Welland hospital expensive, necessary: Smith
Keeping Welland hospital open — even in a diminished form — will cost taxpayers more than Niagara Health’s original restructuring plan, but it may be a necessary expense, says the health system’s CEO.
In an interview with The Standard, Kevin Smith — the architect of sweeping health-care restructuring in Niagara five years ago — said the plan for local health care had to “evolve” to meet changing demands.
In particular, he said, projections that using urgent care centres to treat less-serious conditions would reduce the number of patients arriving at emergency departments didn’t pan out. Visits to both urgent care and emergency departments are up.
“The numbers are up across Ontario,” Smith said. “In the original (restructuring model) there would be one, possibly two urgent-care centres in addition to the two hospital sites. There has been an evolution of what is an urgent care centre, and what is an emergency room, and they are moving closer to together.”
The original plan saw the old St. Catharines General Hospital and Hotel Dieu hospital replaced with the current St. Catharines hospital on Fourth Avenue.
The plan also called for both Greater Niagara General Hospital and Welland hospital to be replaced with a new facility in Niagara Falls for both cities. Urgent care centres in Port Colborne and Fort Erie would provide immediate care for less-serious conditions.
Political reaction to the possible closure of Welland hospital has been heated, and politicians have lobbied for years to keep the site open.
Last week, Health and LongTerm Care Minister Eric Hoskins announced the Niagara Falls hospital will go ahead as planned in that city’s rural southwest and Welland hospital will be rebuilt at some point in the future to offer some services, including a version of its emergency department.
Smith said what services will be located in Welland is yet to be determined — final details won’t be worked out until the Niagara Falls facility is completed — but general outlines are in place.
Welland hospital will primarily service “less sick, quicker to treat” patients including patients needing limited medical observation, day surgery and other less-thanacute care services. The emergency department, while more than an urgent care centre, will similarly be geared toward treating less-serious cases.
Patients who are very sick or badly hurt will still be sent to Niagara Falls or St. Catharines or, in the case of more serious traumas, to hospitals in Hamilton or Toronto, Smith said.
Smith said his original restructuring plan was “more economical because you wouldn’t be paying for a third site.” He said Hoskins is aware keeping the Welland hospital open will be more expensive but the province is “willing to pay for the differential.”
“I applaud him for making that decision,” Smith said.
Smith said he hopes the Welland ER, by taking less serious cases, can act as a further “escape valve” for the pressures on other local emergency departments.
However, Smith said the longterm solution won’t be found in opening more ERs or urgent care centres.
Smith said part of the reason emergency rooms numbers are rising is because people don’t have the access they want to their primary care doctors.
“Patients are willing to wait in an emergency room or an urgent care centre for hours than wait for days for an appointment with their family doctor,” Smith said.
He said Ontario’s primary care model has to be revamped, perhaps drastically, to improve the system. That might include more use of communications technology and even having more health-care professionals visiting patients in their homes, particularly patients who are older and sicker.