OTTAWA, February 24, 1997 - The Health Services Restructuring Commission (HSRC) today released its report and recommendations on restructuring hospital services in Ottawa-Carleton.
The restructuring plan, based on criteria of quality, accessibility and affordability, is contained in the Ottawa-Carleton Health Services Restructuring Report and notices of intention to issue directions being delivered today to local hospitals, the Ottawa-Carleton Regional District Health Council and the Minister of Health.
Local organizations and individuals will have 30 days to send in written comments. After considering new information received during this period, the HSRC will issue its directions to hospitals and recommendations to the Minister of Health.
The HSRC based its report and recommendations on health services needs in Ottawa-Carleton and eastern Ontario projected to the year 2003. The restructuring plan takes projected population growth in Ottawa-Carleton into account, as well as anticipated increased referrals from surrounding areas. It guarantees continuing access to French-language services.
By March 31, 1999 all acute services will be provided at the Ottawa General, Ottawa Civic, Queensway-Carleton and CHEO sites.
To help carry out this transition, the governance structures of the Ottawa General, Ottawa Civic, Riverside and Montfort hospitals will be merged into a new amalgamated hospital. Governance of The Rehabilitation Centre will be transferred from the Royal Ottawa Health Care Group to the new governance structure. The Commission will appoint a facilitator to lead the governance discussions.
Riverside and Montfort hospitals will no longer provide hospital services. Riverside Hospital will close as of June 30, 1998, and Montfort Hospital will close as of June 30, 1999. They will be decommissioned as acute care hospitals.
By June 30, 1998, the Salvation Army Grace will also close, and be decommissioned as an acute care hospital. It will transfer its obstetrics and gynecology program to the Queensway Hospital, and the balance of its programs to the new amalgamated hospital.
The Commission recommends that alternative uses for the newer sites be explored.
Queensway-Carleton Hospital will be governed by its own board, and all its chronic care services will be transferred to the Sisters of Charity of Ottawa. In its new role, the Queensway-Carleton Hospital will provide a full range of hospital services, including obstetrical services and CT scan services.
The Children's Hospital of Eastern Ontario, under its own governance, will provide all children's services, including mental health, and lead development of a network for children's services. The HSRC is recommending that a provincial pediatric task force be formed to examine highly specialized children's services, and determine how these services should be provided so as to achieve high quality care.
All the governance structures must be representative of the communities they serve, and take into consideration their cultural, linguistic, religious and ethnic characteristics.
The Royal Ottawa Hospital will be governed by its own board of directors.
Brockville Psychiatric Hospital will close. The majority of patients who use the mental health services it provides come from the Ottawa-Carleton catchment area, so the HSRC is directing that the Royal Ottawa Hospital will provide forensic and long-term psychiatric care for that part of eastern Ontario. Acute psychiatric programs will be transferred to the new amalgamated hospital and Queensway-Carleton.
To improve mental health care in the region, the HSRC is advising the Minister of Health to create a new mental health agency to co-ordinate planning, implementation and on-going monitoring of mental health services for all eastern Ontario counties.
The HSRC is recommending establishment of an academic co-ordinating body with representation from all the hospitals, academic facilities and other agencies. Its purpose will be to examine issues relating to health teaching and research that will arise as a consequence of restructuring.
The Sisters of Charity of Ottawa will provide chronic care and rehabilitation services at St. Vincent Hospital and Elisabeth Bruyère Hospital, which will continue under their governance.
When the plan has been implemented, Ottawa-Carleton will have 1,370 acute care beds, 125 acute adult psychiatric beds, 28 children's psychiatric beds, 145 rehabilitation beds and 531 chronic care beds. It will also have 132 long-term mental health beds, and 43 forensic mental health beds.
The Commission's plan recognizes the special characteristics, including the bilingual nature, of the community. And it ensures access to French-language health services: while the Montfort site will close, its programs and services will be part of the new, amalgamated hospital. And the Ottawa General is already providing services in French.
Commissioner George Lund said that the HSRC is very aware that the actions that must be taken to preserve Ontario's health services and create a genuinely co-ordinated health care system will displace many health care workers.
"We are therefore appointing a mediator to help hospital administrations develop labour adjustment plans together with representatives of their affected employees," he said. "We will also appoint a fact finder to examine the impact of hospital restructuring on physicians working in Ottawa hospitals."
The Commission's main priority in the Ottawa-Carleton region has been to lay the foundation for an integrated health system, while recognizing the unique characteristics of the region's health care services and their role in the broader eastern Ontario system.
"Ottawa-Carleton already ranks among the best in the province in terms of providing high quality, efficient health care," said Lund. "But there is still room for improvement. Once our restructuring directions are implemented, all Ottawa hospitals will deliver services as efficiently as the top providers in Ontario. As well, integration and consolidation will result in significant savings in overhead costs."
In developing its restructuring plan, the HSRC used the work of the district health council, in particular the extensive data and analysis produced by its consultants. Additional material was gathered from 115 written submissions, from meetings with key stakeholders in the local health system, and from the Commission's own research and site visits.
"Our decisions were aided by the excellent research initiated by the district health council, and by constructive input from the community," said Lund. "Site visits and meetings with groups and individuals also made invaluable contributions to our report."
He pointed out that Ottawa-Carleton has made significant progress since 1989 in improving the use of hospital services. As well, the region boasts a very advanced home care system which promotes communication and sharing of information among facilities.
The HSRC is recommending to the Ministry of Health that an additional $3.8 million should be invested in home care, adding 95,000 home visits a year. It is also recommending $4.6 to $6.1 million for transitional, or sub-acute care.
The Commission is undertaking research into long-term and rehabilitative care throughout the province. This research will establish policy and planning targets to guide our decisions in these areas. It is anticipated that the research will be completed by early March. Following a period of consultation, the policy will be applied in restructuring decisions for communities across the province. The HSRC anticipates significant investments in long-term care in the Ottawa-Carleton region - at least as much as is being saved from reduction to chronic care services.
Overall, the Commission estimates that implementation of the restructuring plan will yield savings of $126 million out of the 1995/96 budget of $680 million. It recommends to the Minister of Health that the additional $26.2 million that will be saved by closing Brockville Psychiatric Hospital should be reinvested in community mental health care throughout the region.
The HSRC is recommending a capital investment of $106 million to facilitate hospital restructuring.
The Health Services Restructuring Commission is an independent and expert agency of the Ontario government, with a four-year mandate to restructure health services across the province. It's mandate is to direct hospital restructuring and advise the Minister of Health on reinvesting in and restructuring other health services to improve quality and patient outcomes.
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Media contact: Ruth Lewkowicz (416)327-5919
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