All County, All the Time Since 2010 MAKE THIS YOUR PRINCE EDWARD COUNTY HOME...PAGE!  Friday, December 4th, 2020

Proposed solutions to QHC deficit ‘unacceptable’, ‘flawed’ and ‘disappointing’

Councillors and a full gallery at Shire Hall got few answers from Quinte Health Care’s executives presenting “proposed solutions” to a $10 million funding gap for the corporation’s four hospitals.
Instead, Mary Clare Egberts, QHC president and CEO, and Katherine Stansfield, vice-president and chief nursing officer, were accused repeatedly of not answering councillor’s questions, and sticking rigidly to corporate bafflegab.

Mayor Peter Mertens said there is no argument that health care needs to change “because what’s happening now is not working. At the same time, where it is working is Prince Edward County – a model for this entire province.

“What’s most important to residents of Prince Edward County is the hospital. So they’re disappointed and discouraged. They raised $750,000 last year for new equipment. They’re feeling abandoned and let down now and I understand that,” said Mertens. “I think this whole process is flawed. The idea of things moving out into the community is the right idea – using the hospice, using homecare and using homes for the aged are all part of that picture and that’s where the province should have started. Where they provide the funding, put the pieces in place and demonstrate to us… we’re not trading one problem for another.

“What’s not taken into account often enough, is that we are a small, rural hospital. Not by our decision did we become part of the corporation but that is the reality. The province itself recognizes that small, rural hospitals are unique – the Napanees and the Campbellfords – and they don’t put near the same onus on them doing what we have to do here. So for us, at this point being part of a large corporate body should bring benefits but in fact it’s working against us.”

Egberts told council it’s analytical data that decides how many beds should be removed – five from Trenton, 11 from Belleville and nine from Picton – and that the reductions would likely start by April.

“When we look at those bed reductions, its very analytical data that has driven us to where the beds are being reduced,” Egberts said. “And I want to remind everybody that just because you have a reduction in beds, does not equate to a reduction in service, or a reduction in quality care.  So it’s not about cutting beds, it’s about ensuring the service is going to be provided in the best place for the hospital.”

“I want you all to hear we remain very committed to keeping a hospital in this community and to keeping the essential primary care services which is what it does currently provide in this hospital. We can’t move secondary level services here  i.e. we can’t move other beds here, but we’re committed to maintaining the service of your citizens in this hospital when that care can be delivered there. Secondary care, and very acute care, ICU care is going to have to be delivered in Belleville… We know this is difficult for everyone, and this is change, but I do believe at the end of the day this is a health care system and this is going to provide better care for this community, it’s just going to take us some time to get there.”

It’s that road to “getting there” that has the County’s 23 physicians concerned.

A number of the assumptions underlying QHC’s proposal are fundamentally flawed, and not evidence based, said Dr. Elizabeth Christie, president of the Prince Edward County Family Health Team.

She noted there is no capacity within the Community Care Access Centre to provide additional home care services. Though hopeful the CCAC is going to get up to four per cent in increased funding, “we actually don’t know if it will do anything more than help bridge existing demand without increasing services.

As a member of the steering committee of the ministry’s new “Health Links Project”, Christie said the program is in its infancy, has no funding in place, no project in place, and a business plan to be submitted to the ministry of health by mid-February, shows no indication of approval or when funds might flow.

Christie is also involved with Hospital at Home, an pilot project initiative of the family health team, with CCAC to provide full care to low acuity patients in their home. Christie said the CCAC has not confirmed its ability to deliver the core services and no funding has been secured.  “It’s a pilot project for the first rural Hospital at home in North America and deserves a pilot project and study before cutting beds on its back.

Hospice Prince Edward’s Nancy Parks also clarified that palliative care beds and residential hospice beds are entirely different and that QHC has no control whatsoever of funding for a residential hospice. “Although hospice has always had the support of QHC, it does not have any responsibility or any control for the funding that is provided for community health care supports, to which a residential hospice facility is… People must understand they are very different funding models. Beds cannot be diverted from QHC to a residential hospice.”

