Few updates available at follow-up meeting on Clinton Public Hospital's future
BY SHAWN LOUGHLIN
As the Clinton Public Hospital nears the five-year anniversary of the beginning of its nightly emergency room closures, little was offered in the way of new developments at a public meeting held on Monday night.
Retired Dr. Maarten Bokhout organized the meeting as a follow-up to April’s public meeting, which drew hundreds of people to the Libro Hall in the Central Huron Community Complex. Concerned residents returned to the hall in slightly lower numbers on Monday night and heard from Bokhout, as well as Huron Perth Healthcare Alliance (HPHA) President and CEO Andrew Williams and Central Huron Mayor Jim Ginn.
As far as developments, however, there were few to report. Bokhout updated those in attendance on what the Community Working Group (CWG) has done since the meeting in late April and Williams was on hand to answer questions from the HPHA’s perspective. And yet, few things have changed. The emergency room remains closed throughout the night and staffing shortages remain a dire concern for the hospital and the alliance on the whole. Having said that, Williams said that there are reasons to be optimistic.
To begin the meeting, Bokhout recapped what has happened with the group since the last meeting. He said the CWG has met with the HPHA board of directors, putting forward a number of concerns and suggestions on how to improve the situation in Clinton. He also noted that the group has been in touch with Huron County Council with some questions from the Emergency Medical Services (paramedics and ambulances) side and they have engaged Huron-Bruce MP Ben Lobb and MPP Lisa Thompson.
Bokhout went back to the announcement of the closure, which was in November of 2019 and was put into place the following month. This, he said, was a temporary measure at the time that was being taken due to staffing shortages. He then reiterated that the COVID-19 pandemic, which would be declared in a matter of months after that announcement, further complicated the world of health care and ratcheted up the severity of the staffing situation not just in Clinton, but in many rural and northern communities in Ontario.
Now, with the emergency room only open 10 hours a day, Bokhout says the residents of Clinton have received about 41 per cent of the coverage they were used to before December of 2019.
Former Huron-Bruce MPP and member of the CWG Carol Mitchell spoke briefly about the group’s discussion with Huron County and its ambulance service. She said that, if patients are having to be transported to other hospitals and served when the emergency room is closed, that would have an effect on the county’s ability to provide care. However, she said that the county had recently received funding in excess of $7 million to handle the pressures on ambulance services in smaller communities.
Ginn then spoke, though he said he hadn’t prepared any remarks, telling those in attendance that he and Central Huron Deputy-Mayor Marg Anderson had formed a delegation at the recent Association of Municipalities of Ontario (AMO) meeting with Minister of Health Sylvia Jones, bringing along Councillors Jennifer Cox and Adam Robinson, the latter of whom is a Huron County paramedic. Ginn said he found the discussion encouraging and that Robinson followed up with both Jones and Huron County in regard to the pressure on ambulatory care in Huron County as a result of the emergency room closure.
From a more general perspective, Ginn said it is in council’s best interests to have a healthy and thriving hospital with an accessible emergency room. He said it’s a box that both existing and prospective residents tick when looking for somewhere to live, so it’s a priority for the municipality, but that local councils don’t typically get involved too much in health care.
Williams then took to the microphone and audience members peppered him with questions, many of which were asked back in April, with a disproportionate amount of attention being focused on the HPHA’s mandate for employees to have been vaccinated against COVID-19. Williams reiterated that the mandate did not severely affect staffing levels. He said that about 20 people across the entire organization, serving hospitals in Clinton, Seaforth, St. Marys and Stratford, chose to leave the organization rather than get vaccinated. He singled out one emergency room nurse who was employed in Clinton, saying that if that person still worked for the hospital, its situation would be no different than it is now.
While some in the crowd advocated for dropping the mandate, others spoke in favour of it, leading Williams to say that the hospitals within the southwest region of Ontario are working together to establish consistency on policies and, if and when the mandate would be dropped, it would be done throughout the region, not just by the HPHA.
He did say, however, that he felt that most patients of the HPHA’s hospitals would likely want to be treated by health care professionals who “fall on the side of safety” in regards to vaccination, but that it wouldn’t necessarily be his decision to make. However, he acknowledged that it is a Catch-22 that is sure to polarize people as time goes on.
Williams also insisted that the nightly closure of the emergency room in Clinton is not a money issue, it’s a people issue. If the HPHA had enough people to fill the positions, the emergency room would be open tomorrow, but, unfortunately, that just isn’t the case.
He did say, however, that things are getting better. New, young people have been recruited and are now working at the hospital, the team in place is great (something Bokhout reiterated at the beginning of the meeting to make it clear that the community and the CWG are confident and pleased with the care being offered by the hospital, just concerned with their restricted access to it) and moral is as high as it has ever been.
As for staffing levels, Williams said there have been some preliminary discussions about expanding the hours of the emergency room, not necessarily to 24 hours a day, but perhaps beyond the current stretch of 10 hours a day.
Williams then broke down the staffing complement, saying that four full-time nurses will be going on maternity leave in the very near future. In addition, one of the three physicians who covers the emergency room is currently on leave. In addition to those challenges, a further three part-time nurses would be needed to reach a full complement, though he said those were rough numbers and that things are always changing depending on professionals’ availability.
Both he and Bokhout noted the importance of a mix of full- and part-time employees and the flexibility afforded and productivity reached as a result.
Williams also noted, however, how specialization is factoring into modern healthcare. He used Bokhout as an example of a medical unicorn that no longer exists; a doctor who would work a family practice, cover the emergency room, work as the coroner and more.
The doctors of old, he said, would do a little bit of everything, whereas health care providers now are much more specialized. So, to cover the work of, say, seven doctors several decades ago now requires between 20 and 25 doctors, though there are also workload and quality-of-life considerations to those statistics as well.
Bokhout then ended the meeting with a series of anecdotes, discussing rule changes in the name of safety after tragedy struck. He talked about the incident in 1975 in Toronto when a train struck a bus, killing eight people, which led to school buses having to stop and open their doors before traversing a rail crossing and the changes implemented as a result of the Walkerton E-coli outbreak and a number of other situations.
He then spoke about one of the last deaths he was charged with investigating as the Huron County coroner, which was in Clinton when someone died on the steps of the hospital, unable to access care due to the closure of the emergency room. Bokhout said the person, knowing the emergency room was closed, attempted to wait out their chest pains as long as they could before going to the hospital, but it was too late and the person died. That, he felt, was a death that could have been prevented if the emergency room was open 24 hours a day as it had been prior to December of 2019.