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The Wingham Advance-Times, 1979-03-21, Page 16.t I r, 0 - ..... ,w Citizens write to the Hon. Dennis i mbrell )l oUming a public meeting last week moue than 100 people sat down and wrote letters to Ontario Health Minister Dennis '!'lmbrell tel lot him why they feel Wingham and District Hospital should not be forced to close beds. A number of those letters were sent to The Advance -Times for publication and they are printed below. Unfortunately in several cases the name of the author had been left off the copies of letters sent to us and we were unable to use these letters. 0-0-0 Dear Sir, I wish to bring to your attention my �vM..nn �-.n•..-..n ........ wriin.. iii.. in►i+n�wii closure of beds at Wingham Hospital. Our hospital currently operates at a bed cost well below many hospitals in Ontario and has operated below budget for many years. The service provided by our hospital is greatly needed in our large rural area. The severe winter storms in this snow belt area often make it im- possible to travel long distances to hospitals. I am concerned that the loss of beds at this time will lead to our hospital losing its viability as a hospital to our community in the future. Wingham hospital was built by the community and I feel we have a right to retain the quality of service we currently enjoy. Ian O.,Clarke, RR 5, Lucknow 0-0-0 Dear Sir: I am a -very concerned citizen of the Wingham area concerning the closing of 14 !reds in our local hospital. I feel we are very undeserving of this cutback for the following reasons: Our hospital is efficient and it has worked within the budget. We have the lowest cost per bed per day, being $95.92, and work at 78 per cent occupancy rate. There is not another hospital in this area any cheaper so there is no way you, as a government, will be saving any money. The 3.5 beds per 1,000 is not applicable to this area since we have 13.8 per cent senior citizens, winter storms, and the only hospital in a radius of 25 miles. The average senior citizen rotfor all of Ontario is 8.6 so you can s we have more than double the.. average. The closure will lead a loss of ser- vices in the future s ch as specialists, consultants, cancer clinic and our nursing school. If you think it is saving money look at the cost it will cost emotionally and financially as you travel to larger centres for care. We need every bed in this hospital, all 100 of them. Merle Underwood 0-0-0 Dear Sir: I am writing to express my concern re the closing of beds at the Wingham and District Hospital. I have been a patient there several times and have received excellent care. We are in a relatively isolated area particularly in wintertime and our hospital area, covering an ap- proximately 25 -mile radius, does not in- ferfere with any surrounding hospital area since other towns with hospitals are not that close by. I understand that our hospital is ex- tremely efficient and the cost per bed per day, $95.72, is much, much lower that many other hospitals. Why close our hospital beds and thus cost yourself more money by forcing us to seek treatment elsewhere? Wingham has pioneered in many fields -we have many specialists who come here. I greatly fear that many of our advancements will be lost if beds are cut back. Please these cutbacks. Mrs. Gwen Laidlaw 0-0-0 Dear Sir: We are 1 about our local hospital! We feel that with the large area that is covered by this hospital we cannot :.ff--d a bed cut of any ai­ This area has many violent accidents and we need hospital space for these. We have many elderly people who need care at times and a bed loss will be very dif- ficult. Our children require care too and it our beds are cut we will run into difficulties again. The Wingham and District Hospital is very efficient and gives excellent patient care. Your consideration on our behalf would be appreciated. We want our beds left intact. We want our hospital! A. Chettleburgh 0-0-0 Dear Sir: I wish to express my concern along with the many other people in this area as to the closing of our hospital beds. I am a registered nurse, active in the hospital until two years ago, so know something of Use situation which will result because of this step. The hospital in this area cannot be assessed in the same way as every other one in the province. We are different in the following ways: 1. We are in a snow belt area which creates travel problems from November until March. The cold weather often means more illness of certain types. 2. It is an, area of a larger percentage of senior citizens. They have their own particular needs. 