October 10, 1997, Windsor, Ont. -- The Health Services Restructuring Commission (HSRC), an independent body of health experts and professionals, today released its
preliminary recommendations to restructure health services in Essex County.
"Our goal is to achieve the best possible publicly-funded health system for the people of Ontario," said HSRC Commissioner Shelly Jamieson "We believe our recommendations will set the stage for building an improved and better coordinated health services system in Essex County, today and in the future."
The Commission issued preliminary recommendations (Notices of Intention to Issue Directions "Notices") and announced that there will be a 30-day response period. Organizations and individuals are invited to comment on the HSRC recommendations by November 10, 1997.
Report highlights
Ms. Jamieson commended the considerable progress the community has made in implementing health services restructuring. The Commission supports, with minor changes, the recommendations of the Essex County District Health Council's 1994 Win/Win report.
"Essex County has been the trailblazer not only in implementing health services restructuring but in planning the development of an integrated health system. The Commission supports the actions taken in this community to develop an IHS, and we believe Essex County should be developed as a pilot IHS" she said.
The HSRC will advise the Minister of Health to fund the development phase of the IHS, and to begin negotiating with representatives of Essex County regarding the partial funding envelope for the region. Also, it will advise the Minister to begin negotiations with the Essex County Medical Society regarding an appropriate method of payment for physicians within the IHS.
Other considerations
Two issues emerged from the submissions and site visits which the Commission addressed in its report: the location of paediatric services and the repatriation of cardiac surgical procedures such as cardiac catheterization, angioplasty and coronary by-pass surgery to Essex County.
With respect to paediatric services, there were differing views as to whether this program should be located with maternal and newborn services at the Metropolitan site of the Windsor Regional Hospital or with the trauma program at Hôtel Dieu Grace Hospital. After consulting experts in emergency services and paediatrics, the Commission decided that the paediatric program would be located at the Metropolitan site.
"We supported the original recommendation of the Win/Win report because the vast majority of the paediatric caseload would be where the obstetrics program is located. Furthermore, the number of paediatric trauma and specialized surgical cases is very small," explained Ms. Jamieson. "We recognize that there will have to adjustments made at the Hôtel Dieu Grace Hospital to support paediatric trauma activity and encourage the two hospitals to work together on this matter."
Regarding cardiac services, the Commission also considered whether there was sufficient volume of cardiac surgical procedures to establish a cardiac surgical centre of excellence in Essex County. Although the data suggests that Essex County would be the smallest cardiac centre in the province this does not preclude them from offering cardiac services. The criteria which would determine whether a centre should offer cardiac services are critical mass and outcomes. Without a recommendation with respect to the number of surgeries that must be performed to attain critical mass, the HSRC will convene an expert panel to address this issue.
The Commission will appoint an independent chair, and its membership will consist of representatives from the Ministry of Health, Cardiac Care Network of Ontario and the Institutes for Clinical Evaluative Sciences (ICES). The expert panel will be asked to identify the critical mass guidelines for cardiovascular surgical services and to recommend the siting of cardiovascular surgical services based on population need and existing growth. The expert panel will be asked to submit its final report no later than January 31, 1998.
Role of Leamington hospital
In keeping with the Win/Win report, the HSRC supports the Leamington District Memorial Hospital continuing in its role as a full service, primary and secondary care community hospital with improved linkages with the Windsor hospitals.
"The Leamington District Memorial Hospital should continue to explore ways to further integrate and coordinate services between a variety of providers, both institutional and community-based, and continue to be a "hub" for prevention, treatment and education services for the population of South Essex County," said Ms. Jamieson.
The Commission expects implementation of its directions and recommendations for Essex County to be completed by December 2000. "I want to stress that there will be no reduction of services as a result of these recommendations. There will be enhanced services for all Essex County residents. We believe that our decisions will lead to improved quality and better access to a wide range of services for the population served by Essex County," concluded Ms. Jamieson.
The Health Services Restructuring Commission is a group of individuals appointed by the Government of Ontario to redesign the Ontario health system. It is an independent agency of doctors, academic health science professionals, hospital administrators, former hospital board members and other experts. The Commissioners work with local district health councils, hospital boards and other health professionals to restructure health services for each community. The Commission has a four-year mandate to restructure hospital systems and advise the Minister of Health on reinvesting in and restructuring other services to meet the health needs of the people of Ontario.
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