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Ontario Health Coalition calls Niagara Health’s plans for the future ‘unsupportable’

Posted: October 11, 2019

(October 11, 2019)

By: Kris Dubé, The Welland Tribune

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Niagara Health chief of staff Dr. Johan Viljoen and interim president Angela Zangari. – Kris Dube, Torstar

Niagara Health is ignoring the needs of Fort Erie and Port Colborne residents with its planned closure of each community’s urgent care centre in the next few years, says Natalie Mehra, executive director of the Ontario Health Coalition.

When a new Niagara Falls hospital opens around 2026, the sites in Port Colborne and Fort Erie will close, says the health system.

In 2008, through the implementation of the Hospital Improvement Plan, both buildings were downgraded from emergency rooms to 24-hour urgent care centres.

Mehra says wait times at Niagara’s three hospitals (Niagara Falls, St. Catharines, Welland) are the longest in the province.

From April 2018 to March 2019, the Port Colborne urgent care centre saw 22,206 visitors and Douglas Memorial in Fort Erie welcomed 18,996 patients, according to statistics provided by Niagara Health.

At Niagara’s emergency departments, there were 46,996 visitors from last April to this March at the Niagara Falls hospital, 31,680 at the Welland hospital, and another 74,843 at the St. Catharines hospital, which opened in 2013.

Mehra said the Ontario Health Coalition, a grassroots health-care watchdog, is “extremely concerned” about the more than 40,000 people who were treated at urgent care sites having to seek treatment at other hospitals that are already very busy.

The new hospital in Niagara Falls will cost up to $1 billion and replace the current hospital in the city.

“That’s great for Niagara Falls, but it does not in any way justify closing any services in Niagara,” she said in an interview, calling Niagara Health’s plans “unsupportable.”

She also said “the public has every right to raise their voices” in those municipalities – insisting that their urgent care sites remain open.

From April 2018 to March 2019, the Port Colborne urgent care centre saw 22,206 visitors and Douglas Memorial in Fort Erie welcomed 18,996 patients, according to statistics provided by Niagara Health.

At Niagara’s emergency departments, there were 46,996 visitors from last April to this March at the Niagara Falls hospital, 31,680 at the Welland hospital, and another 74,843 at the St. Catharines hospital, which opened in 2013.

Mehra said the Ontario Health Coaltion, a grassroots health-care watchdog, is “extremely concerned” about the more than 40,000 people who were treated at urgent care sites having to seek treatment at other hospitals that are already very busy.

The new hospital in Niagara Falls will cost up to $1 billion and replace the current hospital in the city.

“That’s great for Niagara Falls, but it does not in any way justify closing any services in Niagara,” she said in an interview, calling Niagara Health’s plans “unsupportable.”

She also said “the public has every right to raise their voices” in those municipalities – insisting that their urgent care sites remain open.

“They’re highly used and needed in their communities,” she said, adding they are already a “step down” from their former full-service hospital status.

Transportation for elderly people in Port Colborne and Fort Erie should be a major area of concern, said Mehra.

“It’s hard on people and it needs to stop,” she said, continuing that unique weather and growth in both communities should be considered.

A commitment to keep the Welland hospital open has also been made by Niagara Health, with a “new model” for 24-7 emergency services being proposed, as well as observation beds for patients requiring up to 24 hours of care, complex care in a proposed new long-term care facility, as well as dialysis, and mental health and addictions services.

An urgent care centre also exists at the St. Catharines hospital, and the new Niagara Falls site and the Welland hospital will also have one.

Changes, plans developing: Niagara Health

A lot has changed since Dr. Kevin Smith’s recommendations were received in 2012, says Niagara Health’s top brass.

Smith was brought in as a provincially-appointed supervisor of Niagara Health in 2011 to oversee hospital restructuring in the region. He released a report in 2012 that contained a number of recommendations on how to move forward. Smith, who was also CEO of Niagara Health from 2014 to 2018, said in 2012 that two new urgent care centres be made available in south Niagara including the Welland site as one of them.

“From that, it’s evolved into much, much, more,” said Niagara Health interim president Angela Zangari, who said the closure of the two urgent care sites in Fort Erie and Port Colborne are “partly” the result of many services being maintained in Welland — a site that was originally slated for closure as well.

Niagara Falls and St. Catharines have full-service emergency departments but the Welland site will have an “emergency services” department, which will not provide surgeries.

There will be a 24-7 emergency services department, up to 10 observation beds there and staff will evaluate and stabilize people with serious ailments and decide if they need to be transferred.

“It’s much more than was originally planned,” said Zangari.

There is still a lot of uncertainty as to what the model of care will look like in more than six years from now when the new hospital at Lyons Creek and Biggar roads opens.

“By the time we build a new south Niagara hospital in Niagara Falls, it will be a lot different,” said Zangari.

“We’re still six years down the road. We’re still planning,” she said.

Dr. Johan Viljoen, Niagara Health’s chief of staff, said adapting to the ever-changing needs of the region’s communities is vital when restructuring a hospital system.

“The plan doesn’t look like it did in 2012 because we are agile and we are thinking,” he said, adding that partnerships with Niagara EMS on how to bring patients to the most appropriate site in the least amount of time is a key component.

Raising awareness about Ontario Health Teams and Niagara@Home, a partnership with Saint Elizabeth Healthcare for a 16-week supportive program, are examples of heading in the right direction when it comes to delivering the right care to patients — in their homes, according to Viljoen.

“It’s safer to be in a hospital for the shortest period of time that you can,” he said.

Zangari added that at-home opportunities for services will still create a “seamless” delivery model.

“We do want to work with our community and our partners, having more of that care outside of the hospital walls as much as possible,” she said.

Asked whether the more than 40,000 people each year who would go to an urgent care centre in Fort Erie or Port Colborne adding to lengthy wait times already being experienced at the three other sites is a concern – Viljoen said the other “alternatives” like at-home care and rapid access clinics should create fewer trips to the emergency room.

“All of those things together, makes us believe we may be able to decrease the amount of people who come through the doors of the ED,” he said.

He agreed that it may take time to get Niagara residents used to the new format, educating people that a trip to a hospital may not be the best course of action.

People will have to adapt, he said.

“Health care planning isn’t a one-time thing. It’s a moving target,” said Viljoen.

They also said it is too early to decide what will be done with equipment at the Fort Erie and Port Colborne sites that was paid for with community fundraising dollars.

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