3. This hospital in Wingham is run very efficiently, more so than most. We have many extra services which will deteriorate if we lose our beds. I trust that you will honestly aA fairly assess the situation again. This letter touches on only a very few of the reasons why we need to maintain a full hospital. E. Muriel Thompson r Dear Sir: I am writing to you with respect to the proposed cuts is hospital beds at the Wingham and District Hospital. Fewer beds will result in fewer referrals, which in turn will result in fewer beds until we have no hospital at all. Needless to say, having no hospital would create serious problems for many people. If it were not for our local hospital my husband and I would not be alive today. Both of us have had an emergency situation and needed prompt attention. I appeal to you to reconsider your proposal so that the people of this area will have the high calibre medical care that we have enjoyed for many years. !ru a. ♦�. _"Iakp. uu 0-0-0 Dear Sir: It frightens me to look ahlad and see that if the government of this province is allowed to close 14 beds in our hospital in 1979 it is the beginning of the end! It is hard to understand how people unfamiliar with our geographical area can know the hardships that will be suffered by our citizens as a result. Not only is it a long drive to the nearest city hospital, but in fact an impossible drive during some days in the winter. To argue that it is more economical to centralize hospital facilities in large urban areas is statistically incorrect. In our hospital we provide excellent care to the sick and injured for $95 per day, as com- part/dd to $120 to $300 per day in a city hospital. Our hospital functions efficiently, is consistently under budget and is fully accredited. To sacrifice even one life because there is no bed in our local hospital is too high a price! This hospital was built by the community, for our community, and with an average daily census of 78 per cent now we will be unable to serve our citizens with the good medical care they are entitled to if the bed capacity is reduced. Mary A. Lee 0-0-0 Dear Mr. Timbrell: The deletion of 14 active hospital beds plus the financial support this year, and a further 14 beds and money next year, was received as a decided shock to this com- munity. The heap and welfare of ap- proximately 15,000 persons served by this hospital has or will be placed in jeopardy. As the recently retired executive director of the Wingham and District Hospital, with 32 years of service, I was involved with the growth of the hospital from 18 beds tota 100 bed compliment - a gradual growth based on the need for medical and professional care. The 1945 addition was financed entirely by the community. In 1955 we received a partial bed grant only; a financial share of the building was financed by the county," town and townships using the hospital, as was the 1967 addition. The final result, approved by the Department of Health, a modern 100 bed hospital consisting of 48 medical, surgical, and obstetrical beds; 10 cardiac and special care; 12 isolation; 12 paediatric; and 18 chronic and extended care with a daily average census of 78-80 per cent (never lower all year than 74 per cent). Geographically, the Wingham and Dis- trict Hospital is situated in the northern section of Huron County close to the Bruce County line. Thus we serve both counties. Our location resembles the hub of a wheel with the closest hospital 25 miles away on the same highway to our largest referral centre, London. This 75 miles for patients requiring medical and surgical treatment beyond the scope of a 100 bed hospital. During the winter months patients are often unable to be transported out of town due to the fact that we are in the snow belt area. Wingham Hospital serves a population of 15,000 plus, persons within a radius of 20 miles, with an average of 13.8 per cent in the senior citizen bracket. Geriatric patients require more than average medi- cal and professional care with longer hospital stay. Our average hospital stay is: 7.4 Active, 4.9 Newborn, 75.0 Chronic. Why should Wingham remain at the 100 bed capacity? 1. Retain the specialists using the Clinic Building, 13 in all, to provide services to our people. Anything less would not be feasible to have such visits, thus our patients would be required to travel to large centers adding to congestion and in- evitably to long intervals of waiting for appointments. 2. Our school for nursing assistants would be closed because the students could not receive their clinical experience with less than 100 beds, resulting in more ex- pense to the hospital to hire new staff re- quiring orientation. 3. Reduction in hospital beds and budges necessitates dismissing staff members and -or placing them on part-time employ- ment. It i5 a well known fact that part-time help are not as satisfactory as permanent staff without loss of continuity and of care and they require more in-service super- vision. The rate of unemployment would increase resulting in more expense for Unemployment Insurance or welfare. The hospital is the largest employer in the town. Formerly, 260 people were em- ployed, this has recently been reduced to 162 full-time equivalents to comply with the budget - a critical number for safe and competent overall care of the sick and suffering. And a further reduction of 17,500 paid hours will be necessary next year. Wingham hospital pioneered and con- tinues to provide: 1. Nursing Assistant school established in 1942. Copied by Ontario Health, our graduates are in demand by large hospi- tals. Education of the young people of this area rated among the first ten over the province. 2. Cancer Clinic, established in 1950 under the guidance of Victoria Hospital Cancer Centre, London, is conducted twice a month. 3. Huron County Health offices in the Clinic Building conduct Pre -natal, Geria- tric, and Well -Child clinics, monthly. 