Will NHS supervisor rebuild public confidence?

The troubled Niagara Health System is getting a supervisor appointed by the Ministry of Health to take over the hospital.

According to the Ministry of Health news release, “these steps are being taken to restore necessary public confidence in the local hospital system. Despite the hospital’s best efforts, doubts remain about its ability to meet Niagara-area residents’ expectations of their local health care system.”

The appointment follows local pressure over more than 30 C. Difficle-related deaths at the hospital since May 28, although Health Minister Deb Matthews told the CBC that the issue is much more than that – that she had heard concerns about NHS right from day one of her appointment.

Much of the negative publicity the NHS has received stemmed from a hospital “improvement plan” that included closure of ERs in Port Colborne and Fort Erie and the planned transfer of maternity services to the new St. Catharines hospital.

The new hospital itself has been the focus of much criticism over the high cost of building and operating the facility as a public-private partnership.

This lengthy community turmoil was noted by the New Democrats. NDP leader Andrea Horwath told the St. Catharines Standard: “It seems to me that the Health Minister is the last person in Ontario to realize there’s a crisis in confidence in the Niagara Health System. Where has she been for the last couple of years?”

Matthews statement would suggest that the supervisor will have a much greater mandate than exploring hospital-based infections at NHS.

Unlike other hospitals where senior staff and board have been dismissed following such appointments, Matthews has made it clear that she expects the supervisor to work with existing staff and board.

Who gets appointed may be of concern.

The community may perceive an appointment of a nearby Hamilton hospital executive to be a conflict of interest, particularly if recommendations emerge to move any regionalized services to that city.

Given the Minister’s desire to rebuild confidence, it would be preferable to bring a supervisor from outside the region given the track record in the Hamilton Niagara Haldimand Brant LHIN on public consultation. In 2010 the ombudsman was particularly critical of the lack of proper public consultation over changes to the NHS and Hamilton Health Sciences, calling existing practices “simply illegal.”

It is also not clear how this will impact the review of the misnamed “hospital improvement plan” (HIP) in Niagara. The review was supposed to involve appointees from area municipalities in addition to the LHIN and the NHS. There was widespread suspicion over the review given two of the three organizations on the review were responsible for the original HIP.

The appointment of a supervisor may also open up the NHS to investigation by the ombudsman’s office. As private not-for-profit organizations, hospitals are normally off-limits to the ombudsman. The appointment of a supervisor effectively places the hospital under the direct control of the Ministry of Health and Long Term Care and subject to the ombudsman’s jurisdiction.

The Ombudsman has made no secret of his desire to be able to investigate the MUSH sector – municipalities, universities, school boards, hospitals, nursing homes and long-term care facilities, police, and children’s aid societies.

While the St. Catharines Standard says it will be 14 days before a supervisor is named, there is anticipation that such an announcement may come much sooner.