“Something Is Rotten in the State of Denmark”… and the South Bruce Grey Hospital Board

Trying to make sense of last week’s decision by the South Bruce Grey Hospital Board is a ponderous task. On Thursday afternoon, Board CEO Nancy Shaw released a statement advising that the 10 inpatient beds in the Durham hospital would be moved to the Kincardine and Walkerton hospitals and the people in Durham and the surrounding area would be left with an “urgent/emergent” care centre open during daytime hours only.

So many questions arise in the aftermath of this notification. Why were local elected officials not consulted prior to the release of this news? Why was such an important decision not even discussed publicly in the most recent SBGHC meeting? When was the decision actually made and who made it? What the heck is an “urgent/emergent” care centre and who came up with that name? In a practical sense, how would it work? What can local residents and regional supporters do to influence the decision? After this blunder, should Nancy Shaw continue as CEO?

Where to start? First let’s examine this situation from a practical perspective. The 10 beds in question were purchased by the Durham Hospital Foundation with donations from local residents who wanted to donate funds for the betterment of their community. They are rightly asking now for an accounting of this decision. Is it consistent with the spirit of their generosity? Might this impact future fundraising efforts by the Foundation? At present the hospital corporation asserts that they own everything inside the hospital building whether it was paid for by them or not and Shaw clearly feels it is her prerogative to transfer it wherever she likes. In future, will potential donors worry that their donation will be moved to other locations in this willy nilly fashion with no explanation and no respect for the donor? Indeed, there is information that some lab equipment from the Durham facility has already been moved.

Another practicality rears its ugly head. An “urgent/emergent” centre? Shaw puts this idea forward, with a straight face, either because she is not familiar with the Public Hospitals Act or because she thinks she can bluff her way through this. This isn’t just semantic quibbling. It is a key consideration here. The Classification section of the Act lists 22 different categories for hospitals in this province. None of them are described as “urgent/emergent”. Is Durham likely to lose its classification as a hospital in the aftermath of this decision? Asked to explain by local officials, she sidesteps this question as if it does not matter. In the days ahead, this question will need to be settled.

How will it work in a practical sense? An Emergency Room that closes at 5 pm is not, in fact, viable. What happens at 5 o’clock? With no inpatient beds, anyone who has been receiving treatment in this mythical ER will have to leave. Picture this: you have come in with chest pain or a broken limb during the afternoon and the clock strikes five. Do you go home and come back in the morning? Are you taken by ambulance or by a family member to another hospital that does have inpatient beds? Since that hospital is already straining to provide services in the aftermath of all the ER closures, can they even accommodate another patient? How far do you have to be moved to receive the care you need? This is a simple bait and switch tactic: first you will be told the ER will continue to exist and then after a period of time, another of Shaw’s midafternoon memos will advise that unfortunately they can’t keep it open.

Let’s talk about the decision making process. Members of the public are allowed to attend board meetings but not to participate in any meaningful way. Read through copies of the minutes which are available online and you will see that the Board gives some information, but they go into “closed session” frequently and that is where the big decisions are made or sanctioned. No one who attended the most recent meeting heard anything about the Durham hospital decision. The President of the board and the CEO assert that they have the right to do it this way to protect confidentiality. And we acknowledge that they do have to meet certain confidentiality requirements. They cannot release personal information or identifiers about patients or staff. But think about this. there are many types of corporations. The SBGHC is not a private or commercial corporation acting in privacy to protect its brand or its plans. Their only source of funds is the money they receive through or taxation system. They are publicly funded: what about transparency? What about respect for those who have been democratically elected to represent the residents of the area?

So, it seems we must interpret this cavalier decision in its true meaning. CEO Shaw denies that this decision portends the closure of the Durham hospital. A quote from Shakespeare’s Romeo and Juliet comes to mind: “She speaks yet she says nothing.” Nothing that passes the smell test anyway. Whether the physically put the lock on this week, or next month, or the month after that… this decision means the hospital will be closed. It cannot function in any practical way as described in the infamous memo and wouldn’t even meet the criteria for classification as a hospital. Shaw’s disingenuous remarks on this situation should warrant a request for her resignation. Will that happen? Maybe not, but it should.

The people of Durham are holding a rally on Tuesday, May 7th in the arena. The “Save the Durham Hospital Committee” has done a remarkable job of organizing the community to come together and oppose this unjust and unreasonable decision. Residents of Grey Bruce have a history of standing up to assert their rights. We have fought for our small rural hospitals before, and can do it again. We are up to the task.

On May 11th the Grey Bruce Health Coalition is holding an area-wide rally on the steps of Owen Sound City Hall to save local healthcare services and there will be an opportunity there to also show support for the people of Durham. It is important to let them know that they are supported by their community, if not by the Board of the South Bruce Grey Health Centre.

Brenda Scott

Co-chair, Grey Bruce Health Coalition