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SBGHC proposes crews not take mental health cases to Durham ER after 3 p.m.
Posted: July 20, 2024
(July 19, 2024) By: Scott Dunn, Owen Sound Sun Times
Police and paramedics are expressing concerns about a South Bruce Grey Health Centre proposal to stop bringing people experiencing a mental health crisis to the Durham hospital after 3 p.m.
For now, it’s business as usual until agreements are put in place, said Kevin McNab, Grey County’s director of paramedic services.
“There has been discussions about that. But there has been no plan put in place as of yet,” McNab said on July 19.
Durham’s emergency department went from around-the-clock service to 7 a.m. until 5 p.m. in March, then the hospital site lost all 10 of its inpatient beds to sister hospitals in Walkerton and Kincardine by June 3, both due to staffing and safety issues, SBGHC has said. SBGHC has not responded to a request for comment.
McNab said for ambulances to bypass Durham hospital when it’s open would require formal agreements with the nearest hospitals, Mount Forest, Markdale and Hanover, then approval by the paramedic service’s base hospital and dispatch service in London.
McNab said he’s concerned about “added strain” of transporting people longer distances, tying the service up at one of the busiest times of the day. Sometimes safety concerns require police to ride in the back of the ambulance, so he’d need assurances police could do so.
Ambulances automatically take patients to the nearest alternative hospital when Durham ER is closed. But destination agreements are needed to take Durham’s patients to other hospitals when the Durham ER is still open.
He added he doesn’t know how patients get home in those cases.
“This isn’t a single organization’s decision. This is agreeance of the partners to be able to do this,” McNab said.
West Grey Police Chief Rob Martin said in an interview that he learned about the proposed change by email from South Bruce Grey Health Centre about two weeks prior.
“It is a big deal because if we start diverting from our hospital, then we have to start taking people to Hanover or Markdale or Walkerton, which has been suggested in the past. That takes at least one of my members out of the town,” Martin said.
Two police officers would have to go with a violent patient, he said. West Grey police has four officers per shift, so that could tie up half of the officers on that shift out of town, he said.
“And we have a very good working relationship with the Durham hospital. It’s a very smooth transition for us. We have practices because we’ve worked with them for so long. But this is now something new. And how is it going to affect business?” Martin said.
West Grey Mayor Kevin Eccles said in a July 18 interview that the change would be the latest example of service reductions in Durham hospital.
“One of the newest and craziest things, I don’t know whether they’re going to follow through with it or not,” Eccles said. “We understood that the emerg was open until five but yeah, they’ve been restricted until three o’clock.”
The decision to remove all the inpatient beds from Durham hospital prompted public rallies, a public meeting, a march and candlelight vigil, and concerns about whether Durham hospital would be closed completely.
But SBGHC president and CEO Nancy Shaw has committed to keeping Durham hospital open and the Ontario Ministry of Health has said it is working closely with SBGHC to ensure urgent and primary care remains available in Durham.
Some local politicians and community advocates joined an Ontario Health Coalition rally at the end of May at Queen’s Park. They demanded a moratorium on closing local public hospitals and a stop to privatization of healthcare.
Grey Bruce Health Coalition members spoke at the rally about threats to small and rural healthcare, a concern Eccles says he shares.
Local coalition co-chair Brenda Scott has observed that people in Chesley fear for their hospital’s future too. Chesley hospital’s ER is open 7 a.m. to 5 p.m. on Monday through Friday and is closed weekends, also due to staffing shortages.
Reached July 18, Scott said she’s hearing the implications of not having inpatient beds in Durham are as predicted. “We’re hearing that if you go to the ER in Durham . . . they will only refer you to Kincardine” if you need to be admitted.
Hanover is a 15 minute drive away but she understands Durham hospital can’t refer to that hospital because it’s not part of SBGHC. Kincardine is 72 kilometres away and can take an hour to get there, when it’s not snowing, she said.
“That raises that question, what happens to ER patient at five o’clock? You’re either going to have to be discharged, or referred to Kincardine,” farther from family and the person’s support base, Scott said.
Eccles said West Grey’s request for a judicial review of the SBGHC board decision to move the beds out of Durham hospital remains active. The municipality has filed some affidavits and awaits the Oct. 3 hearing in Divisional Court in Brampton. He said the hospital corporation has acknowledged the municipality’s application and indicated it will file a response.
Additionally, a state of emergency remains in effect for the Municipality of West Grey.
The Municipality of West Grey’s Emergency Control Group reconvened on July 22 to review the state of emergency that was originally declared on May 28 regarding the concern for public safety due to the removal of inpatient beds and changes to the emergency room operating that went into effect on June 3.
“The Durham hospital remains a critical piece of our community infrastructure. The municipality and council are continuing efforts to save the Durham hospital, and until such time as there is a satisfactory commitment to resolving this healthcare crisis, the state of emergency will remain in effect in West Grey,” Eccles said in a July 23 news release.
The municipality continues to reach out to government agencies, community partners and healthcare stakeholders to explore opportunities for a collaborative approach for securing the future of the Durham hospital as the critical anchor for healthcare in West Grey and surrounding areas.
