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November 27, 1997, Toronto, ON -- The Health Services Restructuring Commission (HSRC), an independent body of health experts and professionals, today released its preliminary decisions regarding the restructuring of health services in Hamilton-Wentworth.

"Our goal is to achieve the best possible publicly-funded health system for the people of Ontario. We believe our decisions will set the stage for building an improved and better coordinated health services system in Hamilton-Wentworth, today and in the future," said HSRC Commissioner Daniel Ross.

The Commission issued preliminary decisions (Notices of Intention to Issue Directions or "Notices") and announced that there will be a response period. Interested organizations and individuals are invited to comment on the HSRC recommendations by January 5, 1998.

Report highlights

Highlights of Hamilton-Wentworth report on health services restructuring include:

• A comprehensive health system consisting of two hospitals on five sites. The roles of the Hamilton hospitals will be redefined as follows:
  
  • St. Joseph's Hospital will remain a full service hospital with regional programs in nephrology, acute, longer term and forensic mental health, respiratory and thoracic surgery, and complex continuing care. The ambulatory care centre will continue to provide services.
    
  • The McMaster site of the Hamilton Health Sciences Corporation will remain a full service hospital with complex continuing care beds and a regional focus on high risk obstetrics and inpatient paediatric services.
    
  • The General site of the Hamilton Health Sciences Corporation will remain a full service hospital with specialized cardiovascular programs, neurosurgery, trauma and vascular surgery, and regional rehabilitation.
    
  • The Henderson site of the Hamilton Health Science Centre will continue to serve as host hospital for the Regional Cancer Centre with a focus on oncology programs. It also will provide complex continuing care.
• Hamilton Psychiatric Hospital, St. Peter's Hospital and the Chedoke site of the Hamilton Health Sciences Corporation will cease operation, with their programs and services transferred to other sites.
  
• St. Peter's Hospital will be encouraged to pursue a different role in long term care.
  
• The total capacity of the health system to 2003 will be 1,824 inpatient beds, including acute care, sub-acute care, mental health, rehabilitation and complex continuing care to meet the needs of the growing and aging population;
  
• Enhanced services for the elderly include:
  
  • 1,127 additional beds in nursing homes and homes for the aged; and
    
  • 1,210 places for supportive housing, long term home care, attendant care and adult day care;
• Enhanced mental health services for adults, children and adolescents include:
  
  • increased acute mental health beds (from 83 to 91); and
    
  • 17 child and adolescent mental health beds for residents of Hamilton-Wentworth, Haldimand-Norfolk, Brant County and half of Halton Region;
• Enhanced rehabilitation services, with beds increasing from 127 to 146;
  
• $36 million reinvestment in services:
  
  • $3.1 million for acute home care;
    
  • $21 million for long term care;
    
  • $2.8 million in high risk neonatal services;
    
  • $7.1 million for sub-acute care;
    
  • $1.4 million in mental health services; and
    
  • $.3 million in rehabilitation services.
• $72 million for renovation and expansion projects, furniture and equipment; and
  
• $100 million in annual savings or 16.6 percent based on 1995/96 net expenses of $604 million.
  

The Commission intends to direct that St. Joseph's Hospital and Hamilton Health Sciences Corporation retain separate governance and management. The two boards will appoint members to a Joint Executive Committee with delegated powers to make decisions to facilitate the implementation of the Commission's directions.

Pending the closure of Hamilton Psychiatric Hospital, the governance and management of mental health services at Hamilton Psychiatric Hospital will be transferred to St. Joseph's Hospital.

Specialized services

Mr. Ross stated that the Commission is aware of local concerns regarding specialized cardiac services in Hamilton-Wentworth. The HSRC believes that it is a matter of regional and provincial importance to determine capacity for these specialized services so that high quality outcomes and appropriate accessibility to services are maintained. Therefore, the HSRC will convene an expert panel to address the issue of critical mass and the additional, if any, siting of cardiac services in the province. The Task Force will submit its report no later than January 31, 1998.

The Commission also recommended program transfers and consolidations to build on the current clinical services profile and extensive supporting infrastructure of each site. "We believe these specialized program consolidations will improve the quality and accessibility of services to meet patient needs and make best use of surplus capacity in Hamilton-Wentworth," said Mr. Ross.

• Enhance the lead role in respirology services at St. Joseph's Hospital by transferring 50 percent of respirology services provided at the Henderson site to St. Joseph's Hospital;
  
• All inpatient paediatric services will be consolidated at the McMaster site; and
  
• Linkages between the Regional Cancer Centre and the host hospital will be strengthened by concentrating oncology services at the Henderson site.

The Commission supports the Hamilton Health Sciences Corporation's recent consolidation of gynaecology, obstetrics and neonatology services at the McMaster site. The HSRC concludes that Central West Region requires another 14 high risk neonatal intensive care (Level III) beds in addition to the existing 33 beds. These beds will be located at the McMaster site.

The Commission is encouraged by the high level of interest in health system integration expressed by various groups in Hamilton-Wentworth. The HSRC reviewed proposals from both the Academic Health Care Network and St. Joseph's Health Care System to develop integrated academic health systems. The population of Hamilton-Wentworth potentially can sustain more than one integrated health system and the Commission recommends continued planning by the parties work together to further develop integrated health systems locally.

The Commission expects implementation of its directions and recommendations for Hamilton-Wentworth to be completed by April 2000.

Mr. Ross said the Commission believes its recommendations will lead to positive change. "The measures outlined today will lead to improved quality and better access to a wide range of services for the residents of Hamilton-Wentworth. Our recommendations to reinvest in community-based services, and to upgrade and expand facilities will ensure that the health system will be able to meet the needs of the community well into the 21^st century."

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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