The mayor of Minden Hills Township, Ont., asked the area’s health board to resign Tuesday shortly after top officials presented a consolidation plan that includes the closure of the emergency department in Minden in June.
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On Tuesday morning, Haliburton Highlands Health Services publicly released its emergency department consolidation plan. Health board president and CEO Carolyn Plummer and board chairman David O’Brien presented the report during a special meeting with Haliburton County council, again reiterating “severe” and “ongoing” physician and nursing staffing shortages at both sites as the main reason to make the “very difficult decision” to close the Mind IS.
Additional staffing, space changes and parking are among the key areas of focus for the consolidation plan for the Haliburton hospital once the ER in Minden is closed June 1.
But Minden Hills Township Mayor Bob Carter, who has vocally opposed the ER closure since it was first announced April 19 citing a lack of public consultation, called the presentation “spin.” He questioned whether staffing levels will be adequately filled for the summer months with the closure just two weeks away.
Plummer said the hospital is still populating the June staffing schedule and that the summer months were being addressed, including accessing Ontario Health’s emergency department locum program, which is used as a “last resort” in the event of possible temporary closures.
But Carter remained skeptical.
“It’s almost inevitable we will have closures and we will not have an emergency department in Haliburton County,” said Carter.
He asked the board to resign after failing to wait for the results of a strategic plan.
“You’ve taken a fully staffed Minden ER through to September and beyond and have tossed that out and tried to put all your eggs in a single basket,” said Carter.
“We’re being asked to trust you; I’m having some difficulties with that,” he continued. “I will say to the board (chair) that the last time you were here you somewhat lectured county council on pecuniary responsibility.
“I submit to you that you not only had a pecuniary responsibility to the people of Minden and Haliburton County but you also had a moral responsibility. I think you failed on that.
“I find that completely unacceptable. I guess I would be asking for your and the board’s resignation because you have not serviced our community properly.”
Neither O’Brien nor Plummer responded to Carter’s closing comment.
Minden Hills Deputy Mayor Lisa Schell also agreed that neither ER should close, noting when the Minden site opened over 30 years ago it was built to accommodate the population at that time, which has since more than doubled to 7,000. It’s estimated the area’s population triples in the summertime.
“Now all those people have to go to a single ER during the busiest time of the year,” said Schell. “Forgive me as well for having zero faith that your plan is actually going to work.”
Municipality of Dysart et Al Deputy Mayor Walt McKechnie say he and Mayor Murray Fearey “aren’t gloating” about “their” hospital ER remaining open. However, he said he respected the decision made by the health board.
“We feel for everybody in the Minden area,” he said. “… but how would you feel if both of them were closed? I think we have to give credit to HHHS — it’s a decision I’m sure they didn’t want to make, and the Ministry of Health. But the decision had to be made and they must feel they could accommodate the ER in the county in the Haliburton hospital.
“I know people aren’t going to be happy with what I’m saying here but I’m trying to be realistic,” added McKechnie. “These decisions are made because there’s a lot of soul searching and thinking ‘how the heck are we keeping one open?’”
Carter quickly “corrected” his political counterpart.
“You said there was a lot of soul searching going on — I will remind everybody that the doctors, nurses, the other staff, EMS and the population was not consulted at any time before this plan was announced,” said Carter. “So the soul searching was an insular soul searching amongst a few people at the hospital and not total community which is what was required and brought us to this crisis at this point.”
The comments came after Plummer and O’Brien outlined the consolidation plan with a goal to create a “single, highly-focused emergency department” since running two ERs was “no longer sustainable.” Plummer noted that both sites’ emergency departments face the risk of multiple, temporary, short-notice closures, putting the community at risk.
“Because of the physician staffing (24-7) model that was set up at the Minden site, if the Haliburton (ER) had to close due to a physician shortage, the Minden site would be forced to close as well, leaving the county with no emergency services at all,” she said.
Plummer said the consolidation plan is based on an “emergency department closure protocol” initially developed in the fall of 2021 when HHHS was first faced with the prospect of multiple, temporary ER closures at both sites.
The consolidation plan will add a physician to serve from 9 a.m. to 9 p.m. to complement two other physicians who work from 8 a.m. to 6 p.m. and 6 p.m. to 8 a.m., respectively.
“This is a plan supported by our physician group as well as the Ministry of Health and Ontario Health,” Plummer said.
The new model will also add a third registered nurse to each current daytime and overnight 12-hour shift. The hospital also currently has a daytime registered practical nurse and a summertime registered nurse (11 a.m. to 11 p.m.)
The consolidation plan will allow access to an additional registered practical nurse overnight, Plummer noted. The summer shift will begin June 1 instead of in late June.
One charge nurse will also work during the day during the initial transition period.
“Staffing in both of these areas will be assessed regularly throughout the transition and beyond,” she said. “And we will adjust as needed.”
She said the plan will not result in job losses at either site but cautions the Haliburton hospital may see a “slight increase” in patient wait times.
“But I think establishing the fast-track, rapid assessment space and utilizing the second physician, we are hoping to keep any wait times for patients at a minimum,” she said.
However, Carter says the consolidation model essentially means 1.5 doctors per shift as opposed to the current one physician at each site. Plummer explained that depending on patient volume or time of day, there are not always two physicians required.
“And we are expected to be happy with that plan?” asked Carter. “I said to you before, hope is not a strategy, and to a certain extent, a lot of what you’re telling us here today seems to be based on hope as opposed to actual numbers and signatures on the line.”
The Haliburton emergency department will expand from nine to 14 to 15 patient spaces, including adding a third trauma bed, the plan notes.
The plan will also add a procedure/treatment room, a fast-track/rapid assessment room with an exam table and physician workspace, and laboratory space is also being expanded (shared between the ER and the inpatient unit).
Waiting room spaces will increase from 14 to 27, Plummer said.
Diagnostic imaging will remain “status quo” at the Haliburton site, Plummer said, while the Minden site will maintain bone densitometry and outpatient X-ray services, by appointment only.
Plummer also noted the plan will double the number of available patient parking spaces at the Haliburton hospital ER by adding 15 to the current 11. She said some of the space was made available as the Municipality of Dysart et al offered a portion of an adjacent medical centre parking lot for staff parking.
Options are also being explored for use of the Minden ER after June 1 once the transition is complete.
“We want to hear from the community on what might be feasible for the Minden site,” Plummer said.
Plummer said a task force will execute and revise the consolidation plan as required.
The Minder ER closure announcement has sparked public outcry, which has included several petitions with thousands of signatures (including a 17,000 petition last week) requesting a year-long moratorium being presented at Queen’s Park. An online Facebook group fighting the closure has more than 4,600 members.
Ontario Health Minister Sylvia Jones and Haliburton-Kawartha Lakes MPP Laurie Scott have both repeatedly said the decision to close was made by the health board in the “best interests” of the community.
More to come.