Smith helped Niagara prepare for a healthy future

For the past seven years, Kevin Smith has been the steady, insightful overseer of hospital services in Niagara.

Smith, 55, announced Monday he is stepping down as CEO of Niagara Health and St. Joseph’s Health System in Hamilton to become president and CEO of University Health Network in Toronto. His last day is May 21.

Smith’s legacy in both Hamilton and Niagara is weighty. He came to Niagara at a time of crisis. In 2011 when Smith was brought in as a provincially-appointed supervisor, public confidence in the local hospital system was at a low, following a systemwide C. difficile outbreak which claimed 37 lives and cost $2 million to stop. Ontario appointed Smith, known as a healthsystem hired gun, to win back public confidence and restructure the NHS. Smith did that, dissolving the board and reshaping the way health care is delivered in Niagara.

By 2014, much of the Niagara system had been transformed — the new St. Catharines hospital was open, a new board of directors was in place, and Smith entered into an unusual agreement to provide CEO services for both Niagara and St. Joseph’s. Smith was already CEO at the Hamilton hospital, but Niagara Health signed a management services agreement with St. Joseph’s in order to keep Smith’s valued expertise in Niagara.

“I wouldn’t say it was unprecedented, but it was certainly unique,” said John McDonald, chair of the Niagara Health board of directors, of the arrangement.

Smith has overseen some major shifts in health-care delivery — beyond the opening of the new hospital, there has been a realignment in the region, with services shifted and streamlined and the re-purposing of smaller hospitals, such as Fort Erie and Port Colborne, to urgent care centres and Niagara-on-the-Lake to a diagnostic centre. These moves have not always been met with full support from the public, but Smith’s calm purpose has helped steer dramatic changes forward.

Smith believes Niagara health has dramatically changed for the better since he arrived on the scene.

“I am not just saying that,” he said in an interview with reporter Grant LaFleche. “I see the data. I have patient survey results. Staff survey results. This is not to say we get it right every time. We don’t. But I think we have come a long way.”

What happens next is uncertain. Smith’s role has been less public in recent years — Dr. Suzanne Johnston was brought in as president in 2011 and has had a larger public presence than Smith. But the CEO played an important role, particularly in terms of the relationship between Niagara Health and the province and in setting the system’s strategic direction. The management services agreement with St. Joe’s was due to expire this year, and the departure of Smith will accelerate a review of governance.

“This is quite a loss for Niagara Health,” said McDonald. “This is very new to us and we had no prior knowledge that (Smith) was up for this job. Obviously we will be meeting as a board to discuss our options.”

There’s a lot riding on who leads Niagara Health. There’s a new hospital in Niagara Falls to be built; there’s the refurbishment or replacement of the Welland hospital site to be moved forward. And there’s the ongoing problem of overcrowding at the existing sites, caused in part by the opioid crisis and growing elderly population in Niagara. This in turn is helping fuel the offload delays affecting ambulance services.

Smith’s vision is Niagara and Hamilton will need to integrate further than they are now. A new CEO and the two boards may not agree.

But whatever the future holds for Niagara Health, the system is in a better position to meet those challenges due to the work done by Kevin Smith. For that, he deserves Niagara’s thanks.