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Rural health care access among issues raised at Chesley public hearing
Posted: July 4, 2024
(July 3, 2024) By: Pauline Kerr, Penticton Herald
CHESLEY – The Ontario Health Coalition has been holding public hearings in communities across the province, to hear what the public has to say, and to gather input to develop recommendations for the future of our hospitals, including small, rural hospitals.
On June 18, it was Chesley’s turn for a hearing. Some of the panelists and most of the speakers at the Chesley Community Centre were no strangers to the approximately 60 people who attended the hearing. They were certainly familiar with the service cuts and emergency room closures that have deeply affected health care not only in Chesley, but the wider area.
One of the panelists – Brenda Scott – told the crowd it is significant that the day of the hearing, she’d gone to the Chesley hospital ER – and found it closed.
Scott is chair of the small and rural hospital committee with the Ontario Health Coalition and co-chair of the Grey Bruce Health Coalition. The other panelists were France Gélinas – NDP Health Critic and MPP for Nickel Belt; Graham Webb – lawyer and executive director of the Advisory centre for the Elderly; Dr. Adil Shamji, Liberal Health Critic and MPP for Don Valley East (attending via Zoom); and Natalie Mehra, executive director of the Ontario Health Coalition. Host was Norah Beatty.
Those presenting submissions were John Butler, Steph Douglas, Rev. Craig Bartlett, Bernice Kozak, Sybille Walke, Beatty, Hazel Pratt and Arran-Elderslie Mayor Steve Hammell.
During the introductions, Scott commented on the importance of stressing that “small, rural hospitals are not a disposable part of health care.”
Mehra told the audience that they had just returned from Thunder Bay, where the panel heard the full gamut, from a closed hospital ER that’s an hour and a half from the nearest hospital, to a community (Geraldton) where “the community has kept the ER open.”
She said that while there were eight people making presentations, “we want to hear from everyone.” She urged those with a story to tell or an opinion to voice, to send an email.
The information gathered will be put in a report to be released in September “about what is happening across the province.” A key portion of the report will be “concrete recommendations to improve health care.”
If the presenters in Chesley are any indication of what’s happening in the rest of the province, some of the key issues that must be tackled are lack of funding for rural health care, the impact of no public transit on access to health care, increasing privatization (especially agency nurses), lack of timely access to specialists, and a focus on “one size fits all” health care planning in the province.
The first presenter was Butler, a retiree who lives in Grey Highlands and has considerable expertise in health care. He said one of his first jobs was as part of a team that tried to close the Chesley hospital 40 years ago.
He spoke about the challenges facing rural health care – “relentless system failures,” lack of a rural health policy (just “scaled-down” urban health solutions), lack of integration in health care, relentless introduction of privatization, and lack of a rural and hinterland strategy.
Among the questions asked by the panelists was one about the “danger of centralization,” to which Butler replied, “the models don’t work everywhere, for everyone, all the time.”
He later addressed the common assumption a patient’s family will provide care, which is not necessarily the case.
Bartlett told his personal story, of having returned to Canada from teaching English abroad. In South Korea, he’d had good access to health care. Back in Canada, he found himself having to “cobble together” whatever health-care services he could, starting with the Chesley hospital’s ER. He spoke highly of the quality of the health care he’d received, but said the referral wait times are an issue, as are ER closures at the hospital.
He related being advised by his pharmacist that he might have better luck getting a doctor in the GTA. Bartlett said walk-in clinics and urgent care clinics need to be “on top of, not instead of” hospital ERs.
During the question period, the audience was asked if they knew anyone who didn’t have a primary care doctor or nurse practitioner. Every hand in the room went up. Later in the meeting, they were asked how many had a doctor. Many hands were raised. However, a good number of those hands stayed up when the question was asked if that doctor was outside the area.
Kozak described a community suffering from what she termed, “burnout. They feel defeated.”
She said she’d moved to the area because it had good health care; now it doesn’t. When her partner had a heart attack, it took over an hour to see a doctor.
Kozak spoke of “centralization and the drive to privatize,” asking why anyone would take a job at a hospital that’s going to close. Incentives are needed, she said. The agency situation has to be regulated. And centralization and amalgamation pit communities against each other.
As for privatization, she described a health-care system “deliberately underfunded to create a crisis.” And fighting back “feels like whack-a-mole.”
The answer, she said, is new thinking. “We have to do something creative.”
Walke noted that health professionals “don’t seem to have the same negotiating power as other groups, like law enforcement.”
She also commented that the hospital closings “almost seem pre-planned.”
Pratt spoke of “random ER closures” and patients transferred to a hospital too far away for family members to visit.
She addressed the concerns of the Old Order Amish and Mennonite communities, who use horse-drawn buggies and depend on having a hospital close to home. However, even people with access to a motor vehicle can have problems getting to a hospital with an open ER in bad weather.
Pratt had a number of recommendations including restoring all services to the Chesley hospital, looking at why nurses are leaving South Bruce Grey Health Centre hospitals, and restricting the cost of agency nurses.
She also noted the four-hospital SBGHC amalgamation had not benefitted Chesley. “There’s no equality … Kincardine has benefitted,” she said, noting the majority of SBGHC board members are from the Kincardine area.
Hammell stated “nurses are true heroes in the community.”
He noted that while the area has a population of about 7,000, there are many visitors who depend on the hospital in Chesley, which is centrally located in Grey-Bruce.
The mayor described the health-care situation as “the biggest topic in my time.”
CAO Sylvia Kirkwood continued with the Arran-Elderslie presentation, discussing transportation issues, lack of walk-in clinics and “sporadic closures that put a burden on emergency services.
She characterized Arran-Elderslie as a municipality trying to grow, and noted that the developers with whom municipal officials have been meeting are looking for local health-care services.
“We’ve been advocating where we can,” she said – Association of Municipalities of Ontario (AMO), and Rural Ontario Municipal Association (ROMA).”
She and Hammell identified two key needs – sharing health-care information with the public, and “enhanced communication with SBGHC and the public.”
The final speaker of the day was the host, Beatty, who reiterated the need for people to email in their comments to www.ontariohealthcoalition.ca.
She spoke of the need to maintain rural hospitals and provide access to city hospitals.
She also spoke of the 34,000 Grey-Bruce residents without a family doctor, whose only access to the health-care system is the local ER.
“We need a funding model tied to inflation,” she said. “Funding is not keeping up with inflation.”
And shifting beds is something she described as “robbing Peter to pay Paul.”
She was critical of the “creep of private services” in the area, most recently involving lab services, and described Grey-Bruce as the “ground zero model for rural health-care privatization.”
