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Directions attached (Word Document)

The Health Services Restructuring Commission's directions for Thunder Bay and region are based on the blueprint provided by the Thunder Bay District Health Council's (DHC) recommendations. They have also taken community input into consideration. The community responded to the DHC report and to the Commission's Notices of Intention to Issue Directions, which were issued in June, 1996.

The Commission's directions and recommendations for restructuring health services in Thunder Bay are summarized below.

Consolidation of Health Care Services

The Health Services Restructuring Commission has directed area hospitals to consolidate their health care services, as follows:

• Thunder Bay Regional Hospital will provide all acute care services in the region by accepting the acute care program from St. Joseph's Hospital by March 31, 1997.
  
• St. Joseph's General Hospital will provide all non-acute hospital services by consolidating rehabilitation, chronic care, palliative care and substance abuse care under one governance and management by March 31, 1997.
  
• By March 31, 1999, the Thunder Bay Regional Hospital will have a maximum of 314 acute care beds, including 271 medical/surgical beds, 30 acute adult mental health beds and 13 acute adolescent mental health beds. In addition there will be 20 forensic psychiatric beds relocated from Lakehead Psychiatric Hospital to Thunder Bay Regional Hospital.
  
• Chronic care beds will be reduced from 183 to 120 until the Commission completes additional studies to determine the final number needed.
  
• Fifty-four sub-acute or transitional care beds, a new category, will also be added. This level of care provides services for patients who do not need acute hospital in-patient services, but who are either not yet ready for discharge to their homes and communities or for whom alternative arrangements are not yet available.
  
• Thunder Bay Regional Hospital will close its McKellar site by March 31, 1999.
  
• St. Joseph's General Hospital's emergency department will close by November 30, 1996.
  
• Lakehead Psychiatric Hospital will close no later than March 31, 1999.
  
• Hogarth/Westmount Hospital will cease to operate as a hospital by March 31, 1997.

The HSRC directions will result in the following governance structure for hospitals in Thunder Bay:

• The Board of Directors of Hogarth/Westmount Hospital will transfer governance and management of patient programs to St. Joseph's General Hospital by March 31, 1997. Some patients will be transferred to other areas of the long-term care system, depending on their needs.
  
• The Ministry of Health has been directed to transfer governance and management of mental health services at the Lakehead Psychiatric Hospital to St. Joseph's General Hospital.
  
• A Northwestern Ontario Mental Health Agency will be established to operate within the provincial government's policy and fiscal framework. This agency will be responsible for identifying the mental health needs of the population in the region, and will coordinate transfer of the in-patient program at Lakehead Psychiatric Hospital to St. Joseph's General Hospital and Thunder Bay Regional Hospital.

About $40 million a year will be saved as a result of hospital restructuring in Thunder Bay. However the Commission has recommended reinvestments of more than $10 million a year.

Recommendations for Reinvestment of Savings

The Health Services Restructuring Commission is recommending that the Ministry of Health make investments in other components of the health care system to accommodate new demands that will be placed on them by changes to Thunder Bay's hospital system:

• The Ministry should provide additional funding to the following services:
  • $2 - $2.3million in transitional care
    
  • $2.4 million in home care
    
  • $1.0 to operate an MRI service
    
  • $1.2 million for adolescent mental health
    
  • $3 - $4 million for specialist recruitment
• The Ministry should provide funding for information systems and technology needed in the region to support such things as telemedicine and linkages with teaching and specialty hospitals.
  
• Thunder Bay Regional Hospital should be given approval to plan for a capital construction project for renovation and expansion of the Port Arthur site. This new construction and renovation will accommodate the emergency department, day surgery and operating rooms, labour and delivery rooms, and diagnostic imaging. The budget for this work should be set at a maximum of $64.3 million, with the budget for equipment and furnishings set at a maximum of $10 million. The construction project will result in a 400,000 ft² hospital, of which 200,000 ft² would be new, and 50,000 ft² would be renovated, space.
  
• St. Joseph's General Hospital should be given approval to plan for a capital construction project to accommodate chronic, rehabilitation and mental health programs. The total budget for the construction project should be set at a maximum of $10.94 million, in addition to an equipment and furnishings budget set at a maximum of $1 million.

• In all cases, hospital administrations, along with employee representatives, will develop human resources adjustment plans that will address fair and equitable implementation of the Commission's directions.
  
• The funding to Thunder Bay Regional Hospital and St. Joseph's General Hospital should be adjusted to reflect the new clinical and administrative efficiencies achieved through hospital and program transfers.
  
• With 30 rehabilitation beds located at St. Joseph's Hospital, the Thunder Bay District Health Council and the Kenora/Rainy River District Health Council should advise the Minister whether the remaining 15 beds should be located in Thunder Bay or elsewhere in the Northwestern Region.
  
• The Commission has recommended a new regional Acquired Brain Injury (ABI) program that will treat up to five patients at any one time.
  
• The Thunder Bay District Health Council should work with the Kenora-Rainy River District Health Council to advise the Minister on a planning and implementation process for an integrated system of health care services in the Northwest, including the feasibility of establishing an integrated governance structure for health services in the region.

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