HomeMy WebLinkAboutThe Goderich Signal-Star, 1979-03-22, Page 18PAGE 18—GODERICH SIGNAL -STAR, THURSDAY, MARCH 22, 1979
Elderly fear the future �. .and euthanasia..
® from page I
be.
For instance, day care surgery has gone
away up at AM&G recently, and probably will
continue to climb. There's. a whole list of
surgical procedures which are approved for a
day care surgery unit. It means the patients are
brought into hospital in the morning, the
operations are done,, the operating rQOm and
recovery room staff takes care of them for the
day, and in the evening the unit is cleared of
staff and patients. Everybody goes home.
Doctors are looking more and more to home
care for patients, but in Huron County the home
"care program is limited to a very restrictive set
of criteria. Not every patient qualifies for the
program that gets people out of hospital and
home where medical treatment continues
under OHIP funds.
The services of the Victorian Order Nurses
and the staff from the Huron County Health
Unit are also possible alternatives to in-hospital
care for some patients, but provincial funding
for these services haven't increased suf-
ficiently to expect them to accept any increased
load.
There may indeed be other ways of coping
with a reduced hospital bed situation, but as Dr.
Thomson points out many of these programs
aren't in place in Huron County as they are in
some other counties, and really don't provide a
viable alternative.
FLOAT SUNK
The ministry itself understands some of this
conundrum and has provided small hospitals
with a 10 -bed float during the switch -over
period. But it isn't of much use to AM&G.
This hospital has been on a tight . money-
saving regime for months trying to make up a
deficit and will pay a fine of $60,000 for having
more beds open than the ministry guidelines
decreed. AM&G can't afford to run a" 10 -bed
float. The bed cuts must be effected right away.
Doctors in Goderich are really quite bitter
about the penalties imposed by the ministry for
being "over -bedded". In fact, Dr. Ken Lambert
believes they aren't legal and says that if some
hospital would take the ministry to court on this
matter, it might be proven that the ministry
has no right to penalize hospitals and withhold
funds.
Dr. Thomson has a similar feeling. He says
AM&G got "an overwhelming vote of con-
fidence" when it received a three year ac-
creditation recently.
"And then we get hit for $60,000," said Dr.
Thomson in disbelief."We have to maintain
good care in spite of it."
But there's even more to fear. Dr. Thomson
says no one knows what further penalties will
be imposed by the ministry .... or when. AM&G
simply cannot afford any more budget sur-
prises this year, next year or any time.
The ministry has decreed that for 1979, four
beds per 1,000 referral population Will be ap-
proved. That computes to 43 active treatment
beds for AM&G. I.n 1980 that number will drop to
3.5 beds per 1,000 referral population, or 37 beds
for AM&G.
.
It is that the bed allocation will be
appoet
annually_ by the_ministry, and that
about
thee only way to increase a hospital's bed
will be to document an increase in
the referral population.
REFERRAL RED TAPE
• It is exactly• this referral population that is '
concerning not only the community's doctors
but the board of AM&G as well.
Board members have been in the ministry
office time and time again to ask questions and
to express concerns. Until recently, board
members and doctors felt they weren't getting
the number of beds to which they are actually
entitled under the ministry's own guidelines.
But last week it was finally explained that the
ministry accepted 10,032 as the referral
population for AM&G while the hospital board
had assumed from their calculations the
referral population was 14,581.
The administrator of AM&G said it was an
honest•mistake on the board's part.'He said the
board was adding in 4,549 referral population
for obstetrics (based on cases discharged from
hospital). But for ministry purposes, the ob-
stetrics population was included in the 15-44 age
group referral population ... and the board isn't
quite satisfied that this is"fair.
The population allowed by the ministry for
the 15-44 age group is 4,603. That's men and
women.
By the ministry's own calculations, the
referral population includes 4;549 for ob-
stetrical services only which shows that some
women are using AM&G when they have their
babies and other hospitals for all other medical
proedures.
"We really can't dispute the statistics,"
Elmer Taylor has said. "But we still have some
doubts about the referral population figures
and we really didn't get a satisfactory answer
for that."
Doctors have -even more doubts.
Doctors say that the referral population is
based on 1977-78 referral patterns. And there
seems to be little argument that these referral
patterns have changed drastically in the last
year or so.
Nearly the entire medical staff in Goderich
has changed since those referral patterns were
established,•-the•board agrees. Whereas doctors
who formerly practised in Goderich often sent
their patients out-of-town for medical care,
doctors in Goderich now prefer to treat their
patients, themselves in the local hospital,
creating a greater need for hospital beds at
AM&G.
