By Vivian Collings

Tensions were high in the Haliburton County Council chamber as CEO and president of Haliburton Highlands Health Services (HHHS) Carolyn Plummer and HHHS board chair David O’Brien met with council for a special meeting on Tuesday, May 16 to go over details of the plan to consolidate the Minden Emergency Department with Haliburton.

The Minden ER is set to close at 12 a.m. on June 1.

“I want to fully acknowledge the frustration, fear, and angst of the decision made by HHHS to close the Minden ER and consolidate emergency health services into the Haliburton Hospital has caused for residents across the county and beyond, but most particularly here in Minden,” said Warden Liz Danielsen. “Like many members of the public, county council has challenges with how this has rolled out, particularly with what has appeared to be a serious lack of communication or planning … Considerable efforts have been made by this council and individual mayors and councillors across the county, and particularly by local residents, to reverse the decision, or at least to have it put on hold until adequate planning can be in place.”

Members of the public were allowed to sit in on the special meeting.

Danielsen said some of the attacks on HHHS on social media have been “out of control, and it’s disappointing to see.”

“It is for that reason that I have asked for the OPP presence here today, something that in my memory we have never had to do here before,” she said. 

O’Brien began the presentation by explaining the reason for the closure is staffing shortages.

“The decision to do the consolidation was based on severe and ongoing shortages of physicians and nurses at both sites, requiring us to consolidate the two emergency departments into one in order to have sufficient staffing to provide one good emergency department for the entire county,” O’Brien said.

He said Haliburton was chosen because of the 15 in-patient beds in the hospital.

“There are none in Minden. In order to create beds in Minden, it would probably take a considerable amount of time and many millions of dollars, and we’d probably only end up with six or 10 beds anyway,” he said.

Plummer said without making the decision to close one ER, the community risked facing unplanned temporary closures of one, or likely both, departments going forward.

“The organization has fought very hard and for as long as it could to keep both emergency departments open, but with no long term solution to any of the staffing shortages, it’s not something that could go on any longer,” she said.

Plummer said it would’ve been impossible to properly alert the public about short notice closures of both ERs.

She added the decision to close Minden was not a comment on the performance of Minden ER staff.

A task force has been working off of existing ER protocol, and has been meeting twice a week to ensure the plan is being followed. 

Staffing

At the Haliburton ER, there is currently one physician in the ER working a 10 hour shift at all times. Starting June 1, an additional physician will be added from 9 a.m. to 9 p.m. “to deal with the highest-volume portion of the day,” Plummer said.

In addition to two RNs at all times, one RPM from 9 a.m. to 9 p.m., and one additional RN from 11 a.m. to 11 p.m. during summer months, HHHS will be adding one additional RN at all times, access to an additional RPN from 11 p.m. to 7 a.m., and a charge nurse during the day for the transition period starting June 1.

Diagnostic imaging staff will “remain status quo at the Haliburton site, which is basically access to diagnostic imaging 24/7,” Plummer said.

Bone densinometry and X-ray services in the Minden hospital will be by appointment.

Staffing will be adjusted as needed, Plummer said.

Space changes

“We are increasing the amount of patient spaces we have from nine to about 15,” Plummer said.

A third trauma bed, one new procedure room, one rapid assessment room, 13 additional waiting room spots, and an expanded lab space will be added to the Haliburton ER.

Approximately 15 additional parking spaces will be available for ER patients at the hospital and medical centre.

Equipment and supplies will be transported from Minden to Haliburton.

Signs will be placed at the street entrance and and ER entrance at the Minden hospital alerting the public of the closure. A phone will be installed outside the entrance with access to 911. Blue hospital signs around the county pointing to Minden will be removed.

“The shortage of family doctors in the community has certainly had an impact on the ability of people here to access health services, and we know that’s one of the top priorities for what we might do with the Minden site, so we want to hear from the community about what’s most important to them in terms of what might be feasible for the Minden site in the future,” Plummer said. 

Danielsen said she has heard comments about the desire for a walk-in clinic at the Minden site. 

Councillor Lisa Schell asked if any jobs would be lost due to the closure, and Plummer assured council all Minden staff members would be kept employed with HHHS.

Councillor Jennifer Dailloux asked what the impact on patient care, wait times, and mortality/morbidity outcomes might be.

“We did take into consideration what the potential volume at the Haliburton site could be when determining staff needs,” Plummer said. “We do anticipate we may see a slight increase in patient wait times, but I think establishing the fast track, rapid assessment space and in part utilizing the second physician during that period of time that we have two physicians in the emergency department, we’re hoping to keep any increases to wait time at a minimum.”

Plummer said 30 to 40 per cent of Minden ER patients are coming from the City of Kawartha Lakes.

Councillor Bob Carter asked about the number of doctors working at the consolidated ER at one time. 

“You plan to replace that with one and a half doctors, so we are reducing the number of emergency doctors from two to one and a half,” he said.

In a single ER with the combined volume of two, Plummer said, it won’t always need two physicians depending on the time of day.

“I think we have to give credit to HHHS. It’s a decision they didn’t want to make,” said Councillor Walt McKechnie. “The decision had to be made and they must feel they can accommodate the county of Haliburton at the Haliburton hospital.”

Carter said he is disappointed with O’Brien’s response to council at their last meeting for “lecturing” council on fiduciary responsibility.

“I think you failed on that. I find that completely unacceptable, and I guess I would be asking for your and your board’s resignation because you have not serviced our community properly,” Carter said.