A cautionary tale from the Niagara Region

A decade from now -- Will Windsor-Essex residents suffer the same consequences? Big shiny plans made over a decade ago for improved healthcare services in the Niagara Region (anchored by a regional ex-urban mega-hospital) have now resulted in a grim reality for many area residents. The region's multi-decade project has produced a much less attractive local healthcare system than the one it replaced. Ten years of public misrepresentations and broken promises have led to consolidated healthcare services, less hospital accessiblity and increased costs for local taxpayers. Is this what we can expect in Windsor-Essex a few years from now?

"It doesn't matter if you have an 'H' on your hospital if they have gutted your services. They are moving ahead with closing emergency departments ... urgent care centres are not emergency rooms." -- Natalie Mehra, Executive Director, Ontario Health Coalition, 2009

What happened in the Niagara Region? A decade ago, the Niagara Peninsula cities of Port Colborne and Fort Erie lost their general hospitals. People in these communities had loudly voiced very real concerns. The Ontario Health Coalition shared and amplified these issues. Yet this public outcry was ultimately of no use. The decisions had already been made. In June 2009, both cities' emergency rooms (ER) were converted to urgent care centres (UCC).

The Niagara Region is home to a population of 450k, spread over 185,400 hectares. Windsor-Essex is comparable: it's home to a population of 400k, spread over 199,730 hectares. Ten years ago, local Niagara officials offered residents soothing promises about their future healthcare system. Their statements seem very similar to those being made today by Windsor-Essex officials. Rather than addressing the concerns of local residents, Niagara Region healthcare decision makers responded with vague reassurances that sound remarkably similar to what we've been hearing locally in Windsor-Essex: “The fact is, over 90% of the services received by patients at both the Port Colborne and Fort Erie sites will continue to be available to them.” "There will be the capacity to treat anything that comes through those doors.” We've pointed out many times that while the majority of ER patients don't need to be admitted, many are referred to specialist clinics located in or near hospitals - - not at urgent care centres  - - in order to complete their treatment. Is that the case in Port Colborne and Fort Erie too?

A local tragedy. A wider public reckoning Just six months after closing the hospitals, on December 26,2009, a car spun out on an icy patch of roadway almost exactly halfway between Port Colborne and Fort Erie. It was struck by an oncoming vehicle on its front passenger side. A teenager, Reilly Anzovino, was seriously injured. Because both towns' ERs had been converted to UCCs, it wasn't possible to treat her in Port Colborne or Fort Erie. She was taken instead to the nearby Welland County Hospital, where she died several hours later. Ms. Anzovino's family and community members believed the closure of the ERs had played a role in Ms. Anzovino's death. According to The Hamilton Spectator, her death, and the circumstances surrounding it, became an election issue in the 2011 provincial campaign, with both the NDP and the Progressive Conservatives pledging to reopen the shuttered ERs. To date, this has not happened. Almost exactly a decade later, the two communities were both shocked and infuriated by a new revelation: In September 2019, The St. Catharines Standard ran a story about plans to close the UCCs (that replaced the two local community hospitals) when a long-planned new hospital opens in south Niagara Falls in 2026.

What can Windsor-Essex residents learn from the first ten years of the new healthcare system in the Niagara Region? Windsor residents are being promised "emergency services" downtown. County residents are being assured that Leamington's hospital, Erie Shores Healthcare, will remain unchanged. How can residents be sure the politicians' and hospital representatives' promises today won't be changed tomorrow, after they have moved on? Calling out blatant misrepresentations The promises made in 2009 to maintain adequate and accessible (acute-care hospital - ER - and UCC-based) healthcare services to Niagara Region residents are not being kept. Today, - in 2019 -  if these decision makers have their way, 90% of healthcare services will NOT continue to be available to Port Colborne and Fort Erie residents. Capacity to treat anything at all will be eliminated. About conducting community consultation: Where have Windsor-Essex residents heard this before?  Niagara Health's Interim President Angela Zangari stated that there had been a "widespread, thorough consultation process" ahead of the decision to close both UCC sites in a few years. It seems that in the eyes of Ontario's healthcare planners, "consultation process" has little to do with responding to public opinion. Niagara residents have every right to be outraged. Windsor-Essex residents would do well to pay close attention to this story. We still have time to create a better healthcare future for our region than the current plan.