TOURIST TRADEOFF
Dr. Michael Conlon has continually ex-
pressed his concern that the ministry has not
taken into account the fact that ,Goderich is a
tourist town and as such, has an increased
population in the summer months.
Dr. Conlon gave out figures to substantiate
his claim. He says the summer population in
the area swells by 9,311 persons according to
available statistics including 859 in Goderich
Township, 1,169 in Ashfield Township, 733 in
Colborne Township, 580 in Goderich, 1,800 at
Point Farms, 870 at Pine Lake and 3,500 at
Bayfield.
Dr. Conlon had done his homework. He cited
the fact that based on three persons per visiting
car, 38,929 persons had called into the Goderich
Tourist Booth last summer.
While doctors don't believe all these people
require hospital care, the fact remains the
patient load at AM&G does increase during the
summer months and some active treatment
hospital beds are required.
But according to Administrator Taylor, the
health ministry has taken into account
Goderich's tourist population. And facts 'are
facts, says the ministry. Goderich does not
qualify for one extra active treatment bed
becaus o the increased number of people in
the area.
There is a formula to determine how many
hospital beds are required for tourist
population. It is simple, really, In 1977, the
hospital must have had one out -of -the -area
patient each day for 365 days to qualify for one
additional bed. Goderich didn't meet that
criteria. No additional beds.
But as Dr. Lambert is quick to point out,
there's a big difference between rural hospitals
and 'urban hospitals.
"What if there is a mine disaster, for in-
stance?" says Dr. Lam.bert. "Nobody has even
mentioned that."
"The formula is rigid," notes Dr. James
Hollingworth. "And no rigid formula can work
' province wide when you are dealing with such a
personal thing as health services."
"The ministry should allow us to give•quality
care," the doctor argued. "Ontario is the
province with the second lowest number f
da.
acute care beds in Canada. Ontario a a nta o i s supposed
to be a rich province. Why must we go to the
bottom of th'e list forhealth care?"
NO RECOURSE
"We're going to have difficulty funding the
beds we've been allotted and we've been told
we can't use any private money to help,"
lamented Dr. Hollingworth. "Now that's sad."
Dr. Hollingworth said doctors are aware
"government f'.i ds are not bottomless" but he
questioned why the government -was --not -per-
mitting community hospitals to use alternate
methods of financing for operating expenses.
Jack Riddell had the answers for this one ...
from a ministry's point of view. He said he'd
been advised by the Hon. Dennis Timbrell
during question period in the Legislature that
the ministry of health was bent' on providing
uniform health care across the province, and
felt wealthy areas would unfairly be able to
offer a better standard of health care than less
affluent areas.
What's more, Timbrell told Riddell he
doubted if communities, could continue to raise
funds year after year for operating their
hospitals.
"But historically, that's how these hospitals
FOR ALL YOUR
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30 VICTORIA ST. NORTH GODERICH
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were built,". argues Dr. Thomson. "When you
start to destroy local initiative, it is going to
cost the government more money for certain."
But still there's more to worry about. The bid
concern is for the long term patients. Some are
elderly men and women for whom a nursing
home is; the best answer. Some are younger
people with permanent disabilities. Some are
sick people with illnesses that will keep them
confined for months on end.
These are the patients that occupy the
thoughts of many doctors and •hospital board
members. Where will they go?
•NOPLACE TOGO
For those who could be transferred to nursing
homes, there is no .place to go. Dr. Thomson
said he recently put one patient on a waiting list
that has 65 names on it. His patient is the 66th.
Obviously, the hospital will have to care for
these people ... maybe in active treatment beds
until the time comes when they can be moved
to another health care facility.
Some might qualify for home care for chronic
patients, but this service isn't in place in Huron
County. That avenue provides no solution then
for AM&G.
Dr. Conlon has another concern, just as
worrisome. He draws attention to the men and
women in nursing homes and psychiatric wards
who might have to be transferred to hospital for
active care. Where does the hospital put them?
And according to Conlon, the psychiatric unit
in the Bluewater Centre is a special situation.
Patients from all over Huron County are
referred there, and if they need active hospital
treatment they are moved to AM&G. He
estimates one or two beds at AM&G are often in
use for just such patients.
Dr. Conlon pointed out that 38 .psycho -
geriatric beds were closed when the Goderich
Psychiatric Hospital was closed two years ago.
