A significant redistribution of mental health beds throughout Southwestern Ontario is taking place without any decision-making process by the four Local Health Integration Networks that are supposed to be guiding services in this part of the province.
The Ombudsman’s office recently issued a report suggesting public consultation was little more than “LHIN spin” in Hamilton Niagara Haldimand Brant. In the case of Southwestern Ontario, there has been no public consultation at all.
Prompted by the redevelopment of Regional Mental Health Care – London (RMHC-L), the plan will reduce the number of beds in London and St. Thomas to about half of present complement.
While 138 beds will transfer to Kitchener/Cambridge, St. Thomas, Windsor and Hamilton, there are 67 beds unaccounted for. This is in addition to the loss of 24 psycho geriatric beds at RMHC-L in the past year and a half. Further, RMHC-L has told us that up to 80 beds could be gone when the new facilities open in London and St. Thomas, four years from now.
Given the 450 beds that presently exist are frequently at capacity, this raises questions as to how the region will do without.
Over the summer OPSEU contacted the South West LHIN to ask about the plan. At the end of July, the South West LHIN replied that neither they nor the Waterloo Wellington LHIN had yet to receive notice of integration, despite plans to begin moving staff and patients this fall.
The letter sent on behalf of SW LHIN CEO Michael Barrett states: “this process is complex as ultimately it involves four LHINs (South West, Waterloo-Wellington, Erie St. Clair, and Hamilton Niagara Haldimand Brant) and five hospitals.” Barrett says he expects an integration proposal in the “upcoming weeks,” of which time the LHINs will consider the submission “against our usual criteria which includes ensuring adequate community engagement throughout the process.”
In other words, the process has not even begun, yet staff at RMHC-L have been told they will transfer to Cambridge at the end of September with the patients to follow at the end of October. Further, the redevelopment project is presently being bid upon by private consortiums. That bidding is to close in December. The redevelopment is central to this entire plan, and it has gone to commercial tender without a shred of public consultation or detailed disclosure on the overall plan.
Given these circumstances, one has to question what the point of public consultation will be as it appears that everything has been decided.
One of the delays in getting the proposal to the LHIN may have been the dispute between RMHC-L and Grand River Hospital over the first transfer. Despite no agreement between the divesting and receiving sites, workers were initially told that they would begin at the new site at the beginning of September. A number of these workers sold their homes in London, moved to Kitchener, and got their kids enrolled in school for the coming year. Then they were told that events might not quite unfold as planned. Whoops!
It is unfair to both the families of patients and the workers scheduled to transfer to delay implementation of the initial move to Cambridge this fall.
However, the Ministry should wake up and realize that there has been a shocking lack of process in this whole affair.
The Minister of Health should insist the present bidding process on the projects be placed on hold until the public has had an opportunity to examine and comment on the complete plan, not just the immediate transfers.
They need to revise the projects and restore the missing beds, taking into consideration a more realistic needs assessment that takes into account The Alzheimer’s Society of Ontario projection that the number of Ontarians with dementia is expected to double within the next 25 years.
They need to explain to Ontarians why provincial bed counts are falling well below their target of 35 beds per 100,000, especially in light of the lack of funding for alternative community based services. They also need to work with community agencies to make sure they are adequately prepared, funded, and coordinated for the changes proposed in the plan.
Finally, they should scuttle the plans to take these new projects private. One only needs to look at the calls in Britain for renegotiation of the rich PFI (P3) contracts that threaten the stability of front line health services (see Privately financed hospitals squeeze UK’s National Health Service). The bids should be revised to apply for construction only.