4. Ophthalmology specialists from London visit monthly. 5. Pediatric specialists from London visits monthly. 6. Ear, Nose and Throat specialists from London visit monthly. 7. Neurological specialists from Hamil- ton visit monthly. 8. Radiology - a Radiologist serving this and two other hospitals daily.' 9. Surgeons - consultant and as neces- sary for major surgery and gynecology. necessary for major surgery -4and gynecology. 11. Pathologist - consultant as needed with visits monthly from Stratford Hospi- tal. 12. Internal medicine - specialist from London visits bi-monthly. 13. Psychiatrist - from Ontario Hospital in Goderich, visits as needed and weekly to our Mental Health Resource Centre. 14. Cardiologists - special care and car- diac unit which was added in 1973-74. 15. Other services: (a) Ambulance established in 1966, before Ontario Depart- ment financed same. Our ambulance crew manufactured conveyance to transport patients during winter months when roads were inaccessable and snow machines are used for emergency transportation of storm marooned persons; (b) Physical medicine - physiotherapists; (c) Meals - on -Wheels in 1970; (d) Home Care - in consultation with medical staff and dis- charge planning nurse; (e) Infection, safety, and disaster plan committees; (f) Pharmacy. This was the first hospital in this section of Ontario to receive hospital accreditation in 1967 and to date with very few minor re- commendations (presently has a three- year full accreditation). Hospital surveys by Agnew Peckham were completed with the recommendation that service areas should be enlarged - out-patient depart- ment and another operating room - other- wise within the confines of the required criteria for good hospital care. The Wingham hospital has an excellent medical staff consisting of: Teeswater (1 doctor) - 9 miles - Bruce County, Luck - now (2 doctors, 1 radiologist) -11 miles - Bruce County, Brussels (1 doctor) - 15 miles - Huron County, Wingham (5 doctors and 1 surgeon with O.R. privileges) . Each doctor, in turn, stays on call for 24 hours every day of the year. They, plus a dedicated hospital staff give good pro- fessional care, under the direction of a competent executive director and assis- tants. Last, but certainly not least, a volunteer board of directors enforces the rules and regulations that are set by the Ontario Hospital Association and Public Hospitals Act for the safety of patients and staff and the maintenance of buildings, etc,. Special reference should also be given the auxiliary to the hospital, which has raised and given funds for capital equip- ment not covered by the budget. Wingham has weathered storms and re- jected the closure of our Nursing Assistant program, and the Central Board contract similar to the Regional Educational Board which proved more expensive than in- dividual schools administered by ' local citizens. Mr. Timbrell, what is in store for smaller hospitals? Will they be absorbed by large empire building institutions while small town institutions are relegated to the care of the elderly, mentally and chroni- cally ill, alcoholic, or drug addict, and the type of person no institution is interested in helping, as evidenced in pictures taken in Toronto, Ontario? These are human beings and how can a hospital or any institution refer .persons to exist under these condi- tions In what is supposed to be an en- lightened age! People are sentenced in court for treating animals under similar conditions. Wingham at least, gives its people gopd, considerate care and respects human dignity. No one is discharged until adequate care is assured. What is your answer to the article quoting Mr. Trudeau in the March 10, 1979, edition of the Toronto Star? "The Liberal government established medicare on one essential basis - that it be universal and accessible to all citizens. If anything is done by any province to depart from that principle we would have to review the very high payment the federal government is making to the province to cover half the cost of medicare." In the coming year Ottawa has Vlocated $3.9 billion for its three major health care programs: hospi- tal insurance, medicare, and extended health care. This money is transferred to the provinces. Is Ontario not capable of raising its share of these costs without sacrificing adequate care for its people? It is my personal belief that the province is committing political suicide if they persist in closing hospital beds that have already been established and are functioning well. How can Health costs be reduced) 1. Allow each hospital to have autonomy to regulate a realistic budget and stay within its bottom line figure. Reduce em- pire building institutions - no sick or ill person needs to be confined in a "Ritz Hil- ton" building. Regulate large city institu- tions for specialized treatment and com- pare costs of large centres with smaller in- stitutions. Our cost per day at this time is 997 with its many services. Why can't other institutions of similar size operate with similar costs - budget.) 2. Promote suitable nursing homes for the patient who needs care but not neces- sarily in a hospital of expensive serves controlled under an active hospital board and administration. This would free the present active treatment beds for the seriously ill and eliminate a long waiting list for admission to active and extended care treatment. and -or impossible at times. 