“As was said by the councillors, we are in a situation where I believe we’re putting the cart before the horse,” said Christie.

Christie also explained the calculation of bed cuts, in part, is based on a calculation of “conservable days” or the number of beds that might be available if you were able to get the length of stay down to a ministry determined benchmark.

“This causes physicians in Picton grave concern. It’s an entirely inappropriate foundation for making cuts to beds. In addition, the data is flawed. It’s a bit like a game that you have to play as a physician trying to know which diagnosis of the many that this patient has that you should put down on the chart so it gets on the medical record, so it gets on the data sheet, so it counts as a certain number of points, so it counts that the patient is allowed to be in the hospital for a certain number of days. It’s a very problematic formula.”

Christie questions the bed cuts.
“Bed cuts are euphemism for cutting people – for nurses, allied health staff, lab techs, pharmacists, physiotherapists – people who are directly responsible for patient care,” she said. “The bed cuts are the only concrete detailed cuts that are in this proposal and causes us a great deal of concern.”

She noted QHC should look at whether bed cuts, at all, are an appropriate way to save money due to an Ontario Health Coalition study in July 2011 titled “No Vacancy: Hospital Overcrowding in Ontario, Impact on Patient Safety and Access to Care.

In it, risks to patients from inadequate hospital beds included overcrowding, emergency room blockages, cancelled surgeries, patients on stretchers in hallways, inadequate staffing ratios/decreased quality of care; poor health outcomes, increased hospital acquired infections and increased mortality.

“Ontario has the fewer  beds per capita of any province in Canada (2.5 beds/1000 population),” she said. “Compared to 32 OECD countries, Ontario is fourth from the bottom, just above Turkey, Chile and Mexico.”

However, Christie said the focus should be on the positive.

“PECMH is a highly efficient, highly effective hospital with excellent camaraderie, excellent morale, highly motivated professionals who co-operate in quality of care and cost-savings efforts enthusiastically. We have great opportunity to build on the initiatives already begun by the PEFHT, staff of PECMH and PEC doctors.”

The ministry’s new Health Links program, to bring primary care providers together with other health organizations including hospitals, CCAC, mental health programs, hospice programs, etc., is beginning discussion of the initiatives with which it will proceed.

“Every one of the initiatives currently on the table are the expansion or copying of programs or proposals currently operated or planned by the Prince Edward Family Health Team,” said Christie. “And that demonstrates the ingenuity in this community, and enthusiasm to expand beyond the bridges to help other communities.”

The overall consequences of the proposal, she said, will result in significant deterioration in quality of care for patients, of doctors, loss of nurses, loss of the residency program with Queen’s University (must have inpatient and  obstetrics); difficulty recruiting doctors and a direct impact on the Prince Edward Family Health Team and its ability to continue to provide current services and proceed with new programs.

“PECMH is now, despite all the cuts in the past, a vibrant site. We have a wonderful opportunity in PEC to push forward with many ministry initiatives, but we need support of QHC, not to be taken out at the knees.

“We should be saving money for QHC by increasing the number of beds in Picton, increasing the number of scopes and other surgical procedures here, increasing our labour and delivery capacity. This way we can maintain and even grow the allied services, leading to better patient care, decreased length of stay, reduced re-admissions, collaborative efforts for improved community-based care. We have a great model of integrated care now. This proposal risks crushing that.”

Christie said the physicians of the hospital and the family health team were given the proposal two weeks ago.

“We have been in discussions and attempting to get more information in more detail and we will be engaged with QHC to the extent we are able and engage in the discussions in good faith believing as we have been told that no final decisions have been made.”

Christie presented an extensive list of information needed for physicians to be able to provide appropriate suggestions and alternatives.

“We need details of how the funding formula justifies the proposed cuts to Prince Edward County Memorial Hospital and the evidence basis for these cuts. We need details of the six committees created to advise senior management. There were no Picton physicians on any of those committees.”

Egberts told council QHC understands.