",That has to. affect this situation," insisted
Dr. Conlon.
Cook request.
• 0000000000
•
There seems to be little doubt that 15 chronic
beds just aren't enough for AM&G. A more
realistic number would be 25 and the board is
working hard now to document the need for
more beds in this area.
Statistics. show that Huron County has an
unusually high percentage of elderly citizens
(13 percent), much higher than the provincial
average (8,6 percent). In fact, the ministry
does recognize the fact and has built a weight
factor into the formula to adjust Huron's
chronic beds to suit the. needs.
But there just aren't enough nursing home
beds in the area and the government really isn't
compensating the community in that sense. It
was reported by Dr. Hollingworth that a recent
application for more nursing home beds in
Goderich was turned down in Toronto.
"There's no question there has to •be some
movement in that area," Murray Gaunt, MPP
for Huron -Bruce has said.
MORE TO THINK ABOUT
There are other things that are concerning
doctors and board members about the 3.5 beds
per referral population.
Things like the knowledge that 450 beds have
been cut in London hospitals and will un-
doubtedly result in long waits for Huron County
people applying for admittance in the city.
Things like having to make interim
provisions at AM&G for certain patients
waiting to be admitted to other referral cen-
tres.
Things like having to turn down referrals
back from those centres,of patients who want to
recouperate at home, closer to their families,
but for whom there are no empty beds.
Things like realizing if the local hospital can't
accept those referrals, it is only creating more
of a backlog in the city hospitals ... and longer
waiting lists for Huron County patients.
Things like knowing patients are paying
insurance premiums for semi -private ac-
•
commodation in hospital ..: and that there will
be no such luxury at AM&G as a choice off beds
or rooms.
Things like having to turn people away ... or
putting them in holding areas or in the
hallways. Or in improper, inappropriate
mixing situations that run the risk of new
dangers for patients in infections.
Upsetting things. Degrading things.
Frightening things.
In Goderich, the doctors and the board
members have been very vocal about their
•fears and their frustrations. They have been
working hard and furiously t6 get the answers
they need to keep AM&G functioning safely and
adequately.
They have called on the peopl' 'of the com-
munity to think about the situation .... and to
make their; feelings known to government uf-
ficials. That's why Jack Riddell has received
such heart -wrenching letters.
LIVING IN FEAR?
It isn't difficult to understand that senior
citizens ..will be the most anxious about the
implications of the ministry's action. Senior
citizens are naturally fearful about illness and
old age. The two often go hand in hand.
And where will they go? Who will take care of
them?
Sean Conway made a good point. He said the
people of Ontario have been "surprisingly
mute" about the bed cutbacks which he says
have "very little to do with health care and a
great deal to do with budget problems".
It is a comment on the state of Ontario
finances.
Maybe some of the senior citizens who have
been writing to Jack Riddell are more per-
ceptive than this province would like to think.
Maybe euthanasia would ease the financial
crisis for the ministry of health. Who knows
when that very suggestion will be made by
someone?
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BY THE
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• from page 3
committee members that he thought "services
should go before frills (like the gateway)". If
the committee was not allotted as much money
in the budget as it was hoping for, priorities
should be placed in order with services taking
top priority, he said.
"Nobody disagrees that services aren't
important but we must make it (the Park)
outwardly attractive," said committee.
member Elsa Haydon.
"It's a small amount of money for an added
attraction and it should not be written off
because of a lack of priority," she continued.
Committee member Bruce Sully said the
committee should get the conceptfor the
gateway and build it whenever the money is
available. Sully said he would like to see the
north -south road (Mooney Street) completed in
the Park and' the east -west road (Mitchell
Street) opened up. One road dead ends in the
bush and the other ends up in a dirt pile, he
said.
Committee members seemed to agreed that
putting in a water line should take top priority
in the Park. One member pointed out that if this
was not done, there would only be one serviced
lot left for sale there.
The committee passed a motion to support
phase one of the plan drawn up by the sub-
committee Cif Planning Board showing the road
patterns and zoning for the Industrial Park
S Pith of Highway 21 and to concur- with the
basic premise of the overall plan.
Committee members were presented with
terms of reference drawn up under the
headings of Industrial, Commercial, Tourism,
Harbor and Planning subcommittees. Some
terms are applicable to all the subcommittees
and some are specific to certain subcommittees
to be dveloped further.
E'co omic Development Committee chair-,
man, Dave Gower said he hoped the sub-
committees would help the GEDC to operate
more df ficiently.
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