3. Set and maintain the high standard of (b) The fact that our area population has medicare which the USA would like to a Wow than average percentage of senior follow. citizens? (13.8 per cent as opposed to a Consider the cost of a human life! I am provincial average of 8.6 per cent.) afraid you will find it difficult to deprive a (c) The fact that the Wingham hospital person of something that has been given. is the only hospital in a service area of The avenlge person believes it is their over 300 square miles and that it draws right to secure medical care under the in- from outside this large area as well. surance premiums. 4. The closing of beds will redulce the The Wingham and District Hospital number of admissions. This will reduce the Association would welcome a visit from referral population even further, Will this you in the very near future to explain why in turn cause the government to: this hospital should be penalized when it (a) elope even more beds'.+ has always functioned in all aspects well (b) doge the hospital at some future date and within an approved budget. when it is decided that it -no longer has (Mrs.) I. E. Morrey enough beds to function efficiently due to Illi lW:l Ulilt SUVerillllelll UCllUll lure'en Uen Dear Mr. Timbrell, cuts? 5. Is this initial bed reduction the be - I am writing this note to you as one who ��ng of a process that will dose hospi- has really felt the benefits of having easy tals and centralize medical service? access to the Wingham and District 6. (a) Is the combination of budget re - Hospital. straint and bed closure affecting all hospi- My late husband was a person who felt tals equally? - his responsibility toward his country and (b) Will you please supply me with a list fellow -man. He took his share in a quiet of the hospitals that must dose beds along way of projects going on in his area. He with the riding in which they are located? suffered from a lung ailment and had to be May I thank you for considering these admitted several times in the last two questions about our local hospital. I am years because of breathing difficulties. deeply concerned with the future of this in- Becuase of the nearness of the hospital he stitution and I shall look forward to was able to receive oxygen and necessary receiving your replies to the issues I have medication to send him home again to raised. carry on. If we had had to travel a good John H. Mann, B.A., M.Ed. distance to hospital this just would not have been possible just would not have 0-0-0 made it. He and I both received excellent Dear Mr. Timbrell: care while patients in hospital at Wingham As a concerned citizen, president of the and while he passed away just two weeks medical staff, Wingham and District ago, I have the satisfaction of knowing that Hospital, family practitioner and surgeon, everything possible was done for him. I urgently request that you reconsider Please don't close beds, we need them all. your decision to reduce our budget leading Mrs. Eva Carter to the immediate closure of 14 active treat - RR 2, Wingham ment beds to be followed by a further 17. 0__0_0 I feel that your advisors at the Ministry of Health must have failed to indicate to Dear Mr. Timbrell, you the special circumstances which As a concerned citizen of I urge you to necessitate the maintenance of our present reconsider the closure of beds at the bed complement which is barely adequate Wingham and District Hospital. now. The medical staff have to exercise I have worked in the health care field for the greatest discretion in the demand on over 35 years in spite of being a han- our present beds and on many occasions dicapped person (i.e. a polio patient). we have to restrain ourselves from ad - Were it not for the hospital I would not be mitting patients who really should be. This alive and as productive as I am today, hazard will increase very greatly when the For all like me we need all the care and beds are closed and I can only visualize support we can get. serious medical disasters occurring. Miss G. E. L. Norris R.N., D.N. (Ld) Wingham and District Hospital was built 0-0-0 by the communities and by the drive of - Dear Sir: concerned citizens to satisfy the -medical I enjoy being able to say how much I like needs as they saw them for this area. Wingham and District Hospital. I have As you are well aware, the hospital prospered and maintained its financial been a patient in the hospital and have had stability by public support and by pri- real personal care. I was treated won- vately insured hospital care costs until the derfully by nurses and doctors and I have a government intervened. healthy respect for the chance to uphold it As you know, the provincial government in every respect. I do hope they will not was reluctantly pushed into medicare by take beds away but will add as many as the federal government using the carrot of they possibly can to it. I have enjoyed about two years at the mental health inducement - large tax dollar con - centre resort and have been given free cessions. The government contracted with the meals and transportation to and from it. I