Scarborough-Rouge Merger: Some potential questions for tonight’s tele-town hall

Tonight The Scarborough Hospital and Rouge Valley Health System are having their second public telephone town hall to discuss the benefits and risks of a merger.

The first town hall on September 24 attracted more than 8,000 participants.

The irony of this process is that it has provided incredible amounts of information but many have still come away feeling that they don’t have enough detail to make a decision to support or reject merger.

Scarborough CEO Robert Biron says there is no hidden agenda.

He is right. What we have are two large urban hospitals that are under similar pressures to 149 other hospital corporations in Ontario due to the province’s decision to freeze hospital funding at least until 2018.

Most, however, have decided not to examine formal merger to deal with the funding freeze as have these two hospitals.

The question is, will merging the two help or hinder in that process and what needed health services will be at risk along the way?

The two CEOs are quick with answers for most of the “risks” that stakeholders raise. The answers are not always reassuring.

Merger or not, there is going to be plenty of uncertainty as a result of the decision by the province to deliberately flat-line hospital base funding. Even if the hospitals do merge, they will still be faced with what essentially amounts to a cut of about three per cent or more per year.

There are 14 working groups looking at opportunities and risks associated with various parts of the two hospitals’ operations. That doesn’t mean by November 12 — the date the two hospitals boards make their final decision — there will be a draft operational plan for the merger.

In fact, the more talk there is, the less clear it is what a merged hospital system might look like.

From the standpoint of professional and support staff at the two hospitals, there has been no clear answer around concerns that these workers will have to shuttle between the four campuses in the name of labour flexibility. Nor is it clear who would pick up the cost of such travel.

The hospitals are doing the province a political favor in presenting the Ministry’s “health care spending is out of control” argument to the focus groups even when the financial data doesn’t support it. In the last three years health care spending has not only been in decline as a share of the province’s economy, but also as a share of program spending. That cost curve already got bent.

We’d respect the process a lot more if they simply admitted that the province’s plan is to starve hospitals as a blunt method of shifting services to the community. While the hospitals are receiving zero, health care funding is slightly more than 2 per cent annually.

If you are on the call tonight and are looking for questions to pose, here are some we still have:

  • What are the estimated costs associated directly with merger and who picks this up?
  • With three of four hospitals located in Scarborough, what assurances can the hospital give that Durham residents will have their interests protected in such a lopsided merger?
  • Given the special demographic needs of Scarborough residents does the hospital believe the current hospital funding formula reflects those needs, particularly when it has already said that the impact of the funding formula will be negative to neutral in a merger?
  • With both hospitals expected to balance their budgets by the end of this year, how much risk is there in stepping into a much more volatile situation where the fiscal outcome of a merger is largely unknown?
  • Many of the workbooks call on new investments to make the work of the hospital more efficient. With the hospitals looking for a combined $28 million in savings next year, how likely are these investments to happen in such a fiscal straitjacket?
  • Given a decision will have to be made before the granular detail on its implications can be understood, what scoring criteria are the hospitals using to decide upon a merger?
  • There are 151 hospital corporations in Ontario. The modest sized West Lincoln hospital is merging with the gargantuan Hamilton Health Sciences and the Windsor Regional and Hotel Dieu Grace hospitals are at this point swapping campuses as a means of focusing services. If the merger benefits are as apparent as we have been told, why are not more hospitals openly examining this option? What is the end point of all these mergers, and could we be going through this again with another super hospital in five to 10 years?
  • We’ve heard what the hospital believes to be benefits to existing services under a merger. Surely it must also have some idea which services are most at risk?
  • The hospitals have assured residents that no hospital will close, no ER will close nor any patient services removed from the two Rouge Valley sites. It has also said no services will transfer from Scarborough to Rouge. So why would the hospital not also guarantee that no patient services will be removed from the two Scarborough sites? If they are not transferring to Rouge, where would they go?
  • How can either hospital make guarantees – no ER will close, no site will close, no patient services will be moved from Rouge Valley — when these decisions will be completely up to a new merger board?

If you want to participate in tonight’s town hall, you have to first register on the merger website. Click here to do so.

One response to “Scarborough-Rouge Merger: Some potential questions for tonight’s tele-town hall

  1. This merger discussion is ill considered and certainly not good for the residents. Rouge has had and continues to have its own problems. Scarborough has a history of problems post merger of the then Grace and Scarboro hospitals. It is a hospital that has been rudderless and has had consistent poor leadership for over a decade. Why merge two poorly operated hospitals. Why not fix the problems plaguing the two hospitals now with better integration of services amongst them? All any merger will do is create a bigger problem for the next board.

    What facts and evidence guided the two hospital boards to come to the conclusion that a merger should be explored? Can the community get this important background information? Is mega-merger really needed and the only viable response? Any such merger will set back improving care as the culture of these hospitals will hamper nimble response to much needed improved care in our community.

    The town hall session was not a serious attempt to engage the public. There were no risks outlined and really no benefits. Will it really improve quality of care and if so, why can the quality not be improved by better integrating programs now?

    Too many unsettling questions and it begs who will really benefit from this ill-conceived merger-perhaps the CEOs as one of them will manage an even bigger titanic and the other gets a handsome package! Wake up Scarboro- where are the local politicians?

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