Ontario Health Coalition Lessons from Niagara Health System Restructuring Plan and Process

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Ontario Health CoalitionLessons from Niagara
Health System Restructuring Plan and Process

• Process
• NHS required by LHIN to submit a Hospital
  Improvement Plan (HIP) to eliminate the NHS
  deficit (running at 15 - 17 mill. /year
  projection)
• HIP recommends major centralization plan, inclu.
  closure of Port Colborne Fort Erie
• LHIN brought in external advisor Dr. Kitts.
• He presented his recommendations (extend hours of
  operation for Urgent Care Centre but close more
  hospital beds faster).
• Oral version of report given days before written
  version put on website give communications lead
  to LHIN
• NHS ammended HIP to adopt Kitts recommendations.
• LHIN voted to approve the ammended HIP.
• Glitch because of local advisory boards from
  small hospitals.

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Lessons From Niagara Health System Restructuring

• No vision for small and rural hospitals
• NHS vision anemic
• Dr. Kitts vision non-existent
• 2. Government broke promise not to close small
  and rural hospitals
• 3. Centre of Excellence re-defined to simply
  mean centralization

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Lessons from Niagara Health System Restructuring

• 4. Rhetoric about listening to concerns about
  transportation infrastructure, lack of primary
  care etc. No follow up. No plan. No money.
• 5. Misalignment between infrastructure planning
  and hospital service planning.
• 6. No capacity for remaining hospitals to serve
  local population.
• 7. No consultation with CHC, region.
• 8. Download of costs to region transportation,
  EMS.

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Lessons from Niagara Health System Restructuring

• 9. McGuinty has not understood the direction of
  the MOH Restructuring mis-aligned with
  findings of MOH on small and rural hospitals
• Policy made on the fly, budgets set purposely
  but there is little policy and the plan is
  evolving
• 10. Vision of highly centralized/specialized
  hospitals has won out
• 11. Consultation process already a done deal
• 12. No legislative debate, parliamentary process
  etc.
• 13. No policy to set a floor ie. protect rural
  access, protect patients from being downloaded

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Lessons from Niagara Health System Restructuring

• 12. Budget cut driven process cloaked in
  rhetoric of quality of care and safety
• 13. Urgent Care Centre is not a hospital, not
  in the Public Hospitals Act, no funding formula,
  no policy
• 14. NHS financial projections implausible,
  utilization projections implausible (projects
  declining ER use, shorter length of stay, and
  implausible reductions in ALC need)
• 15. Plan is slated to cost tens of millions to
  implement but all the savings are implausible

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Lessons from Niagara Health System Restructuring

• Minister of Health supports the closures
• Premier has been silent to date