“We all agree that these changes are happening very fast – probably too fast. And we have to know that the services are going to be in the community as we’re moving the supports there. We 100 per cent agree with you and we’ve been having discussions with the LHIN and I’m about to begin discussions with the Community Care Access Centre that they have to be there lock-step with us and if we are going to be held to our budget reductions and we have to transfer services into the community, they have to be there to pick up those services.”

Egberts said a 12-bed hospital is viable and the reduction in beds would not affect plans for a new hospital, “the future model that we believe in, with the Family Health Team and the community support services working with the hospital  to provide the full care for all of the patients in this region… We need that new hospital here in the County. We would all like to stay where we are. It’s not realistic. That hospital is not up to today’s standards for what we need. But, the new model that we want to build is exactly what this province needs and is exactly what this County needs.

“We had a meeting just this past week with Family Health Team and QHC meeting with the LHIN to say what are the next steps to moving this model forward. It has not changed because of the change in the beds. A 12-bed hospital is very viable hospital and will provide the care needs of this community. We are awaiting the LHIN for the next steps.”

Mertens shared a story of a conversation he had with an 87-year-old Wellington resident who told him she will not drive to Belleville for treatment. “She told me. ‘If I have to have a procedure, I’m already stressed enough. Don’t stress me further by having to drive there, find parking, pay for parking, go into a large facility that I get lost in. Don’t do that.’ And I think she’s absolutely right. I think it’s not always just about dollars and sense. It’s remembering a rural community, with rural needs, an aging population and it’s about respect.”

Former mayor Leo Finnegan spoke of the joyous occasion October 14, 1958 when the ribbon was cut on a brand new 58-bed hospital in Picton and on Feb. 24, 1965 when a new 40-bed wing was opened, bringing the bed count to 98.

“In the 70s the cuts started to take place and in 1998 when we were forced to amalgamate with Trenton, Bancroft and Belleville, there were 38 beds.” There are now 21. The proposal brings the number to 12 – just three more beds than when the first hospital opened in 1919 with nine beds.

Finnegan was elected to the hospital’s board of governors in 1991 and served as chair from 1994-1997.

“Generally speaking, our books were balanced, we spent money as it became available… We raised money through a myriad of sources, and are still doing that today.

“You can all recall the many times we have had to have town hall meetings in the arena, the high school or in the United Church with crowds of citizens, sometimes 600-800 voicing their displeasure with the cuts that were taking place.

“Over the last three or four years I have attempted to take a proactive approach as a member of the hospital foundation, community person on the family health team and as an advisory member on QHC. I have participated in discussions about a new hospital 10 to 15 years from now, which I now think is make believe.

“As a municipality, Prince Edward County made a commitment to donate $750,000 to the Imagine Campaign and that pledge is 75 per cent completed. At the time I debated with chair Lyle Vanclief that we would donate the money provided there would not be any further cuts to our hospital. In hindsight, I should have stuck to my guns.

“I have lost confidence in QHC. The position they have brought forward is unacceptable. They say we have to change our thinking and trust the LHIN and the CCAC to be innovative. I say, put these alternatives in place, demonstrate they work, then come back and talk to us.

“I encourage you to voice your opinions strongly; write letters to the minister of health, MPP Todd Smith, the LHIN, and anyone else you think can help… How many times do we have to do this? I don’t know about you, but I am tire and fed up with being poorly treated by QHC.”

Former councillor Monica Alyea wants the QHC and the ministry of health to furthermore replace the word “Picton” with “Prinyer’s Cove” or “Long Point”.

“A cab ride from the Point is about $82 when I asked four years ago, so it’s probably closer to $100 now.”

She wants health minister Deb Matthews to participate in a fake heart attack, wait for first response… then the ambulance. “I know it’s called RR3 Picton, but it’s a long, long way…and longer to Belleville.”

Council accepted all the day’s deputations and has requested staff to report back on Feb. 12, with all implications to the County, possible actions and solutions the County could initiate.

