A different angle

He couldn’t breathe. The pain bearing down on his chest was becoming more than he could stand. Every intake of air was work. The fit young man had had flu symptoms for days, but now it was worse. Much worse. The decision was made to take him to the hospital. It was 10 o’clock at night.

At Prince Edward County Memorial Hospital, he was assessed immediately. It was serious. He needed more care than could be provided there. Hospital nurses and physicians prepared the frightened, but stoic, young man for the trip to Kingston by ambulance.

He spent the next five days at KGH—two in the intensive care unit. A viral infection had begun attacking his muscles, heart and liver. He was very sick. But he had come to the right place. The hospital had seen this before. A young woman had had a heart attack a few days earlier as a result of a virus. In a bit of a fish bowl, he was never out of sight of the folks caring for him.

He is better now, although it will be weeks before his body recovers from the workingover delivered by this virus. He is lucky. And thankful. The system worked. As it should.

The experience provided another angle of view on our local healthcare system. One doesn’t escape this intense experience without a sense of immense gratitude for the skills, experience and technology that are resident in our community and beyond. Grateful that, despite cyclical interventions by bureaucrats and administrators determined to shed costs— and predictably looking in the wrong places—that our community hospital perseveres to provide the insight and knowledge to understand the array of symptoms presented to them each day. And respond accordingly. After this experienc, however, I wonder if I have been looking at our hospitals and the healthcare system the wrong way—from the wrong lens?

Pressures of an aging population, shortage of human skills and the increasing reliance on technology has driven escalating costs in our healthcare system. On this nearly all agree. How to respond is where opinions diverge. Provincial ministries and their emissaries on the ground have long pushed for the centralization of specialized services around a regional hub or the factory hospital.

I, and many others, have argued against this uninspired approach, primarily because it has led to the simple-minded destruction of very good services and care in our community— even as we recognize, and have always recognized, limitations to the care available, and appropriate in a community hospital like PECMH.

Over the last couple of weeks, however, I have come to change my thinking on this idea. I have encountered many other stories of great experiences at Kingston General Hospital, working in concert with PECMH.

So perhaps it is time to look at things differently. Perhaps it is time we embrace the notion that our specialized treatment and care will be centralized in a regional centre—where they can focus skills, technology and treatment options.

I mean fully embrace it. Let us consider consolidating specialized care in Kingston rather than Belleville. Doing this means we can relieve Belleville General Hospital of the responsibility and cost of maintaining redundant systems better delivered in Kingston.

Perhaps the full realization of the centralization doctrine is that BGH become a great but modest community hospital, just like PECMH and Trenton Memorial. In this way, vast swathes of facilities, costs and technology may be released to enable first-class primary care in each community, rather than fund a system that isn’t sustainable—a system that currently requires the bigger hospital to cannibalize its smaller partners every couple of years in order to balance its budget.

The shift to a primary care focus for all four hospitals would enable QHC to shed layers of administrators and salaries. It would free up dollars to recruit and retain more professionals at the bedside. In Belleville, Bancroft, Trenton and Picton.

It would encourage performance excellence. The most efficient provider of colonoscopies, say, would be the region’s centre for this service.

It is clear the pressures driving rising healthcare costs—hospital costs in particular—are rising faster than the cost of living. These pressures aren’t subsiding. It is time this community, the LHIN and the provincial government took a breath, and considered, in a fresh way, the road ahead.

Certainly, before we contemplate further erosion of precious community hospitals in Picton and Trenton, let us stop and have a closer look at BGH and its role in our lives. And the potential for Kingston to relieve BGH of its burden as a full service hospital.

We have an opportunity end 17 years of bitterness and frustration from an amalgamation that benefitted only one of four partners. Instead, we can use our healthcare resources to create four great community hospitals—celebrated by their residents and donors. Let us embrace this.

RICK@WELLINGTONTIMES.CA

POOCH (Patron’s of our County hospital) is gathering on February 2 at 7 p.m. at the Picton Town Hall (above the Fire Hall) to rally support for PECMH). All are welcome.