board of governors of the hospital to pro - have had personal care from 9 a.m. to 3 vide medical services at the hospital in re- am. daily. I knitted different articles and turn for financial support. enjoyed myself very much. I do hope you The government, in my opinion, have all will think well about this outrage and abrogated their agreement and withdrawn will hurry to give every need to the hospital. this financial support whilst the board of Ellen Walker governors have maintained the highest RR 2, Wingham medical hospital facilities. The hospital is accredited at the highest grade, namely 0-0-0 three years, which is, public recognition of Hon. D, Timbrell: its excellence. On behalf of the 19 nursing assistant A full range of specialist services has students training at Wingham and District been attracted to the hospital. There are Hospital I am writing to you to let you two surgeons resident in the town, one know of the concern we have for the visiting surgeon, two consultant internist hospital bed closures. physicians, a pediatrician, an ophthamolo- It not only affects staff, patients having gist, an obstretrician, a psychiatrist, a to go to larger cities, the medical neurosurgeon, a radiologist, a pathologist, profession, the economic cutback in a gaenocologist and a mental health day money to the community, but also the care annex is available. nursing school and the students. The The hospital has excellent laboratory nursing assistant program at Wingham is -and physiotherapy facilities, an intensive the only one in Huron County and I'm care unit with 10 beds with available car - proud to say it ranks as one of the finest in diac monitoring and the hospital is a bust - Ontario. ling hive of activity in this area. We have We, as a group, can't understand that an active cancer clinic which draws pa - with Wingham's lower cost per bed (lower tients from as far away as Owne Sound in than other hospitals) beds have to be cut, the north and Exeter in the south. As no Where are the savings?! doubt you realize, that when the active bed This hospital was -built by the com- complement is reduced by the proposed 31 munity and all of a sudden the people of the beds, many, of these specialists will not community don't have a say. Why? find it warrants the effort of visiting on a Our population of senior citizens is 13.8 regular basis. per cent. Compare this with other areas. There has been an active nursing school We are the only hospital within a 25 -mile for the training of registered nursing radius and not infringing on any other. assistants for many years which has a high Please reconsider, taking into account the reputation in the profession and a modern cost in terms of dollars, emotional tension physical facility with 20 graduates a year. and time when people in this area have to I enclose a map of the whole area and travel to larger centres for care. you will see that circles with a ten mile . Come and live in our area! Try one of radius have been inscribed around each of our winters when you are snowbound for a the towns. You will see that there is con - week! Get sick and then try and find siderable overlap in all hospitals with the 'Where are the beds?'. exception of Wingham. Thus, we have to jean Sier tsema Supply the needs of 315 square miles of Class President territory and a referral population of (and 18 other nursing students) 15,000 with little assistance from any of the 0-0-0 nearer towns. Our closest is Clinton, 25 miles away. Dear Sir: The hospital has not only been efficient As a citizen of Wingham I am concerned from. a medical point of view but has main - that our hospital will be forced to close tained this efficiency on a very strict bud - beds because of the way your ministry has get. We have consistently been below bud - allocated funds. I have a number of ques- get for many years and it would seem that tions that require answers so that4 may rather than being awarded for this we understand the government position. I have been given more budgetry re - have heard, sir, that you do take time to strictions than our much less efficient answer your mail and I sincerely hope that neighbours. Our occupancy has been you will take time to respond to my con- always at a maximum and yet our day ceras. stay has been befow the average for the 1. Is the 3.5 beds per 1000 referral popu- province because of a high turnover and lation a ratio that was established for rea- efficient disposal of patients. sons of financial management or a revi- Our daily dollar rate of $93 compares sion of a provincially established stan- very favourably with that of the larger dard? hospitals where patients of necessity will 2. How was the size of Wingham's re- be referred when our beds are closed, so ferral population established? that the ultimate cost to the provincial ex - 3. How has your department made chequer will be increased rather than re - allowance for each of the following factors duced. Lastly, Wingham has a special re - when arriving at the number of beds that sponsibility to the geriatric patient. Our must be cut to meet current budget? geriatric percentage of population over (a) The severe winter conditions we ex- a#e 66 or 12.5 per cent is the fourth hi "t perience which make travel dangerous