By Doug Draper
“Another day older and deeper in debt.”
That lyric from an old American folk tune could just as well serve as a theme for the Niagara Health System – the body created by the province a decade ago to manage the affairs of most of the hospitals in the region.
Much has been made of the fact that the NHS is swimming in red ink that includes an annual operating budget of somewhere between $10 and $20 million, and a $100-million plus capital deficit that is expected to swell to $129 million within the next two years, according to the NHS’s own projections.
And much should be made of the NHS’s deficits because they are driving a controversial “hospital improvement plan” it was directed two years ago by another provincially appointed body – the Niagara and Hamilton areas’ Local Health Integration Network – to find ways of getting out of the red by consolidating more and more of our hospital services, including emergency and maternity services, into ever few of our hospitals.
It is a plan that is already having an impact, and many would argue not a good one, on people living in Niagara’s southern tier. And within the next two or three years, it could significantly impact the accessibility of hospital services for a majority of residents in the region, including larger municipalities like Welland and Niagara Falls.
Port Colborne and Fort Erie have already found out what the NHS’s “improvement” plans for the region’s hospitals, lathered in words like “consolidation” and integration,” mean with the downgrading last year of their hospitals’ emergency rooms to ‘urgent care centres.”
The hospitals in Niagara Falls, Welland and the St. Catharines General are expected to find out more about what they mean within the next three years with the transfer of what is left of their pediatric, gynecological and obstetrical services to the one and only new hospital complex the NHS is building for the region, next to a an asphalt jungle of clogged streets and big box stores in west St. Catharines.
And that’s not likely to be the end of lost services in Niagara Falls and other central and southern communities across the region as their aging hospitals become too dated to retrofit for 21st century medical tools and practices, and the west St. Catharines complex (expected to cost us more than $1.5 billion just for the construction of it over the next couple of decades) inevitably becomes the only fully functioning hospital left in Niagara unless the province is willing to approve another one for the growing southern tier.
Given all that, there has understandably been a good deal of finger pointing over who is responsible the region of Niagara hast – in a location that likely has more to do with politics and other shenanigans than is does with where future hospital services should be sited for the benefit of all Niagara’s residents.
There has understandably been a good deal of finger pointing over who is responsible for the deficits driving so many of the changes that have so many residents concerned about losing ever more hospital services in their communities. Is it a result of mismanagement on the part of the NHS itself or is it largely due to an unwillingness on the part of the province to provide the NHS with the funds it needs to keep hospitals across the region functioning with a range of services residents expected from these sites 10 or 20 years ago.
To listen to a presentation NHS administrators made at a “community advisory forum” it hosted in Niagara Falls earlier this month on its “financial position,” one would be left concluding that a chronic shortfall of funding from the province has more than a little to do with the mess the region’s hospital services are in.
According to NHS CEO Debbie Sevenpifer and her chief financial officer Angela Zangari, some of the debt was inherited a decade ago when the NHS was created as an amalgamation of hospitals in the region. The amalgamation was the province’s idea but the province never made up the debts some of Niagara’s hospitals were carrying at the time when the NHS took over.
“This is something that we have struggled with since amalgamation,” said Sevenpifer during the forum. Then there is the $85.4 million in additional funding the NHS has received from the province’s Liberal government since it came to power.
As it turned out, said Sevenpifer and company, about $47 million of that disappeared in services transferred from the former Hotel Dieu Hospital to the NHS, including oncology and chronic kidney disease. On top of that, the NHS has only been able to raise about $5 million annually from local foundations and other sources for the more than $14 million it faces each year in capital expenses.
If all that it is true, then there is certainly a case to be made for going after the province for more funding for Niagara’s hospitals. Asked by this reporter why she doesn’t go after the province more publicly and aggressively over the funding shortfall, Sevenpifer said that isn’t her style.
Instead, she’s taking a good deal of the heat – I’ve taken to calling her a heat shield – for Premier Dalton McGuinty, his health minister and company. And maybe it is worth it to her for the $350,000 annual salary she gets, but it doesn’t help the rest of us very much. By the way, the province’s two main other political parties – the Conservatives and NDP – have been slamming McGuinty’s Liberal government for not providing enough funding to hospitals in Niagara and elsewhere in Ontario.
This February, the Conservatives issued a media release charging that McGuinty recently placed “politics ahead of patient care” by approving $15 million in a Toronto Centre riding where a provincial by-election is underway to keep a hospital in that area from closing after cutting $15 million in Niagara that could have saved the emergency rooms in Fort Erie and Port Colborne. The media release goes on to argue that Kim Craitor, a Liberal government member for a Niagara Falls riding that includes Fort Erie, should be so “embarrassed” by all this and his support for a Liberal budget going back to 2004 that he should resign.
There are a couple of things to take issue with here.
First of all, Craitor is one of the few politicians in this region and province that has placed the interests of his constituents ahead of partisan politics and criticized his own party for not taking enough action to deal with hospital issues here. He has openly called for a provincial investigation of any mismanagement that has led to service cuts.
Second, it is a tad bit hypocritical for the Conservatives to be aiming a gun at the Liberals for any shortfalls in provincial funding the NHS is facing. The Conservatives were cutting health care funding significantly while they were the government in the last half of the 1990s and the first three and a half years of this decade, and they were the ones that created the NHS without giving them the funds to pay off old hospital debts.
Perhaps they are hoping voters here have the memory of a fly and have forgotten all that, along with the fact that it was their party’s idea to create the LHIN, an unelected body that seems to have more power than the province’s Ministry of Health when it comes to the fate of our hospitals.
Sue Salzer, head of the Yellow Shirt Brigade, a south Niagara citizens group fighting to save hospital services in that part of the region, recently had this to say about the Conservative media release; “The recent attack by the Progressive Conservative Caucus on Liberal MPP Kim Craitor is politics in its most bilious form. … Kim Craitor has been one of the many political voices raised in support of efforts … to regain some form of adequate health services. He supported us, rallied with us and has provided one of the few voices that are being listened to in the halls of Queens Park. I wish we could say that we have received the same support from the Progressive Conservative Party.”
Indeed, Niagara residents face some serious challenges with respect to hospitals and the future of the region’s health care services in general and it would do well for our provincial politicians to put partisan politics aside and work honestly and openly with our region to address them.
(For related news and commentary of interest to the greater Niagara region, click on www.niagaraatlarge.com for Niagara At Large.)