Five years later

Fran Renoy called this week to say that Scott Rowand had passed away. Readers will remember Scott Rowand as the consultant hired by then-Health Minister George Smitherman to paper over Quinte Health Care’s plans (at the time) to gut the hospitals in Picton and Trenton in order to shore up resources at Belleville General Hospital.

QHC was in disarray in 2005. Management under CEO Bruce Laughton no longer enjoyed the confidence of the hospital membership or a significant portion of the board. When he presented his famous seven-step process for slicing and dicing services at the four hospitals under this forced amalgamation, he faced open revolt, much of it from Prince Edward County. Laughton eventually backed down and threw the mess at the feet of the minister.

Enter Scott Rowand.

Rowand had emerged as a rising young administrator from the health care system in Alberta. In 1996 he landed the job as the first CEO of the newly amalgamated Hamilton Health Sciences Centre but was forced out just four years later by Tory Health Minister Elizabeth Witmer after the hospital had racked up a $40 million deficit.

Despite his missteps in Hamilton, the new Liberal government felt Rowand was their man to fix the troubles at yet another failing amalgamationexperiment—this time in Belleville.

His thin report—just 36 pages—was titled New Beginnings; a rather warped description for what was essentially a blueprint to downgrade Trenton Memorial and reduce Prince Edward County Memorial to little more than a first aid station.

He found plenty wrong with QHC. High on his list were the annoying and persistent voices from Prince Edward County. He believed the open membership structure— whereby anyone interested could pay $5 and become a voting member—gave the agitated folks in the County too much influence in the governance of the hospital.

He found, too, that few had accepted the imposed amalgamation and were clinging to the unhelpful notion that QHC ‘sites’ were still viewed as ‘hospitals’. He believed the economies promised by amalgamation would remain unrealized until folks, including health care professionals, let go of their community hospital and began to see it as simply a cog in a bigger, more sophisticated system.

Though he wasn’t asked for his views on operations, he opined in his report that the outpost emergency room in Bancroft provided a useful model of what the Picton hospital should become.

Smitherman came to Picton in June of 2006 to release Rowand’s report. He explained how services such as maternity care no longer belonged in small hospitals like Prince Edward County Memorial—that ‘moms and babies are safer’ in larger centres. He was wrong. There were no data to support the statement or the more general belief that the future of modern health care lay in centralized factory hospitals.

For Smitherman, Rowand and their cohort, the pressures of an aging population, increasing role of technology and the shortage of health care professionals spelled only one future for hospitals: centralization and specialization. Bigger and more complex hospitals.

But they didn’t have any data to support their grand plans—all they had was ambition and the conviction of their own ideas.When pressed to explain the risks associated with such a single- minded focus, Rowand famously responded, “shit happens.”

We can all be thankful many in this community rose up in defence of the Picton hospital. People like Eleanor Lindsay-MacDonald, Fran Renoy, Mark Larratt-Smith, Ernie Parsons and Leo Finnegan and many, many more. They’d had plenty of practice.These folks pushed back tirelessly against the tyranny of the singleminded solution.

Today, things are far from perfect at Prince Edward County Memorial Hospital—the pressures of demographics and rising costs have become more pronounced since 2006.The hospital has lost beds to Belleville and more are at risk. But five years later, our hospital is still a hospital.With maternity care and an array of primary care services including a new emergency room and diagnostics centre.

More importantly, our hospital has a future—a future that, with some luck, will see a brand new hospital erected in Picton before the end of this decade. It will feature close collaboration among a broad array of health care professionals and service providers in one location. Electronic records and media links will bring leading specialists, wherever they happen to be, into the discussion between patients and their primary health care providers in Picton.

Many believe, including the new chief administrator at QHC, that Prince Edward County Memorial, rather than shrink into oblivion to support a greater Belleville General Hospital, may soon become a model of rural health care delivery in this province.

We largely averted the fate prescribed by Scott Rowand—but we must remain vigilant, particularly in this, an election year, to press for provincial support for the redevelopment of the Picton hospital.

Scott Rowand was likely decent guy and certainly his passing at 57 years of age came too soon. He was, after all, just a messenger.The one sent to finish the job started by Mike Harris a decade earlier.

And perhaps that is yet another compelling reason why the McGuinty government must go this fall-for it had the opportunity—perhaps responsibility— to reverse or correct some of the poorly considered and ill-fated schemes enacted by Harris.Yet it didn’t. Worse, it acted to cement the worst of these ideas.

rick@wellingtontimes.ca