Update: Matthews limits role of supervisor despite scathing report into northern hospital

“In 1970, Dirk sued Stig, Nasty, and Barry; Barry sued Dirk, Nasty, and Stig; Nasty sued Barry, Dirk, and Stig; and Stig sued himself accidentally. It was the beginning of a golden era for lawyers…”– From the UK Comedy The Rutles

Iroquois Falls residents may have found the circumstances at their local hospital similar to Eric Idle and Neil Innes’ comedy The Rutles, but few of the 4,500 community residents of this northern Ontario town were likely laughing.

At one point even the Minister of Health’s appointed investigator realized that he was also subject of an action which was withdrawn before he could be legally served.

“This was the first time I had been made aware of this action,” Ron Gagnon wrote in a scathing report into the governance of the Anson General Hospital submitted at the end of June and made public in redacted form about a month later.

Gagnon, whose day job is CEO of the Sault Area Hospital, wasn’t the only one to be subject to litigation by the small northern hospital.

With an annual budget of $13.8 million and 157 staff, the Anson General was spending more than $10,000 a month on legal fees – an estimate Gagnon believes to be low.

The 34-bed hospital planned to take the North East LHIN to judicial review over its decision to appoint KPMG to investigate public complaints over how the hospital was being run — an investigation the hospital failed to cooperate with.

The Anson Hospital also submitted a Freedom of Information request to the LHIN to seek any correspondence that may have mentioned the hospital.

What really sent a chill was a $500,000 statement of claim by the hospital and several of its senior staff over comments made in the media and on social networks by nine residents of Iroquois Falls. “The Northern Nine,” as the defenders call themselves, include a former Mayor of the town. The suit was dropped days after the investigator’s report was made public. (The money spent by the hospital on this suit was redacted in the investigator’s report).

The big spending wasn’t just on lawyers. Embroiled in a war of words with the North East LHIN, members of the community and even the local NDP MPP, the hospital paid about $15,000 for communications advice of which CEO Bruce Peterkin ignored much of the key message at a subsequent press conference.

While the hospital tried to portray community unrest as limited to a small group of individuals, the investigator described Iroquois Falls as a “town divided” and laid much of the responsibility for it at the feet of actions initiated by the CEO and board.

“The approach taken by the Hospital’s Board and CEO appear to have significantly contributed (negatively) to the situation that exists in Iroquois Falls today,” Gagnon writes.

Anson is one of three hospitals belonging to the MICs (Matheson, Iroquois Falls, Cochrane) partnership. The three hospitals share administrative services including one CEO: Peterkin. Gagnon strongly recommended placing both Anson and MICS under Ministry supervision. That didn’t happen – Health Minister Deb Matthews gave supervisory responsibility only for Anson to Hal Fjeldsted, former CEO of the Kirkland and District Hospital.

The arrival of a Ministry-appointed supervisor often means the departure of a CEO, but the multiple role Peterkin plays complicates matters. Fjeldsted cannot supersede the boards of either the Cochrane or Matheson hospitals — the other two-thirds of MICs.

Gagnon suggests the board may have been too passive in taking advice from Peterkin, making the specific recommendation that “the Board needs to apply its own experience and judgment in governing the organization.”

Yet the problems of Anson go much further than the board’s strange ideas of getting out of the state of siege they were under by taking detractors to court.

Gagnon concludes the increases in executive compensation at Anson and MICs did not comply with “at least the spirit, if not the provisions of the Public Sector Compensation Restraint to Protect Public Services Act.” In one of the odder sections of the report, the investigator notes the hospital did seek legal opinion on the issue but could not show it to him without the legal counsel’s written consent. The CEO later relented.

Further, the report suggests that the board made it easier for the CEO to receive bonus compensation by setting performance targets that were actually lower than current results. Performance bonuses also failed to take into consideration employee satisfaction surveys, which had dropped dramatically under Peterkin.

Gagnon writes that “there is sufficient evidence to suggest that an environment of retaliation, bullying, intimidation and potentially harassment exists.” He notes the board chair expressed skepticism, suggesting that if this were true it would show up in sick time and staff satisfaction surveys. Gagnon responds that “the information available indicates that there are indeed problems in these areas.”

When asked if they were overall satisfied with the organization, fewer than 25 per cent of Anson’s employees expressed a positive response – a 48 per cent decrease since 2010. Just over half – 55.4% of employees felt their work environment was safe.

“These results are significant indicators of a potential problem,” writes Gagnon.

The investigator says he had difficulty meeting with residents of Iroquois Falls. “I first thought that this was an overreaction by a few individuals but a trend developed that I find unsettling,” Gagnon writes. “Anyone who was employed at the hospital or provided services to the hospital was terrified of loss of employment or loss of business.”

The investigator’s report finds many other problems with governance at Anson as well as sides with the hospital on some of the complaints made by community members, including allegations the dismissal of two board members was improper.

CEO Bruce Peterkin claimed the “Northern Nine” had spread misinformation about the hospital, but the investigator found several claims by Peterkin to be untrue. One was Peterkin’s assertion the hospital had absorbed a $200,000 deficit from the Family Health Team. It turned out this cost was taken up by the Ministry of Health. The other allegation is the LHIN was forcing the MICs into formal amalgamation, which Gagnon writes was also not true.

Fjeldsted has the power to remove the Anson General’s Board, but given no authority over the MICs, he doesn’t have complete authority to remove Peterkin from his post as CEO of the three hospitals.

Deb Matthews may have made this a lot more complicated that it need be by limiting Fjeldsted to only the affairs at Iroquois Falls.

“Overall I have concluded the AGH Board is not capable of properly governing the affairs of the Hospital and that a Supervisor should be appointed,” writes Gagnon. “I have also concluded that given the interconnectedness of AGH and MICs governance and administrative structures and practices the Supervisor should be given authority over MICs as well.”

5 responses to “Update: Matthews limits role of supervisor despite scathing report into northern hospital

  1. Not all accurate – one of nine!

  2. Perhaps Jim you’d like to enlighten us on what the inaccuracy is?

    • ‘The investigator says he had difficulty meeting with residents of Iroquois Falls’. Fact ‘the investigator did not meet with any residents of Iroquois Falls’. We requested meetings with him numerous times He only talked to Hospital staff. How can it be a truly factual investigation when you only hear one side of the story. It’s just like reading half a book then writing a book report. Mr. Gagnon’s report is greatly flawed and did not delve into some very serious issues. Such as bullying and harassment. It would have been more damming had he talked to the N9 and other community members and patients. Why is still a mystery, but a huge void and tainted! Shame on Gagnon and shame on Mathews for getting an insider to complete a job that an independent investigator should have done.

      Furthermore, given the amount of white paint used, for report cover-up, the Wynne government should consider buying CIL.

  3. I think they had a sufficient supply of white paint given how much of the report was actually redacted. We don’t know what was taken out. However, while there are clear limitations to the investigator’s report, the document does provide evidence and support to much of what the community was saying, including credence to the poor work environment at the hospital. Therefore your reaction is a bit surprising. While the investigator expressed some clear bias, particularly around the role of the community in the governance of the hospital, the report did make some strong recommendations — including the appointment of the supervisor. That the Minister chose to limit that role is disappointing.

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