The QHC way

And so it begins. Again. Quinte Health Care (QHC) has dug itself another financial hole. And whenever this happens (and, sadly, it happens often) Prince Edward County Memorial Hospital and Trenton Memorial are sacrificed. Limbs are amputated at PECMH and TMH to spare Belleville General Hospital.

Eventually, of course, there will be nothing left to cut. Some fear that day is imminent.

Perhaps then, the administrators and governors of this broken and calloused hospital corporation will begin to examine how it is, despite a doubling of the amount of funding it receives from the province since 2002, QHC still can’t balance its books.

By then, it will be too late for our community hospitals. That is why this community must rise again to make it clear to the province, in the loudest possible voice, we want our hospital back. Before QHC burns through another few hundred million dollars the healthcare system can ill afford.

QHC was a failure before it began. It was a bad design. Doomed to fail before the forced arrangement was consummated . Remember, the goal of amalgamation was efficiency. It was anticipated that, collectively, a group of hospitals might achieve savings through joint purchasing of services and supplies. Human resources could be used more effectively and efficiently across four hospitals rather than one. Facilities might be specialized to offer technological or skills-based procedures in higher volume.

By every single measure, this 16-year experiment has failed. Savings have not materialized. Instead, the administrative layer has become fatter and more voracious in its appetite. If you listen to the mantra long enough, one understands that for QHC, the ideal is a hospital with no patients. No nurses. No doctors. Just administrators.

I began writing about QHC in 2004. In those early years, QHC ran over budget every single year. And each year the province would write a cheque to bail out the hospital corporation. The province grew weary of enabling this mismanagement. It insisted, to no avail, that QHC balance its budget. Then, at last, it passed legislation forcing administrators to balance their books. Yet the deficits kept coming.

Now QHC is compelled to make deep cuts to keep its books balanced. Disproportionately, these cuts have come from PECMH and TMH.

Meanwhile, QHC has seen its provincial funding rise from $107 million in 2004 to $179 million in 2013—a 60 per cent increase in precious healthcare dollars needed to feed this unresponsive and increasingly arrogant beast. Sixty per cent more just in the decade I have spent covering QHC—a decade in which we have witnessed services, resources and capacity of PECMH and TMH slashed over and over again.

This surely can’t be what the architects of amalgamation had in mind.

In the coming weeks, QHC is expected to eliminate endoscopic services at PECMH— emptying this amalgamation experiment of it last promise, that facilities could be used more efficiently as regional centres of specialized care.

By all accounts, PECMH managed well on its own. It served the needs of this community effectively, responsibly and proudly. The hospital changed and evolved over the better part of a century. It had tough times, but it balanced its budget. It was accountable to both the community and to the province.

When, in 1998, Graham Scott and Maureen Quigley imposed amalgamation upon PECMH and TMH, along with BGH and North Hastings, they would have been more merciful had they simply closed Picton’s and Trenton’s hospitals right then and there, rather than allowed these beloved community hospitals to continue to be hacked and slashed by uncaring, highpriced administrators over a decade and a half.

It is humiliating for a community to be forced to watch an institution suffer such ignominious brutalization in slow motion. This community built, funded and relied upon their hospital. Bit by bit, it is being dismantled before their eyes.

It is a humiliation made worse by QHC administrators and the nodding heads on its unelected board, who operate under the belief that we are all too stupid or too stubborn to see that their way is the only way forward.

All evidence, however, points the other way. A decade and half of failure by QHC to balance an ever expanding budget ought to give the province pause about the wisdom of the QHC way.

Both the province and the Local Health Integration Network must open their eyes to the failure of QHC— before PECMH and TMH are whispers of history and BGH is consuming $300 million a year, yet still unable to balance its budget.

We must help them see what is plainly visible from Prince Edward County.

rick@wellingtontimes.ca