The dog barks

A great day to fight for Picton hospital

After Leo Finnegan had finished briefly outlining the issues in Prince Edward County, Health Minister Deb Matthews looked at him and other POOCH representatives (Patrons Of Our County Hospital) assembled in the small room at Queen’s Park and paused before asking, “So you want to de-amalgamate?”

Finnegan, and everyone else, responded, “Yes.”

So, at a minimum, the health minister of Ontario now understands, firsthand, what it is that the four busloads of County residents who had travelled to Toronto last Wednesday April 17, wanted her to know: “We want our hospital back.”

For two hours the County POOCH members marched, chanted, mingled; waiting for news. Earlier in the day they had learned that a delegation of their group would meet with the health minister and later with the Tories’ Health Critic Christine Elliott.

Leo Finnegan, Dave Gray, Wolf Braun, Willem Maas and Al Reimers spent about half an hour briefing Health Ministry Policy Advisor Jacob Mksyartinian and Rural Policy Advisor Peter Cleary. Then Health Minister Deb Matthews joined the meeting.

Dave Gray illustrated the challenges faced by County residents of diminished hospital services in a rural community. He explained to the minister that the distance from Milford to Belleville is roughly the same as between Queen’s Park and Richmond Hill.

“If you have a heart attack or stroke and looking at that kind of distance, you might just as well call a Hearse as an ambulance,” explained Gray.

Quinte Health Care says it does not intend to close Prince Edward County Memorial Hospital’s emergency department—indeed it contends that even with just 12 beds it will remain a viable hospital.

But few in this community are convinced. They have seen services, staff, capacity and beds at the community-built hospital whittled down steadily since it was forced into amalgamating with Belleville General, Trenton Memorial and North Hastings in Bancroft in 1998. Each time QHC has hit a financial wall, administrators have cut disproportionately into the Picton hospital to balance the budget.

In 1998 PECMH went unwillingly into amalgamation with 42 beds and balanced books. For much of the previous century the hospital served the needs of the community, as defined by the community, built and rebuilt by the community.

But since 1998 the community hospital has alternated between acting as a reserve account for QHC administrators to draw upon in tough times, and a parochial irritant defiantly refusing to fold into the role the hospital corporation has set for it.

In the QHC model, Picton is being stripped down to something closer to North Hastings in Bancroft—six beds, small emergency room and some diagnostic tools. But this view ignores the history, needs and requirements of this community. Mostly it ignores the fact that Prince Edward County’s population is older than the provincial average and getting older still. The need for hospital services in this community is growing—not shrinking.

North Hastings Hospital was developed by the Red Cross as an outpost hospital after the Second World War. It was built to patch folks up and transport them to another hospital; whereas PECMH was built by the community as a full-service hospital—emergency services, surgery, obstetrics and internal medicine—to serve the particular needs of this community. And it paid its own way.

In the 15 years since, QHC has repeatedly redirected resources from Picton to shore up its finances. Currently PECMH manages with just half the beds with which it entered amalgamation. Frequently these 21 beds are full with overflow patients waiting in hallways and the emergency department. Now QHC plans to cut another nine beds. Cut out obstetrics and maternity care.

In the last round of cuts, QHC administrators agreed that PECMH would be allowed to continue to provide endoscopic procedures as a sop to County doctors with this training. But now even these services are targeted to be stopped in Picton— ending the history of surgical procedures in the County. Worse, it forces physicians and support staff with these relevant skills to move or work in Belleville; neither is a welcome proposition for these folks.

Back at Queen’s Park, Councillor Barb Proctor paced before the Legislature with a sign hoisted above her shoulder that read “Save our Picton hospital services.” The signs are 13 years old. Proctor dug them out of her attic and cleaned them up for this most recent struggle.

Proctor, a former nurse, has watched the Picton hospital get steadily smaller since QHC took over in 1998. When beds, services and staff are eliminated, the capacity and capability of the hospital is diminished. Its role and relevance, and indeed its viability, is compromised— making it more susceptible to more cuts. Proctor and others in this community worry not just about the most recent service reductions, but the trend. Thirty beds have been cut from Picton hospital since amalgamating with QHC. At this rate PECMH won’t be around for its 100th anniversary in 2019.

POOCH supporters hope to forestall this eventuality. They want the provincial government to intervene—to enable it to break away from QHC. Mayor John Williams of Quinte West wants the same thing for Trenton Memorial.

The health minister made no commitment, nor did her officials. But the door was left open for a second, more fulsome meeting, perhaps in May or June.

POOCH supporters won’t go empty handed. They intend to begin to assemble a business case for a return of independence for the Picton hospital. They will need to show the medical, financial, administrative and funding rationale for an independent PECMH. It will need to be compelling; the ministry will be loathe to let PECMH out of QHC for fear that other bad amalgamation arrangements might begin to unravel.

But POOCH has several factors in its favour: the Picton hospital has a long history of serving this community, cost effectively, that was interrupted in 1998. The plan will likely have the support of most, if not all, of the physicians and health care professionals in this community.