Hospital-eating disease

Where is the explanation? Where is the justification? Before one more scalpel or tongue depressor is removed from the Picton hospital QHC must explain why it has chosen yet again to cut disproportionately from this hospital. And how it arrived at this conclusion.

These answers they owe to this community. But they must also answer for themselves whether they are they fixing the problem, or simply buying time? After a decade and a half of stealing from PECMH and Trenton Memorial to shore up BGH, QHC’s picture is as sick as it ever was. Worse perhaps. What happens when the reserve accounts called PECMH and TMH run dry and these hospitals are finally erased? Where will QHC turn then?

These questions need real answers. Not the puffy kind that point to all-consuming health care budgets and generic arguments that we need to improve the way we fund and finance health care and hospitals in this province. Most folks know the pressures health care administrators stare at every day—at least in a general way. They understand that healthcare spending in Ontario chews up too much of the province’s overall budget. They know, too, that this strain will increase as the baby boom generation ages. We can also see that technology plays an increasingly vital role in detection, diagnosis and treatment of disease and illness. This community recently contributed mightily to a campaign to fund expensive diagnostic tools installed across QHC. They know, too, that the costs of people who care for us in the hospital continue to rise.

Simply repeating these pressures over and over again doesn’t explain why Picton hospital must bear the deepest cuts. It doesn’t explain why, when faced with financial pressure, QHC has repeatedly robbed resources from this proud community hospital.

Is it because the hospital offers poorer care? No one has ever even hinted at this as a possible explanation. Anecdotal evidence from those who work there and have been treated there describe it as a wonderfully safe and caring place.

Is PECMH an expensive place to provide care? No. Before it was dragged into a forced marriage with QHC in 1998, the Picton hospital’s books were balanced. There had been rocky times in its history, and there had been some cuts along the way, but the last time this community saw the financial workings of its hospital it was a healthy and thriving facility of 42 beds. Now QHC officials propose that it whither to 12 beds.

Even now QHC’s own data suggest that it costs less to treat most diagnosed illnesses at PECMH than it does at BGH. Administrators say this is because BGH bears overhead costs that appropriately accrue to its other three hospitals— but hasn’t yet quantified this. These remain generic, puffy responses—not answers.

No, the more likely reason PECMH and TMH are diminished each time BGH runs into a budget squeeze is simply because health care administrators believe it is cheaper to operate one large hospital than four of varying size. They have been trained to find and root out duplication. They believe if they erase this redundancy— they are releasing resources for the benefit of the overall corporation. But in doing so successive QHC administrators have failed to examine the role these resources play, either in terms of the health of the community, or even their own business in terms of raising funds and leveraging volunteer goodwill.

Worse, any potential saving has been gobbled up by the lethargic and bloated centralized organism and exhausted without materially altering the trajectory of the QHC’s woeful finances.

So in the end, nothing is added. Soon the beast needs to be fed again. Nothing has been fixed.

With each passing year there are fewer beds and services left to steal from Picton and Trenton to feed BGH.

But alas this is the cruel and fatal flaw of amalgamating these very different hospitals. Each serves a different and nuanced role in the community. Each was built, funded and operated by its community. Each was created and shaped to serve the distinct needs of its community. They are not— and never were—one hospital.

But once PECMH and TMH were thrust into this arrangement it was inevitable that when faced with tough choices, QHC administrators would hack away at what it views as non-core assets to protect BGH. It will continue to do so until both PECMH and TMH are gone. It is what they are paid to do.

This is why this marriage must end. PECMH and TMH are not partners in QHC. They are lunch. They are being consumed by this arrangement. Slowly but surely.

Prince Edward County and Quinte West must begin the messy business of retrieving their hospitals from this perilous predicament and salvage what is left of them.

There are few other answers available.

rick@wellingtontimes.ca