Stay tuned for Part 2: There's a lot more to be learned from what happened in the Niagara Region. In our next eblast, we'll examine the additional costs to taxpayers, very few of which have ever been revealed to Windsor-Essex residents.

In their own words: Members of our community continue to comment on the issues

"I wonder if there is a plan for when people with emergencies go to the Ouellette UCC because they can get there easily; like with chest pain or sudden injuries but who don't think it is worth calling an ambulance. How much contingency is planned for transfers to the mega?"

"Everyone deserves access to good quality health care. However, its impossible to have a single location that is going to be accessible and “convenient” for everyone. And while Windsor is not paying for the hospital alone, on a greenfield site in an undeveloped area, it IS paying for all of that additional infrastructure - construction, and maintenance forever, at a time that that growth is far from justifiable. Certainly, by far, the greatest density of population in the entire county is in the core of Windsor and Windsor has a large infrastructure deficit to deal with already. Many people who live in the core, by necessity, or by choice, do not drive. They live in the core because of accessibility by foot, bike, or public transit. It really does not make sense to be making vital health care services (like a real emergency room) less accessible to the highest density of population, and truly inaccessible for many, while making it only marginally more “convenient” for the county. By doing this, we only create a situation where more people NEED to drive, putting a much bigger strain on roads, traffic congestion, the environment, and family budgets. Such services are traditionally located in city centres for a reason. What we really should be asking is, if the county population is expanding, its no longer so rural, and warrants better access to healthcare, why on earth should we be downgrading our hospital system to ONE emergency room and the same or lower number of beds and putting it in a location that is much worse for the city (for access and many other reasons), and only very minimally closer for some county residents. Lets not sell ourselves short by bickering over who deserves a hospital a few minutes closer....This is an investment of a lifetime, not a “its not perfect but just get’er done.” We all deserve a much more thought out plan that will better benefit both the city and county."

"When IODE er was closed about twenty yrs ago an UCC was promised with the same drs and a blood lab and xrays. In the beginning it did have all the same er drs working in it with a blood lab an on site xray dept. It originally operated from 8-8 7 days/week. Over the years the hours started dwindling to 6 pm then 5 now it's 2 or 3 pm but you have to get there by noon to get your name on the list to be seen. Pretty sure it is not open on Sundays now. There MAY still be an er dr there but i doubt it. The blood lab and exray dept are long since gone. They MADE the SAME promise back then and they will BREAK the SAME promises NOW!!. I have absolutely NO TRUST in their system."

"Mayor Drew Dilkens You accused Jennifer Keesmaat of being a hired gun. Name one planner that supports this hospital that isn't paid by the city or hospital to say so. You also insinuate that all doctors are on board with this plan by saying they all agree we need improved hospital infrastructure. Almost everyone says that, including CAMPP. Doctors with hospital privileges by contract are not allowed to speak against the hospital or its plans. There are so many alternatives to this plan"

"Mega Sprawl gobbling up valuable farmland is NOT sustainable development!"

"Growth pays for growth has repeatedly proven false."

"All farmland is valuable. Basing this rating on whether it can be cash cropped with the holy trinity of corn, soybeans, and wheat should not be our benchmark. Even the most marginal land as far as cropping goes is valuable to our ecology."

"The most calls come from the most densely populated area of the city. As if that is hard to determine. Moving the hospital to the bean field will reduce service without additional ambulances because of travel time from the core to the new hospital. Yet, no one wants to talk about that."