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Directions attached (Word Document)

October 1, 1997, Sarnia, Ont. -- The Health Services Restructuring Commission (HSRC), an independent body of health experts and professionals, today released its
directions regarding the restructuring of health services in Lambton County.

HSRC Commissioner Douglas Lawson unveiled a comprehensive redesign of health services for Lambton County that goes beyond hospital-based services to include essential reinvestment in mental health, rehabilitation, sub-acute care, home care and long term care.

"Our goal is to achieve the best possible publicly-funded health system for the people of Ontario," said Mr. Lawson, founding chair of the Association of District Health Councils of Ontario.a "We believe our recommendations will set the stage for building an improved and better coordinated health services system in Lambton County, today and in the future."

Report highlights

• Lambton County will have a comprehensive health system consisting of three hospitals on two sites:
  
  • acute inpatient services in Sarnia will be provided by Sarnia General Hospital at the St. Joseph's Health Centre site;
    
  • complex continuing care (chronic care) and rehabilitation service will be provided by St. Joseph's Health Centre; and
    
  • the range of services at Charlotte Eleanor Englehart Hospital will be determined following the Lambton County District Health Council review in light of the Ministry of Health's Rural and Northern Health Care Framework.
• There will be a total of 359 beds including 31 to meet future needs to the year 2003:
  
  • 212 acute care beds plus 25 adult acute mental health beds;
    
  • 22 rehabilitation beds;
    
  • 26 sub-acute care beds; and
    
  • 71 complex continuing care beds.
• Lambton County will be able to meet the growing need to provide services to the elderly with 517 additional long term care places needed to 2003, including:
  
  • 182 long term care beds (nursing home); and
    
  • 335 long term care places in long term home care, supportive housing, adult day care and attendant care.
• A common Chief Executive Officer, Chief of Staff, Medical Advisory Committee and medical staff for all three hospitals;
  
• A reinvestment of up to $7.5 million in services is recommended:
  
  • $3.4 million in long term care;
    
  • $1.3 million in home care;
    
  • $0.3 million in rehabilitation;
    
  • $0.7 million in mental health;
    
  • up to $1.9 million in sub-acute care (for people who need acute care such as nursing and therapy, but do not require daily physician involvement); and
• Recommended reinvestment of up to $37 million in construction, renovation and equipment.
  
• $19 million in annual savings based on 1995/96 net expenses of $98 million.

The Commission announced that it would defer a decision regarding the scope of services at the Charlotte Eleanor Englehart Hospital in Petrolia until the Lambton County District Health Council completes its review of health services in the context of the Ministry of Health's Rural and Northern Health Care Framework.

"We will delay our decisions concerning the content and configuration of services for the Charlotte Eleanor Englehart Hospital until we are able to consider the additional advice from the DHC," said Mr. Lawson. "We realize people are eager to move forward with restructuring, however, we don't want to predetermine the outcome of the DHC's planning. We must, nonetheless, provide a basis for the continuation of the restructuring work now under way."

Recognizing that further implementation of restructuring is dependent on renovations and expansion of the current St. Joseph's Health Centre site to accommodate the programs and services of the two hospitals, the Commission has developed capital cost estimates for the two Sarnia hospitals based on the following two scenarios:

Scenario 1:	The Sarnia General Hospital and the St. Joseph's Health Centre would provide all inpatient services for Lambton County. The CEEH would continue to provide access to emergency care and ambulatory services.
Scenario 2:	The Sarnia General Hospital and the St. Joseph's Health Centre would provide inpatient services for Lambton County except for those inpatient services which would be necessary to support the role of the CEEH in Petrolia, including its emergency service.

Mr. Lawson stressed that these are only two potential scenarios and did not represent the Commission's intended directions concerning hospital services that could be provided in Petrolia. "Once the Commission has had an opportunity to review the recommendations of the district health council on the designation and scope of services for the CEEH, we will issue directions concerning services in Petrolia," he stated.

Commission praises progress

Mr. Lawson commended the considerable progress the community had made in implementing health services restructuring. "Lambton County has moved forward and made tremendous progress in implementing many of the recommendations contained in our November 1996 report. The community should be commended for working together in such a positive and constructive manner," he said.

While generally supportive of the governance model developed in Lambton County, the Commission had some reservations about the structure and process used by the hospitals. As a result, the HSRC is directing the board of directors of the three hospitals to jointly:

• appoint one CEO to lead and manage the operations of all three hospitals;
  
• appoint one Chief of Staff and Medical Advisory Committee in common to be accountable to the board of directors of each hospital;
  
• appoint an equal number of representatives of each hospital's board of directors to the JEC, as well as the CEO and Chief of Staff for the three hospitals; and
  
• delegate to its representatives on the JEC the power to make decisions that will develop and operate the three hospitals as a unified system of health services while maintaining three separate operating corporations.

The Commission expects implementation of its directions and recommendations for Lambton County to be completed by March 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 Lambton 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 Lambton County," concluded Mr. Lawson.

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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