By Emily Stonehouse
The Minden ER physicians have spoken. “This shouldn’t have happened now,” said Dr. Bruno Helt of the Minden ER during a private media interview.
“In terms of the physician resources in Minden, we have been fully staffed, without need for any outside support, for more than 25 years.” He noted that the first time they required assistance was in April of this year, where they needed support from Health Force Ontario.
With this in mind, they have a very clear-cut schedule in place between April and the end of September of this year. While the Minden schedule has some openings, Helt had no concerns that all the shifts would be covered.
“The Minden Hospital would never have closed this summer because we didn’t have enough physicians to cover.” Helt shared that if “worse came to worst”, for those few gaps in the schedule that could not be covered by Health Force Ontario, he, or others in the Minden group would have stepped in. “We were sufficiently staffed to get us to the end of September.”
According to Dr. Helt, the Haliburton ER is the facility that continually relies heavily on Health Force support. And it’s not a clear-cut solution; closing one hospital does not guarantee that all resources shift gears to practice wherever the open facility is.
“Many of the Minden physicians are not prepared to work in Haliburton, and that was made clear to HHHS during discussions we had last year”.
Helt said that Minden physicians aren’t going over to Haliburton for a variety of reasons, none of which are related to any specific Minden/Haliburton politics, rather, it was related to the extended travel and a working situation that not all physicians are comfortable with.
With the closure, the Minden physicians are no longer a formalized group, resulting in all physicians becoming independent contractors. Many are picking up shifts in Peterborough and Lindsay, and while some may go to the Haliburton site, it is up to the individual physician to decide where they may go.
“It’s not a consolidation of two hospitals, and two physician groups. The Haliburton Emergency Department (ED) is in a very vulnerable position where their one ED now needs to cover an additional 30-31 shifts per month with the same limited local physician pool,” said Helt.
“Some Minden physicians will cover some of these shifts but now there will be additional openings that Health Force will need to cover if the Haliburton ED is to remain open.”
Helt said that Minden was guaranteed to stay open until at least the end of September, but there is one caveat in which they would close. “If Haliburton were to close in the summer, and we didn’t have anybody to provide some double coverage for us in Minden, we felt it was too unsafe for one physician, who works 24-hours, to safely care for the entire community.”
That is the only circumstance in which Helt felt a Minden ER closure would be possible any time over the summer months.
He also noted that the HHHS Board broke their contracts with the physicians, as they were required to provide 90-days notice for a closure, and staff received six weeks.
Dr. Helt asked what many community members are curious about: why wasn’t there more public consultation in the decision making process? “There are all sorts of people who might have a better idea how to tackle this problem, and why not put it out there to have them involved in this discussion as well?”
After last summer, Helt stated that there was ongoing concern regarding HHHS Nursing and Haliburton ED physician shortages, but there had been no further communication on these issues with the Minden group until all staff were notified of the Minden ER closure on April 20.
Helt addressed the question of potentially providing a “pause” rather than a formal closure of the Minden ER site. “The Minden Hospital ED Service contract is between the Ministry of Health (MOH), the Minden physician group, and HHHS. If the MOH understands the Minden physician group can come together again after the summer, they may be able to put a pause on the decision for a complete closure if HHHS agrees to do the same”
Dr. Dennis Fiddler was also at the media conference, and piped up at this comment. He noted that even if the decision to reverse the closure was made at this point, the damage has been done, as most physicians have already scrambled to take shifts at surrounding hospitals at this time. “We know the community is rallying really hard to have this reversed or postponed to keep it open, but that’s also a concern, because if it does, we’re still not going to have physicians to fill those holes.”
At the end of the interview, Dr. Helt and Dr. Fiddler agreed that the closure should not have happened now. They both agreed that the decision required more community, stakeholder, and physician engagement overall. While there are components of the closure that make sense to the local physicians (such as the acute care beds and areas of residence for doctors), it didn’t need to happen in this manner. “It was a terrible way that the whole thing unfolded,” said Helt, “and it shouldn’t have happened.”
