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October 9, 1997, Chatham, 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 Kent 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 decisions will set the stage for building an improved and better coordinated health services system in Kent 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

The Commission's recommendations include:

• Consolidation of all inpatient and ambulatory programs including emergency, day surgery, acute mental health, rehabilitation and complex continuing care at the Public General Hospital site, with the St. Joseph's Hospital site to close by June 1999.
  
• St. Joseph's Hospital is encouraged to identify another purpose for the site. .
  
• The role of Sydenham District Hospital will be confirmed following the Kent County District Health Council review of health services in light of the Rural and Northern Health Care Framework.
  
• The Kent County hospitals will amend the Chatham-Kent Health Alliance to include the participation of Sydenham District Hospital. The amended Alliance agreement calls for:
  
  • three separate hospital boards supported by a Joint Executive Committee empowered to make decisions;
    
  • one Chief Executive Officer, and one Chief of Staff, Medical Advisory Committee and medical staff for all three hospitals; and
    
  • Public General Hospital and St. Joseph's Hospital to determine the specific roles and program responsibilities for each hospital on the Public General Hospital site.
• There will be a total of 300 beds including sufficient capacity to meet future needs to the year 2003, based on:
  
  • 177 acute care beds plus 22 sub-acute care beds;
    
  • 21 acute mental health beds;
    
  • 19 rehabilitation beds; and
    
  • 61 complex continuing care beds.
• Kent County will be able to meet the growing need to provide services to the elderly, with 15 additional complex continuing care beds and 224 additional long term care places in supportive housing, long term home care, adult day care and attendant care.
  
• Recommended reinvestment of $5.7 million in services in Kent County:
  
  • $1 million for acute home care;
    
  • $1.8 million for complex continuing care;
    
  • $1.6 million for sub-acute care (for people who need acute care such as nursing and therapy, but do not require daily physician involvement);
    
  • $.6 million mental health; and
    
  • $.7 million for rehabilitation.
• Recommended reinvestment of $27.8 to $39.7 million for renovation and expansion projects.
  
• $9.8-$12 million in annual savings, or 14 to 17.5 per cent based on 1995/96 net expenses of $69 million.

The Commission announced that its decision concerning the scope and content of services at Sydenham District Hospital will wait until the Kent County District Health Council completes its review of health services restructuring in light of the Rural and Northern Health Care Framework. Recommendations are to be provided to the Ministry within a six month time frame.
Ms. Jamieson stated that the Commission does not wish to predetermine the outcome of the DHC planning work, "however, we believe it is important to provide the basis for the continuation of the restructuring work now underway." With this in mind, the HSRC developed capital cost estimates under two scenarios:

In Scenario 1, Sydenham District Hospital:

• provides 24-hour emergency triage, assessment, resuscitation and stabilization;
  
• no inpatient beds; and
  
• provides a range of ambulatory and outreach services to the local community.

• provides 24 hour emergency care with physician on-site or on-call;
  
• inpatient acute care beds to provide the same volume and scope of services as previously provided; and
  
• complex continuing care services as previously provided.

Ms. Jamieson commended the considerable progress the community has made in implementing health services restructuring. In particular, she noted the efforts of the Chatham-Kent Health Alliance to begin the process of administrative and clinical integration.

"There is real evidence of goodwill and collaboration in the community. We believe the Alliance agreement represents a significant positive step forward and reflects the ongoing commitment of the hospitals to achieve a restructured and integrated health system in Chatham," she said. "Wherever possible, the Commission supports locally-determined governance solutions."

The Commission views the Alliance agreement as a viable governance option for services in Kent County, with some modification. Specifically, the Commission directs the hospitals in Kent County to amend the Alliance to include the participation of Sydenham District Hospital.
The Commission also directs both the Public General and St. Joseph's hospitals to allocate specific clinical program and service responsibilities between the two hospitals. In addition, the hospitals will be asked to review the Alliance as it pertains to the dissolution of the Alliance to ensure that the process meets the needs of all parties.

The Commission expects implementation of its directions and recommendations for Kent County to be completed by June 1999.

"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 Kent 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 Kent County," concluded Ms. Jamieson.

The HSRC 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.

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