Watch It Welland! Your Hospital Services Are Next

A View by Pat Scholfield

(Pat Scholfield is a long-time south Niagara resident who is fighting for equitable access to hospital services for all the region’s residents. The following is based on a January 25 presentation she made to the Health Care Committee for Welland’s city council.)

Welland people should no longer be kept in the dark about the fate of their
hospital. Accurate information should be distributed to all residents of
Welland.

How much longer will that 'H' remain at the top of the Welland Hospital?

In 2008, the Niagara Health System (NHS) released its Hospital Improvement Plan
(HIP), which alarmed the physicians at Welland Hospital. Under the HIP, they
would lose so many surgical specialties, they would no longer have a vital hospital or a viable 24/7 ER (emergency department). They went to the mayor of the day with their concerns, but he supported the NHS  and the HIP. They then went public and then former Mayor Damian Goulbourne suggested the physicians form a Task Force with the help of a paid consultant to prepare a report. He said it would only take six weeks. That was in May of 2009.

Six months later, a 44-page draft report was released, with the physicians reaching the same conclusion as they did originally. The mayor then told them to produce a report saying what they wanted at Welland hospital and to negotiate with the NHS. In November, 2010 a brief presentation of negotiations to date was released by Dr. Willard, chair of the Task Force.

Both reports conclude that the Welland Hospital will no longer be a full service
hospital.

Services lost under the HIP will be the following inpatient surgical
specialties: Ear, nose and throat, plastic, obstetrics, pediatrics, mat/child,
urology and orthopedic surgery. The NHS might allow orthopedics to stay at the Welland Hospital for five years, but if that is calculated from the release of the HIP, that would be 2013. None the less, orthopedics will ultimately leave.

Even though the NHS has agreed to some additions services at the Welland Hospital, they all appear to be elective or day surgery.

After reading the reports, it is clear that day surgery will not allow the Welland
Hospital to retain after-hours staffing, inpatient beds, or an acuity level
sufficient to sustain a 24/7 ER.

Both Drs. Bonsu and Willard encourage the public to fight to retain services at
the Welland Hospital, but if the public is not properly informed as to the fate of their hospital, it is difficult for them to put up a fight. They are entitled to know
what is going on.

After almost two years of reports and negotiations, now is the time for the HCC
of Welland to go with the information they have to date about the future fate of
the Welland Hospital, and distribute, by mail to all the residents of Welland.

If council is wondering how to pay for this mailing expense, I would suggest it
would only take a small portion of its recently discovered $800,000 surplus.

(A little bit more about Pat Scholfield, her experiences fighting for hospital services in her former hometown of Port Colborne before recently moving to Welland, and her fear for services at the Welland Hospital).

Task Force Report and Welland County General Hospital

Introduction: Lived in Port Colborne over 54 years

§    Witnessed dismantlement of Port Colborne General Hospital
§    Had been full service hospital.
§    Had 3 babies there, tonsillectomy, hernia surgery
§    Lost Obstetrics and Pediatrics in 1990s.
§    Rapid decline, doctors left, beds closed
§    ICU closed, reopened and closed again
§    Final coup de grace when NHS released HIP in 2008
§    PCGH converted to a type of nursing home and ER shut down
replaced by UCC
§    Welland hospital became destination for acute and emergency
services.

Is Welland facing a somewhat similar fate?

§    NHS released HIP in 2008.
§    Welland doctors alarmed.
§    So many departments lost at Welland hospital would no longer be full service and 24/7 ER not viable.
§    Doctors went public.
§    Mayor then recommended a Task Force of physicians prepare a report with assistance of a paid consultant
§    Six months later draft report released with same conclusion
§    Mayor then sent Task Force back to report what they wanted
and to negotiate with NHS
§    Over 1 ½ years later Dr. Willard, chair of Task Force made Power Point presentation to council to discuss progress of negotiations

Results of both reports

Both reports basically state loss of following inpatient surgeries at WHS under the HIP:

§    Ear, Nose and Throat
§    Plastic
§    Obstetrics
§    Pediatrics
§    also referred to as Mat/Child
§    Urology
§    Orthopedic  (NHS has agreed to allow Orthopedic Inpatient Surgery to remain for 5 yrs. From date of release of HIP that could be 2013), but ultimately Orthopedics will leave Welland hospital.

Task Force Report is still being discussed at NHS, but they have basically agreed not to back down from any of above closures, but will add some new programs to Welland hospital.

§    All new programs appear to be day surgery and/or elective surgery and procedures.

The conclusion is Welland Hospital will no longer be a full service hospital.

The question is with the loss of so many surgical specialties, how can WHS continue to provide 24/7 emergency services?

Task Force Report states, “Emergency Surgery is the linchpin in maintaining the acuity level of an acute hospital supporting a 24/7 ER”

§    Orthopedics provides greater than 50% of after hours surgical volume
§    Obstetrics provides over 60% of weekend emergent cases
§    Loss of inpatient Pediatrics has widespread impact on ER.

These services will all be gone under the HIP.

If WHS basically provides mainly day surgery and elective procedures, there will be no need for after hours staffing, will there?

Loss of surgical specialties and after hour staffing will lead to eventual collapse of a 24/7 ER won’t it?

These questions all need to be answered.

Both Dr. Willard and Dr. Bonsu are encouraging the public to fight to retain pediatrics at WHS.

Do the residents of Welland know the facts of what is going to happen at WHS under the HIP?
Do they have accurate information on the future of WHS?
Do they know there is a strong possibility they could lose their 24/7 ER?
How do you get accurate information to the public to ensure they are thoroughly informed?

Purpose of me being here is to encourage make recommendations for the Health Committee of Welland City Council to consider:

1.   Get accurate information out to the public
(ie.) print a flyer outlining all proposed removed and retained services
at WHS as expediently as possible and ramifications of the HIP
2.    Distribute flyer by mail to all residents of Welland
3.    Include a questionnaire for residents to fill out and add comments.
4.    Possibly set a date for a public information forum, where citizens can
return questionnaires, ask questions and give comments.

Direct personal distribution of material will ensure all citizens an opportunity to be fully informed.

Not all People read papers.
Not all People go online.
Not all People watch COGECO.
Everyone has a mailing address.

It is incumbent upon this council and administration to do everything in their power to notify the citizens of Welland about the possible future fate of their hospital.

You can then rest, knowing you did your part to inform your constituents.
In closing would also point out loss of 24/7 ER should not only be a big concern to Wellanders, but also a serious threat to Port Colborne, Fort Erie and the entire southern tier.

Therefore I want to suggest to the Health Committee that they consider incorporating into the mandate of their structure the inclusion of representatives from other groups and municipalities to strengthen their fight to retain essential services at the Welland Hospital.

(Visit Niagara At Large at http://www.niagaraatlarge.com for more news and commentary on matters of interest and concern to our greater binominal Niagara region.)