/County chips in on CT equipment, but there’s a rub for HHHS

County chips in on CT equipment, but there’s a rub for HHHS

By James Matthews, Local Initiative Journalism Reporter

Haliburton County council should have a voice in local health care decisions.

Councillor Bob Carter, the mayor of Minden Hills, said the upper tier council should have two seats on the Haliburton Highlands Health Services (HHHS) board of directors.

And Carter said during council’s regular meeting Nov. 8 that a recent HHHS request for money should be part of the 2024 budgeting process.

HHHS asked county council in October to kick in $1-million toward the purchase of a CT scan, CT mammography equipment and the necessary hospital renovations to accommodate the equipment.

The total cost of the diagnostic equipment is $4.3-million.

Council was asked that the money be forwarded as soon as possible if the request was granted. Costs for design, installation, and the associated construction have already begun.

Council agreed to provide the requested money in two installments. Carter was the only councillor to vote against writing a cheque outside the 2024 budget process.

It is expected that the new diagnostic tools will be installed and operational by next summer.

Michael Rutter, the county’s CAO, said there are limited reserves available to fund unplanned projects. But, given the importance to the community, staff recommend the contribution be paid to HHHS in two installments of $500,000.

The first installment to be paid in January and the second in January 2025.

Rutter suggested $200,000 be included in the annual budgets over the next five years. And staff recommend that $300,000 be transferred from reserves in 2024 and 2025 to fund the two installments.

The funds would be repaid to reserves at $200,000 beginning in 2026 with the final installment being made in 2028.

Rutter provided details about how local CT services would yield monetary savings and create health care efficiencies in the county.

Providing CT services locally would not eliminate inter-facility transfers, but it would reduce the number significantly. It’s estimated that 60 per cent of the total number of transfers would be eliminated.

County ambulances spend as much as 2,000 hours per year transporting patients for diagnostic services in other communities.

“This is time that our ambulances are not available in the county to answer emergency calls,” Rutter said.

Ambulance call volumes continue to increase because of a growing reliance on CT services, an increasing and aging population, and increased tourism activity.

Transfers for CT rose from 218 calls in 2019 to 357 in 2021.

On average, each CT transfer takes as long as six hours. As a result, staff are experiencing more and more challenges maintaining an appropriate emergency response capability.

In the county’s EMS Master Plan recognized these challenges, the three top priorities to be addressed immediately and six of 13 goals to be addressed in the next three years relate directly to inter-facility transfers.

“Our staff are dedicated and they are committed, so they will do what we ask them to do,” Rutter said. “But it has been a topic of conversation at every labour management meeting that we’ve had in the last number of years.

“These transfers take a toll.”

The county’s Physician and Health Care Recruitment Co-ordinator has reported to council that physicians considering working in Haliburton’s emergency department are unwilling to commit when they find out there’s no CT equipment.

“I just wanted to make clear that the lack of a CT scan has an impact on our EMS department, on our health care, and physician recruitment,” Rutter said. “That doesn’t even touch on the economic benefits of keeping our money circulating locally.”

Coun. Lisa Schell, the deputy mayor in Minden Hills, said the lack of public consultation is concerning, especially given that its public money being requested.

“While there’s no doubt having a CT scanner in the county could be beneficial, I still struggle to believe that we will find the staff to operate it,” she said.

HHHS closed one of two emergency departments in the county in June.

“I want to remind the community and everyone in this room that we had a fully-staffed Emergency Department that HHHS closed, throwing away emergency doctors who had been faithfully staffing the Emergency Department for decades,” Schell said.

“And now they’re asking for $1-million for a CT scanner to attract emergency doctors.”

She said she’d like to vote for something that will benefit county residents, but she’s struggling with the fact that county council has no say on how health care services are delivered. There’s no council presence on the board of directors.

Coun. Murray Fearrey, Dysart’s mayor, said council should be able to find $200,000 in a multi-million-dollar budget. And he weighed that against the dreadful possibility that a patient facing a serious health issue must wait a couple hours because of travel rather than minutes if the diagnostic tests were done locally.

“I’m not going to debate the overall public opinion of it,” said Coun. Cecil Ryall, Highlands East’s deputy mayor. “I’m looking at purely the dollars of it and I would find it very difficult not to support this.”

“I’m a bit surprised and stymied as to why we’re not considering this motion when we do the budget as opposed to just ad hoc thing where somebody comes and asks for money and we decide that we’re going to give it to them in a special manner,” said Coun. Bob Carter, the mayor of Minden Hills.

Carter said HHHS had been working on getting the equipment for quite some time and they knew as far back as June that the Ministry of Health was going to grant approval. HHHS had a lot of time to request financial help from the county.

“I suspect that they didn’t want to show their faces around this council in around June, just after they closed the (Minden) emergency room,” he said. “So it’s been delayed until now.

“But bad planning on your part does not constitute an emergency on my part. I think this should be done as part of our budgeting process.”

HHHS has not been very transparent with county council, he said. Council should demand two seats on the HHHS board of directors to get county support.

“I know they (HHHS) haven’t been transparent,” Fearrey said. “But … we can’t keep going back and finding fault. We’ve got to move forward here.”

“I look to others as to whether you’d like to pass it today or wait until budget,” said Coun. Jennifer Dailloux, the deputy mayor of Algonquin Highlands. “But, in general, I’m in support of this initiative.”

“A million dollars is a lot of money,” said Coun. Walt McKechnie, Dysart’s deputy mayor. “But the way it’s laid out, it’s not going to be a big hit on anybody right away.”

Warden Liz Danielsen, the mayor of Algonquin Highlands, said there much work to be done to re-establish trust and communication between the county and HHHS.

“There has been some effort made, but nowhere near enough,” she said, and added that representation on the board should be a condition of the funding.

“I have been given understanding from at least three members of the board that that is in the works.”

Carter said the budgeting process will begin in a couple week, so it isn’t unreasonable that the funding request wait until then.

“Doing this outside of the process is not acceptable to me,” he said.

“I do take a bit of offence at any suggestion that the rest of us do not take due consideration for our taxpayers,” Danielsen said. “I think the fact that we’re wanting to move forward with this is, in fact, in support of our taxpayers.”

“I didn’t imply that,” Carter said.