Expert Panel To Advise On Future Location Of Maternity Care Services In Niagara, Ontario

By Doug Draper

Kevin Smith calls it “the most contentious issues” he has yet to deal with before wrapping up his year-long stint as supervisor of the Niagara Health System with a set of recommendations to the provincial government on how and where the NHS should manage hospital services in this region for years to come.

Niagara, Ontario area doctors Chander Bhagirath and Ken Reddy, in foreground, urge Niagara Health System supervisor Kevin Smith and expert panel to keep maternity services at Niagara Falls and Welland hospital sites. Photo by Doug Draper

Where should maternity care services – pediatrics and obstetrics – be located in Niagara, Ontario in the years ahead?

Should they all be based at the new hospital complex the NHS is opening in west St. Catharines next year? Or should maternity care be split between the new hospital and two other hospitals the NHS operates in Welland and Niagara Falls. 

With medical staff in the NHS divided between “consolidating” the services at the the new hospital or splitting them between three sites, Smith has called on a panel of hospital experts to help him arrive at a decision where he warned during an initial meeting of the panel this August 14 that whatever decision is made, “someone is going to be unhappy” because there is no room for compromise between those two choices.

The expert panel, made up of Hamilton Health Sciences obstetrics chief Nicholas Leyland, along with the Hamilton Health Sciences pediatrics chief Lennox Huang and pediatrics chief and its vice-president, Brenda Flaherty, and Mary Jo Haddad, CEO of the Hospital for Sick Children in the Greater Toronto Area, heard vigorous arguments from medical staff on both sides during an evening session at the Casablanca Winery Inn in Grimsby this August 14.

Moving all the maternal care services to the new hospital site in St. Catharines would be “very disruptive to many families in the Niagara Falls and Welland areas,” said Dr. Ken Reddy, president of the Greater Niagara Medical Society and pediatrics chief at the Welland hospital site. Making families in Niagara’s southern tier travel so far for services in a hospital in the region’s north end may also “risk the lives of mothers and children,” he said. “I cannot overemphasize this.”

Niagara family physician Alison McTavish speaks for keeping maternity services in Welland and Niagara Falls. Photo by Doug Draper

Dr. Gurnam Cheema, an obstetrician in Niagara Falls, added that while some refer to moving all the maternity services to St. Catharines as centralizing them, the hospital being built in St. Catharines is not a centrally located hospital. “The hospital, unfortunately, is located in the northwest corner of the peninsula,” he said, adding that parents in Niagara Falls and other south tier communities who don’t have cars will be disadvantaged if the services are moved to the north end. “We wished to have a central hospital but that did not happen.”

“We are fighting to keep obstetrics and pediatrics close to where the people are,” said Dr. Alison McTavish, a family physician and child service provider who joined Drs. Reddy, Cheema and Chander Bhagirath, a pediatrician in Niagara Falls, in pressing for continued maternity services at the Welland and Niagara Falls sites.

The doctors also emphasized that while some of their colleagues feel it is better to move maternity services to one larger hospital site, there is the West Lincoln Memorial Hospital in Grimsby, which operates outside the sphere of the Niagara Health System and has an excellent record when it comes to those services.

Those medical staff members arguing for consolidating maternity services at the west St. Catharines site included Dr. Parminder Brar, Niagara’s chief of pediatrics, Dr. Johan Viljoen, the region’s chief of obstetrics, and an NHS nurse working in the maternity programs field, Eric Doucette.

Niagara Health System’s provincially appointed supervisor Kevin Smith will soon table recommendations for reshaping region’s hospital services. File photo by Doug Draper

Dr. Viljoen said he sincerely believes that consolidating all of Niagara’s maternity service professionals at one site – that being the new hospital being completed for opening in west St. Catharines – will ensure safer, higher quality services for patients and will also make for more cost-effective services at a time when all hospitals across the province are under pressure to keep costs under control 

As for the location of the new hospital, “we can’t move it (to a more central site) unfortunately. … Certainly this location is not making it any easier for us,” Viljoen added, but “the location is what it is and we have got to make that work.” 

Viljoen said he believes the NHS also has to consolidate maternity services to ensure that the right specialists will always be on hand when patients need them. At the smaller and older hospital sites, where there are few professionals on hand to provide the services at any one time, if one of those professionals suddenly calls of sick or is not available for other reasons, it could have serious consequences for patient care, he stressed. And with a disproportionate number of doctors and nurses approaching retirement age, the chances of a key person not being there when they are needed increase. 

The doctor also argued that the new hospital is also more likely to attract new doctors and nurses in the maternity field, and keep them in Niagara. The facilities are also being built to standards that make it easier to control any threat of infectious disease.

Following the presentations to the panel, Smith said he hopes to get advice back from the panelists soon so he can send his recommendations to the province’s health minister, Deb Matthews, by the end of this August.

Smith unveiled a set of draft recommendations this spring which included moving maternity services to the new hospital when it opens and leaving open the possibility of providing maternity services at a new hospital site in Niagara’s southern tier should the province agree to build another new hospital closer to residents in Niagara Falls, Welland, Pelham, Port Colborne, Fort Erie and Wainfleet.

Niagara At Large will continue updating readers on developments as the recommendations for the health minister are finalized. In the meantime, we invite you to share your views below.