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The Health Services Restructuring Commission has issued directions and recommendations for restructuring hospital services in Sudbury. These are contained in Notices of Intention to Issue Directions and the Sudbury Health Services Restructuring Report.

The Commission relied on the blueprint provided by the Manitoulin-Sudbury District Health Council and on input from organizations and individuals in the community.

The decisions are based on the criteria of quality, accessibility and affordability.

There is a 30-day period for the community to comment on the directions and recommendations. The Directions themselves will be issued after the Commission has considered information and data received during this 30-day response period.

Summary of Directions

• With the help of a mediator, Laurentian, Memorial and General Hospitals to create a governance structure and a new Sudbury Regional Hospital Corporation by March 31, 1997.

• The Paris (Sudbury General) and Regent (Sudbury Memorial) sites will be closed by March 31, 1999.

• All services will be operated on the Ramsey (Laurentian) site by March 31, 1999.

• A new transitional level of care, also known as sub-acute care, will be created, with 75 beds.

• The Sudbury Regional Hospital Corporation will operate a maximum of 365 acute care beds by March 31, 1999. These beds will comprise 334 medical surgical beds (including 25 ICU/CCU beds) and 31 acute mental health beds. As well, there will be 100 chronic care beds and 31 rehabilitation beds. To accomplish this, a capital investment of up to $68 million plus $8 million in equipment is recommended.

• The Commission has advised the Minister of Health to create a $3.3 million pool for recruiting 11 new specialists to the Sudbury area. This money will be outside OHIP funding.

• The Commission has advised the Minister to repatriate neonatal intensive care patients and hip and knee surgery patients to the north east at an additional cost of $2 million.

• The Sudbury Regional Hospital Corporation will implement plans to achieve utilization improvements in acute care that will result in rates of 697 days in hospital per 1000 population by March 31, 1998, and 540 days per 1,000 population by March 31, 1999. The current rate is 854 days per 1,000 population.

For the future provision of mental health services, the Commission is recommending that the Ministry of Health establish a committee of the district health councils of Northeastern Ontario to develop a regional mental health plan by March 31, 1997. This plan will include a governance structure for hospital-based psychiatric programs and the sizing and siting of community mental health programs. In addition, the plan will propose a budget for reinvestment in mental health services. It will develop a proposal for a regional agency to plan and purchase mental health services, but not to deliver services directly.

Integrated Delivery System

The Commission has advised the Ministry of Health to work with the Commission to create a committee in Northeastern Ontario to submit plans for integrated delivery of health services by June 30, 1997.

Consolidation of Support Services

The Algoma Hospital, Sudbury General Hospital, Laurentian Hospital and Memorial Hospital will develop and implement, by March 31, 1997, a plan to maximize the efficiency of administrative services, support services and diagnostic imaging.

Savings

The Commission estimates total net savings from restructuring the Sudbury hospital system at $41.85 million or about 25% of current total hospital expences. The savings will result from restructuring, clinical efficiencies and administrative efficiencies.

The Commission recommends that the Ministry of Health reinvest in the region's community services, especially home care and related services, and address health promotion needs. This includes between $2.8 and $3.2 million to be dedicated to transitional care (a new level of service), $1.2 million for home care, $2 million for repatriation of hospital services to the Sudbury region and $1 million for MRI services.

The Commission has advised the Ministry of Health to give the Sudbury Regional Hospital Corporation approval to plan for renovation and expansion of the Ramsey site. this expansion will accommodate the emergency department, day surgery and operating rooms, labor and delivery rooms, diagnostic imaging and other support services.

Labour Adjustment

The Algoma Hospital, Sudbury General Hospital, Laurentian Hospital, Memorial Hospital, with organized labour and other employees, will develop a human resources/labour adjustment plan by May 31, 1997.