By James Matthews
The shortage of medical staff is at the root of the decision to close the Minden Hills Emergency Department.
Haliburton Highlands Health Services recently announced the facility would close June 1. The Haliburton Emergency Department will continue to accept patients.
Carolyn Plummer, the CEO and president at HHHS, and David O’Brien, chairperson of the health service’s board of directors, explained the reasons for the decision when Minden council met April 27.
The Zoom online broadcast of the meeting drew 165 viewers before the HHHS delegation. Soon after Plummer and O’Brien assumed their hot seats, viewership shot up to 214 people.
“It was one of those days in your life that you never want to come across,” O’Brien said of when the decision was made to close a facility.
“In order to maintain our health service provision here in the county, we need to have more staff,” he said. “We need more doctors. We need more nurses. We need more of the whole support system.”
Plummer said the decision to consolidate emergency medical service isn’t a comment against the quality of service provided at the Minden Hills facility. It was simply the result of a difficult decision to maintain health care service for all of Haliburton County.
O’Brien said the need to close the Minden Emergency Department is directly related to the current staff shortage.
“It’s taken an extraordinary amount of effort over the last 18 months to keep the team together, to keep it focused, to keep it delivering the services that we need,” he said.
Existing staff routinely made incredible personal and professional sacrifices.
“It got to the point that we can’t continue to do that,” O’Brien said. “We’re going to lose people more than we’ve already lost.”
Indeed, the county could have lost its total health care service if the pressured situation progressed and worsened.
“That was the focus of making this decision,” he said. “The staff that we have are under extreme pressure. They came to us and said, ‘Look, you’ve got to do something because we can’t keep going on like this.’”
He said staff expressed concern that the system would fail.
“That is the crux of why the decision was made,” O’Brien said.
Plummer said she’s spoken about the dearth of staff members in every public board meeting over the last couple years. The COVID-19 pandemic has caused many people to abandon the health care profession, she said. And the recruitment pool has shrunk.
“In 2022 alone, we had more than 20 official close calls,” Plummer said. “And many other close calls that were not made official where we were just one step away from having to temporarily close one or even both of our Emergency Departments at the same time on very short notice.” It was noted later in the meeting that these closures were based out of the Haliburton site.
Mayor Bob Carter charged that there was little to no consultation with parties outside HHHS about the closure.
Plummer and O’Brien juggled the microphone. O’Brien said she couldn’t comment on Carter’s assertion.
Plummer said the closure was a board decision, supported by the executive leadership, and informed by staff.
“It was an operational decision that had to be made,” she said.
Nurses stretched themselves so thin because nobody wanted to feel as if they had a hand in the closure of an Emergency Department.
O’Brien said patient volumes, financial and other resources, the alignment with HHHS priorities and values mission, the political will at Queen’s Park, and the health needs of the county before making the decision on which facility would close.
“This is a very complex business, health care,” he said. “If you don’t have the stability in the system that drives the delivery of the service, it’s very, very hard to do.
“People continue to get sick. That doesn’t change. The hospital system has to be ready to go to move to support that particular fact of life.”
Plummer said a big part of the rationale for consolidating services at the Haliburton site was because that’s where the region’s in-patient acute-care beds are located.
The Minden space isn’t designed to support an acute-care unit and would cost millions of dollars and significant renovation to accommodate such a unit, she said.
Paramedic personnel indicated that the Haliburton site is more centralized in the county, she said.
“Contrary to what has been circulated on social media, both Emergency Departments are having physician staffing challenges,” Plummer said.
O’Brien said retaining both facilities would have maintained uncertainty in the community among staff and residents. And that uncertainty would have been incredibly damaging.
“We needed to be able to give them clear direction about where the community could access emergency care,” he said.
Plummer said they have many ideas for consolidation. The administration is soliciting staff input on how to best pursue that process.
“We will work with our staff who are the experts in frontline care to choose from various scenarios that were created with respect to patient flow and how to accommodate the increased (patient) volumes at one site,” she said.
Carter said staffing issues have been ongoing at HHHS. There were even discussions in 2022 about the possibility of temporary closures at either of the facilities.
“At no point was there a discussion that one of these facilities would have to close permanently,” Carter said.
He said his colleagues in the other three lower tier municipalities agreed that there was no such talk. News of the permanent closure came as a complete shock, he said. He’s fielded hundreds of questions from residents.
Carter suggested the closure be pushed back to November or later to allow for stakeholders’ discussion about implementation of the plan. Such a decision should have a duty to consult stakeholders.
“This would get us through the busy summer period and allow a transparent public process,” Carter said.
Plummer said the decision was an operational one that had to be made when it was made.
“We know the timing is not ideal,” she said. “This summer would have seen multiple temporary but short notice closures on one or likely both Emergency Departments all summer long.”