Part 2 : A cautionary tale from the Niagara Region

Will Windsor-Essex residents suffer the same consequences a decade from now?

Windsor-Essex is home to a population of 400k, spread over 199,730 hectares. The Niagara Region is home to a population of 450k, spread over 185,400 hectares. Their experience serves as a point of comparison for the future healthcare plan being foisted on our community.

In our last eblast we talked about human costs. This week we're examining financial impact.

Recap Of Part 1: Big shiny plans made over a decade ago for reconfigured healthcare services in the Niagara Region (anchored by a regional ex-urban mega-hospital) have now resulted in a dismal reality for many area residents. In 2009, the hospitals in Port Colborne and Fort Erie were replaced with urgent care centres. In September 2019, it was announced these UCCs will be closed when the new hospital opens in south Niagara Falls in 2026.

Years of public misrepresentations and broken promises in the Niagara Region have led to consolidated healthcare services, less hospital accessiblity for patients, and increased costs for taxpayers.

What resulted in the Niagara Region: Higher taxes for local residents and less accessible healthcare. One major result of the loss of accessible acute-care hospitals in Port Colborne and Fort Erie is that the costs for ambulance services have escalated throughout the region. The St Catharines Standard wrote on June 16, 2009 about a report that had gone to Regional Council, warning about the need for a $1.1M "temporary budget bump" to prevent longer ambulance response times and off-load delays at hospitals.

Officials with Niagara Emergency Medical Services estimated in 2009 the hospital closures could cost regional taxpayers more than $3M a year:

"That’s because ambulances will have to be on the road longer, travelling with patients from those south end communities to emergency departments at the hospitals in Welland, Niagara Falls and St. Catharines, meaning upwards of 19 full-time paramedics and more ambulances could have to be added to the service." -- Niagara This Week, June 23, 2009

Fast forward to 2019, let's see how those cost predictions worked out:

"[Niagara EMS Chief Kevin Smith] said he has been before regional council 12 times in the last four years, talking about the pressures Niagara EMS is facing. 'It has not gone away,' he said. However, the resources provided by Niagara Region council have consistently fallen short of requests — only increasing by about 25% since 2014, despite the 50% increase in call volume. But since it costs about $3-million to pay for a new ambulance as well as the staff to operate it, 'we recognize that it's an expensive proposition.' 'It's really unsustainable.'" -- St Catharines Standard, March 8, 2019

Learning from the Niagara Region's healthcare experience, what do Windsor-Essex residents need to know? AM800 reported on November 6, 2019 that a recently released Essex-Windsor EMS 10-year master plan outlines a need for 57 additional paramedics and 10 ambulances. The cost for these additional resources is estimated at between $10M-$18M. We're wondering how, on a per-ambulance basis, the Windsor-Essex master plan's costs are so much lower than the Niagara Region's $3M per ambulance estimate. In the absence of an explanation, we're forced to accept the costs at face value. The AM800 story also mentioned the region's busiest EMS station is located in downtown Windsor. Population density is much greater in the heart of Windsor than any other place in the entire region:

"Essex-Windsor EMS handles an average of 139 calls each day with about two thirds of those taking place within the city. The busiest station of the 12 across the region is located in downtown Windsor on Mercer St."  --  AM800, November 6, 2019

Earlier this month a local resident also raised this logistical issue in an online comment:

"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."

It's not clear in the AM800 story whether these additional resources took into account the reconfiguration of EMS routes if the new hospital is built on County Road 42. If these resources weren't taken into account, we can anticipate taxpayer-funded ambulance costs will rise over and above the additional $10M-$18M estimate. The maps below illustrate the exponentially increased distance from the region's busiest EMS station to the nearest hospital if the plan for the single site acute care hospital on County Road 42 goes forward as proposed:

There's very good reason to expect an even greater financial impact in Windsor-Essex than the one affecting Niagara residents today. Windsor's urban and suburban population (pop. 217k) is considerably larger than that of Port Colborne (pop. 18k) and Fort Erie (pop. 31k). The city's most densely populated neighbourhoods, Windsor's Wards 2,3,4 & 5 (pop. 86k), will be the most negatively affected by the proposed loss of Windsor Regional Hospital's Met and Ouellette campuses. These wards are home to the region's greatest numbers of seniors, people with impaired mobility and those living on fixed incomes. As noted in the AM800 story, these neighbourhoods (13-18 km from the proposed County Road 42 hospital site) use EMS the most.

