Four hospitals in Southern Ontario would permanently close their doors and be replaced with a new acute-care centre, under a proposed controversial restructuring of the troubled Niagara Health System.
Hospitals in Port Colborne, Fort Erie, Niagara Falls and Welland are slated to close, according to the plan Niagara Health posted on its website on Thursday. The region would be served by two large hospitals – one in St. Catharines now being built and one at a location not yet chosen – as part of an effort to consolidate medical expertise, create critical mass and provide higher quality care to patients.
Nothing on this scale has been contemplated since the 1990s, when the Harris government's Health Services Restructuring Commission oversaw the biggest shutdown of hospitals in Canadian history. The commission closed or merged 35 hospitals in Ontario. The amalgamation of Niagara Health was the biggest of all.
The latest proposed restructuring of Niagara Health, a sprawling network of seven hospitals serving 434,000 people in a dozen communities, takes place against a backdrop of enormous fiscal challenges for the sector. The deficit-ridden provincial government has frozen hospitals' operating budgets for this fiscal year.
But the plan also highlights the depths of the discord within Niagara Health. Doctors passed a vote of non-confidence in its former leadership, residents have come to the Ontario legislature to protest the closing of two local emergency departments, and a deadly superbug outbreak last year claimed the lives of 31 patients.
Kevin Smith, the chief executive officer of Hamilton, Ont.-based St. Joseph's Health System who was appointed supervisor of Niagara Health last August, said nothing short of radical action was needed.
"The status quo was unquestionably unsustainable," Dr. Smith said in an interview. "When I look at the morale of the staff, the perception in the community of the organization, the economic and political challenges, it was heading for even more bad times."
Health Minister Deb Matthews said in a statement that Dr. Smith is taking the necessary steps to ensure that community members have confidence in their hospitals.
"I know that there have been significant issues of trust around the NHS the past few years," she said.
John Church of the University of Alberta's School of Public Health said Ontario is lagging behind other provinces, many of which have created larger governance structures to oversee the delivery of hospital care. In a more centralized system, patients benefit from better care because the higher volumes allow surgeons to practise their skills.
"It just means that you never have heart surgeons sitting around in a hospital because they have no patients," Prof. Church said.
However, Dr. Smith said he is bracing for pushback from the community. Many residents complained that the closing of two emergency departments in Fort Erie and Port Colborne in 2009 was a cost-cutting exercise that compromised patient care.
Ontario's Chief Coroner is holding a public inquest to determine whether a Fort Erie teen involved in a car accident in December, 2009, would still be alive if the emergency department in her hometown had not closed its doors. The ambulance took nearly twice as long to transport Reilly Anzovino to the hospital in Welland.
"I don't expect that everyone will like the model," Dr. Smith said. "But I think already we've heard from people who have been less than confident of the NHS."
Port Colborne Mayor Vance Badawey is one of them. He said the proposed new hospital is welcome news. But he cautioned that it could be some time before the proposal becomes reality.
"Until it gets the [Health]Minister's blessing, it's simply talk," Mr. Badawey said in an interview.
Progressive Conservative Leader Tim Hudak said Niagara residents have lost all confidence in the NHS, which has become a "complete mess."