 

South East LHIN
71 Adam Street
Belleville, Ontario
Canada K8N 5K3
(613) 967-0196
Toll-free – 1-866-831-5446
Fax (613) 967-1341
email southeast@lhins.on.ca .

Quinte Health Care
Corporate Headquarters
265 Dundas Street E,
Belleville, K8N 5A9
969-7400 ext 2027
Fax: (613) 968-8234
email: info@qhc.on.ca
website feedback: http://www.qhc.on.ca/feedback-form-p1321.php

Contact information for Todd Smith, MPP

Belleville Office
81 Millennium Parkway, Unit 3
Belleville, ON
Tel: 613-962-1144
Fax: 613-969-6381
Toll Free: 1-877-536-6248
todd.smithco@pc.ola.org
Mailing Address:
PO Box 575
Belleville, Ontario
K8N 5B2

Picton Office
Unit C
The Armory 206 Main Street
Picton , Ontario K0K 2T0
Tel: 613-476-9616

Queen’s Park Address
Room 357, Main Legislative Building
Queen’s Park Toronto, Ontario M7A 1A8
Tel : 416-325-2702
Fax: 416-325-2675
todd.smith@pc.ola.org

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  1. Fran Renoy says:

    The song that appears on the Home Page of Countylive titled “Restructure This-The Prince Edward County Memorial Hospital Song is brilliant. Jeannette Arsenault. Janet Kellough and friends have done a masterful job in creating a song with humour that explains how important our local hospital is to us. This song will certainly lift your spirits. Under the song their is a direct link to QHC where you can leave feedback about the proposed service cuts at PECMH. Thanks Amber and Sue for posting so much information about our hospital.

  2. Mark says:

    Becoming part of QHC smelled from the very beginning. Amalgamations are all about the big fish swallowing the small fish and in this case Belleville General has got Picton on it’s menu. Everything is streamed towards BGH and it’s only a matter of time. Haven’t amalgamations been great in their promise of better services and lower costs!!

  3. Jan says:

    I think Mayor Mertens should be in talks with Mayor Williams to see if the 2 against 1 scenario can put the brakes on QHC and the almighty Goliath better know as BGH!! Trenton and Quinte West are just as upset and angry about this situation as we are!!

  4. Doris Lane says:

    I always wondered what happened to the Benson Bequest and other bequests that were made to Picton Hospital over the years Did QHC get this money
    Yes Steve it is too bad we cannot ditch QHC but I doubt it can be done.
    Dr Christie was a lawyer before she decided to become a doctor, a very clever person with a great background.
    Thank you for a great presentation

  5. County Steve says:

    This is a brilliant piece of writing on a very complex subject … good work Sue and Amber. It’s a news story that makes my heart swell with County spirit.

    Dr. Christie has earned a place in my list of Top Five presentations ever made.

    I can only hope that such a clear mind – gathering together facts, passion, dedication and cooperation – will not be overlooked by the money-crunchers and bean counters.

    Good points made all the way around – Mertens, Monica, and nice to see Leo Finnegan has grown a pair.

    I agree, nothing good has happened at PECMH since we joined QHC. Thanks to Leo for the neat comparison with our de-evolution to 1919. Sweet.

    This is an insult to everyone in the County – particularly the Women’s Institute, Hospital Auxiliary and the current Cornerstone Foundation – who have devoted their time and effort to keep our hospital thriving, not to mention the devotion of hundreds of doctors and nurses over the years.

    Dr. Christie offered the way out … put the back-up systems in place BEFORE the hospital is completely neutered … then we’ll talk.

    Call me a fool, but I have to ask the question: Is there any way we can buy ourselves out of QHC? Or have we signed a soul-contract with the devil?

  6. Doris Lane says:

    A great report and Dr Christie and mayor mertens have it right and the lady in Wellington has it right too.

  7. Fran Renoy says:

    Well done Sue. I attended this 3 hour presentation by QHC that consisted of comments by Mayor Mertens and council.There were also additional comments from the audience. Everyone was definitely on the same page. It was a wonderful feeling to see how proud and passionate all the speakers were of their local hospital.

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