Friends of the Ajax Pickering Hospital
68 Hills Road, Ajax, Ontario L1S 2W4
March 26, 2008
Foster Loucks, Chair
and Members of the Board
Central East LHIN
Suite 204A, Harwood Avenue South
Ajax, Ontario
L1S 2J1
Dear Mr. Loucks and Members of the Board,
On March 17, 2008 The Friends of the Ajax Pickering Hospital wrote to Rik Ganderton, C.E.O. RVHS requesting clarification of how the proposed budge cuts will affect hospital services and staff at the Ajax Pickering Hospital. In Rik Ganderton’s reply of March 20, 2008, he outlined the “key planning parameters” in the “restructuring” to get a balanced budget position. Mr. Ganderton further stated he cannot discuss this plan in any detail with any third party until such time as it is approved by the RVHS Board, and the Central East LHIN. That approval happened today, March 25, 2008.
Now that the Friends are aware of the details of the Deficit Elimination Plan and restructuring, we are very concerned about two major issues.
Firstly, the major reduction in nursing staff will make it completely impossible to deliver the present level of services to the present population, plus it will mean a decreasing level of service as the burgeoning population of our communities grows. Spin it as you will, but the levels of service will severely decline. Even now with present staffing levels the nursing staff is struggling to serve present patient needs.
Secondly, the Friends are very much alarmed by the plan to transfer all the major mental health services at Ajax Pickering to Centenary leaving the third floor, west wing, almost vacant. Here we go again. The RVHS Board continues its policy of using the population base of Ajax, Pickering and Whitby to concentrate core services at Centenary in Scarborough when Scarborough already has three hospitals with all the key hospital services and more.
According to the Integrated Health Services Plan of the Central East LHIN, Mental Health Services is one of its top priorities. The Central East LHIN Plan states that “In 2004, 18% of the population in this LHIN over the age of fifteen accessed a physician for mental health concerns.” 18% of the population of Ajax Pickering and Whitby is 54,000 people. Moreover, “people with mental illness spend more days in hospital than for the treatment of cancer or heart disease combined. Mental health illness accounts for one in seven hospitalizations and one third of all days in hospital.” (p 23) Despite these statistics, the RVHS Board plans to remove major core Mental Health Services from the Ajax Pickering Hospital. This proposed plan will make it difficult if not impossible for people of Ajax, Pickering and Whitby suffering with mental illness to access a full range of core Mental Health Services locally at Ajax Pickering. Mental health is a basic local core community hospital service. This plan to move core Mental Health Services to Centenary is as bad as the attempted plan to move obstetrics to Centenary. This time the victims are the mentally ill.
In addition, it appears to the Friends that the RVHS Board is using the mental health patients of Ajax Pickering to build a Mental Health Centre of Excellence at Centenary. The RVHS Board is doing this despite the fact that the Peer Review Team stated in its report “that the RVHS must ensure the provision of core services before embarking on establishing Centres of Excellence ... . “ (p 4)
In the document distributed by the RVHS Board at the ground breaking ceremony for Phase I of the Redevelopment Plan in December 2007, the community was told that the Mental Health Services at Ajax Pickering would be greatly expanded as follows: “An expanded Mental Health Unit will accommodate nine more beds within the adult inpatient area, including seven beds for psychiatric intensive care, and services will be expanded for outpatients including day treatment, day hospital crisis assessment, and consultation services.” In December 2007, Mental Health Services at Ajax Pickering are to be greatly expanded; in March 2008, they are to be eliminated. What is the rationale behind this about face in planning? What is going on? Can anyone place any trust in the planning of the RVHS Board? Are the nurses and the mental health patients to be the victims of the Board’s deficit reduction plans? This must not happen.
It is the clear understanding of the Friends that Section 16(6) of the Local Health Services Integration Act requires that health service providers such as the Board of the RVHS must “engage the communities of diverse persons and entities” when developing plans and setting priorities for the delivery of health services. The “diverse persons and entities” include local residents, patients, service providers and employees.
What steps has the Board of RVHS taken “to engage” the local residents of Ajax, Pickering and Whitby seeking approval by the Board of the Central East LHIN for their planned cuts to the nursing staff, and the virtual elimination of Mental Health Services at Ajax Pickering? The Friends know of none.
1In the Central East LHIN document entitled A Framework for Community Engagement and Local Health Planning (June 2006) under the heading of “The Goals, Objectives, and Principles of Community Engagement” it states: “ A consumer focussed health care system must engage the end-user in the planning process as they are the most knowledgeable about their needs, experience and satisfaction with health care services.”
(p 2) (emphasis added) “At the heart of community engagement is the democratic ideal, that people who are impacted by a decision or course of action, have the rightful opportunity to shape and form the decision before it takes place. Community engagement serves not only practical and strategic ends; it is also a principled undertaking. At the heart of community engagement is the democratic ideal, that people who are impacted by a decision or course of action, have the rightful opportunity to shape and form the decision before it takes place. While the provincial government will continue to be held accountable for the overall performance of the Health Care System, the LHIN mandate to undertake local health planning and community engagement provides the citizens of Ontario with the greater occasion to inform the direction of their health care system.” (p 4 and 5) (emphasis added)
Consequently, what steps is the Board of the Central East LHIN planning to take to require the RVHS Board to comply with the requirements of the LHSIA and the Central East LHIN’s “Principles of Community Engagement” before the Board of the Central East LHIN considers approving any of the RVHS Board’s plans and recommendations? Is the RVHS Board going to be permitted to make these major nursing staff cuts, and the elimination of core Mental Health Services at Ajax Pickering with absolutely no explanation to, or the involvement of the people of Ajax Pickering and Whitby in public meetings in each community?
The Friends believe strongly in the principle of “engaged communities, healthy communities”. The Friends urge the Board to see that these “principles of community engagement” are upheld by all the parties to these decisions. Thank you.
Sincerely,
Yvonne Bosch Bill Parish
Co-Chair Co-Chair
copy/ Deborah Hammons, C.E.O., Central East LHIN
Rik Ganderton, C.E.O., RVHS
Tom Atkins, Chair and Members of the Board, RVHS
Joe Dickson, M.P.P., Ajax Pickering
Wayne Arthurs, M.P.P., Pickering Scarborough East
Christine Elliott, M.P.P., Whitby Oshawa