical specialist support, 14 inpatient beds in single patient rooms for short stay admissions (up to 72 hours) and four Intensive Care Unit beds. The model envisions surgical expansion including orthopedic joint replacements in the future, closer to home.

Inpatient care including obstetrical labour and delivery is concentrated in Huntsville with 139 beds for acute care for longer stays, the addition of specialized rehabilitation care to help patients recover from stroke locally and new reactivation care to ensure patients leaving hospital are equipped to transition home successfully. Also, a higher- level intensive care unit, growing to 10 beds will keep more advanced critical care patients in Muskoka. Just like in Bracebridge, the 24/7 Emergency Department also has access to surgery and full diagnostics. Magnetic Resonance Imaging (MRI) services for the entire region are also included.”

Although it was not mentioned in the MAHC media release, and I have not yet been able to confirm it, I have been told that chemotherapy and dialysis will be available at both campuses. 

One significant problem, as I see it, is that the MAHC Board has not been as transparent about their overall plans as they should have been. For example, they have a job to do in reconnecting with municipalities within the region to explain why there was no transparency about changes they knew had to be made to the original plan when asking for local financial support.

Also, the Board has said that there could be some “wiggle room” in their proposal but they have not said what that would be. Does that mean, for instance, that Bracebridge could be given some additional beds to more effectively carry out the job they have been asked to do, without affecting what is required in Huntsville?  If so, why not just say that?  

I have spent almost my entire career in the field of communications, and I do believe that a strategy for effective communication, including transparency, was somewhat lacking here.

On balance however, it is my view, given the demographics and the statistical and financial realities of providing excellent hospital care to the Muskoka region, that both North and South Muskoka have been treated fairly in a manner that provides state-of-the-art hospital care in Muskoka and East Parry Sound within a model that the province can financially support in a climate where two totally equipped hospitals within twenty miles of each other is clearly no longer in the cards.

There is a long road ahead of us and the province still has to approve this proposal within the financial model they previously agreed to. In my view, we have two choices. We can work with the MAHC Board to fine-tune their proposal without penalizing either North or South Muskoka. Or we can fight it tooth and nail to the point that the province shrugs and directs their financial commitment to the many other priorities for hospital care in Ontario.

I know which one I would choose.

Hugh Mackenzie

Publisher

Hugh Mackenzie has held elected office as a trustee on the Muskoka Board of Education, a Huntsville councillor, a District councillor, and mayor of Huntsville. He has also served as chairman of the District of Muskoka and as chief of staff to former premier of Ontario, Frank Miller.

Hugh has also served on a number of provincial, federal and local boards, including chair of the Ontario Health Disciplines Board, vice-chair of the Ontario Family Health Network, vice-chair of the Ontario Election Finance Commission, and board member of Roy Thomson Hall, the National Theatre School of Canada, and the Anglican Church of Canada. Locally, he has served as president of the Huntsville Rotary Club, chair of Huntsville District Memorial Hospital, chair of the Huntsville Hospital Foundation, president of Huntsville Festival of the Arts, and board member of Community Living Huntsville.

In business, Hugh Mackenzie has a background in radio and newspaper publishing. He was also a founding partner and CEO of Enterprise Canada, a national public affairs and strategic communications firm established in 1986.

Currently, Hugh is president of C3 Digital Media Inc., the parent company of Doppler Online.

Don’t miss out on Doppler!

Sign up here to receive our email digest with links to our most recent stories.
Local news in your inbox three times per week!

Click here to support local news