in the province. The nursing hpmei and chronic care beds are apparwHy per- manently blocked and It is a frightening thought to wonder what is to become of our aged population. I fed that this letter is far too long for you to read but we in Wingham look to you, air, to redress the injustice that is being perpetrated under your name. Should the disasters occur which one can anticipate, one can only quote the prayer of the Lord Jesus, "Father forgive them for they know not what they tiro,,' ` R. D. WlIkUw, F.R.C.S. President of 1"cal Staff 0-0-0 Dear Mr. Timbrell; T am a I i naranl eifiyow) tar. payer and voter living in Wingham in Huron County. I find myself appalled at the apparent unfairness and indifference shown at present by our government of which you are a representative as minister of health and welfare. We inWingham have a hospital that was built by the people of the community for that community and surrounding area. The government took it over and is now trying to cut back beds and so indirectly its services and effectiveness. Our local board manages the hospital very ef- ficiently, more so than many other hospi- tals - yet a formula of bed cuts is applied to all alike and, of course, hits harder a hospital such as ours which has kept and is keeping its expenses to a bare minimum. We belong to a rural area where the population is widespread and distances are far greater than in densely populated regions, an area where extreme weather conditions such as snow storms dominate our lives four to six months of the year - yet your ministry seems to feel that all that can be ignored and cities and rural areas treated alike. Huron County is also an area with a high accident ratio. Unless accident victims can be treated immediately in a hospital with full facilities and adequate bed space, many more deaths may occur. Even in the most serious cases that have to be trans- ferred to London or elsewhere, the im- mediate help a hospital such as ours pro- vides saves many of those lives and makes further transport possible. During the summer and winter too, our government tries to encourage tourism as a potential means of income - but who would want to travel and holiday in an area that does not offer adequate medical services? Are we not defeating our own purposes? Our local elected representatives recog- nize the needs in this area and are in a much better position to try to meet them than the provincial bureaucrats who seem to have only one fixed approach - that of eliminating services already established and paid for. Compromises and attention to other means of solving the problems of higher costs seem to be possible in some areas such as Windsor. Why not here? One such solution might be a user service fee paid to and administered by the local hospital boards as they see fit in response to the needs of the communities they serve. Should we be penalized for trying to help ourselves? I understand that our hospital board rep- resentatives have unsuccessfully tried to present our case to your ministry, but per- haps if you, not long ago the youngest minister in our province, could give this matter your personal attention, a more constructive solution could be found. I would hope that the fact that this is a liberal riding would not prevent flexibility and positive, creative thinking on your part from being applied to us too. I appreciate your attention to this matter. Mrs. Inge Wraith 0-0-0 Dear Mr. Timbrell: Wingham Hospital is currently facing bed cuts as a result of your budget restrictions. Of particular concern to me as a parent is the cutback that will be necessitated in the paedi tric wing. My children have expreienced centralized urban centre "large hospital" care and I have been appalled. We came to the Wingham area, in part because of the availability of a hospital. When we had occasions to utilize the paediatric wing we were extremely impressed. The level of personalized 'human' concern for the children was outstanding. This is no health care machine you are dealing with but a most remarkable 'community' hospital.. Sinee our visits have all concerned acute respiratory problems, the nearness of Wingham hospital is also clearly of great importance to us. I am confounded that you would even 'consider restricting Wingham hospital. It is by far one of your most efficient hospitals ($95 per day), as well as serving an area with an unusually large senior citizen population. Further it stands alone, servicing an area of approximately 350 square miles. I STRONGLY urge you to reconsider. Mrs, Ian O. Clarke, RR 5, Lucknow 0-0-0 Mr. Timbrell: As a member of this. community I want to express my concern at the cutbacks of our hospital., My own family has received personal care in a way we very much appreciated. In every way possible nurses, doctors and others involved used their skills and thoughtfulness to every extent. Statistics prove that it is a very ef- ficiently run hospital and at minimum expense. We simply cannot afford one bed cut because of the wide area it services. If one will view it practically it will be seen that it is not saving money as unemployed need to be insured and the sick transported to a larger centre some miles away. We need our hospital and every beef in it! Mary Weber G