Since 2015, when the County Road 42 hospital location was announced, Windsor-Essex residents have never been provided with any analysis of ambulance response times or financial impact on EMS services. Tax-paying residents deserve insight into these impacts. Without comprehensive and accurate budget projections, including data for additional costs such as new ambulances, EMS staff and other operating costs for transporting patients, the process is neither transparent nor accountable. Paying with our taxes and our lives Without additional taxpayer-funded financial infusions, ambulance response times will undoubtedly deteriorate. Add to that Windsor Airport, which is a permanent barrier to the chosen hospital location. One can't simply build new roads across the 813 hectare Windsor Airport lands. And that's just distance. Remember the 2017 flooding of access roads to EC Row Expressway, the city's major East-West route? This event literally cut off Windsor's largest population centre from areas to its south, including County Road 42. It's not unrealistic to predict that future patient outcomes will be grim if the region's only acute-care hospital is located there.

You're invited   Come join us for our annual holiday gathering for a beverage (alcoholic or not). Maybe order some food or split a pizza with us. If you have a gift item to donate to CAMPP's prize draw, please email us ASAP. Where: Marco's Pizzeria & Valente's Pasta House, 4141 Tecumseh Rd. E. When: Friday, November 29, 2019 at 8.00 p.m. – 11.30 p.m. Please join us. Bring a friend. No purchase is necessary and all are welcome.

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

"Hopefully, the tribunal will make a good decision with regard to the appeal of CAMPP that the site on Hwy. 42 is not the right location for this building. This hospital is being built not just for the elite and healthy people in Windsor and the region, but for all our citizens — the elderly, handicapped, unhealthy and low-income who will all have a problem travelling to this site."

"Hospitals are not just the emergency ward. Hospitals have sick people admitted whose family needs to visut or be there to make decisions. Hospitals have ongoung outpatient services such as cancer clinics, dialysis, diagnostic imaging and fracture clinics. The vast majority of people who must travel to a hospital are not going to the emergency department. I drive dialysis and other outpatients for a living. I see the hardships and difficulties people have in accessing care every day."

"The tragedy of Niagara health care impacted friends. A man who had stents put in for cardiovascular problems in December, died in February because he could not access care. He had no car. His partner took him to two emergency rooms, and one was closed. The other was open and wouldn't take him. He had been in the Niagara Falls hospital in December (admitted, sent to St. Catherines, then discharged from Cardiac surgery in St. Catherines back to Niagara Falls hospital) and didn't want to go back there. (He had been discharged from St. Catherines after cardiac surgery,  into the emergency room at Niagara, due to no beds.)  He thought he had an upper respiratory infection, and had pneumonia. He developed septicemia, and his organs shut down, within a day. So Friday night he was looking for an urgent care, and within a few days they had called the family about taking him off life support. His partner, not actually married to him, was sent out of the room as they sedated him (he was thrashing around etc due to hypoxia imo), and never got to say goodbye.  Is this what we have to look forward to? Niagara Falls has had a terrible reputation for years, and now the new hospital is out by Marineland."

"I'm really curious to know what is the added cost for the [public transit] route extensions to the proposed hospital site are. If we didn't need to make these connections... how much could be saved? (if the hospital were to be located in a more urban area)."

"Adequate healthcare is a backbone of a healthy population, it must  be protected from fraudulent claims, illogical plans."