Building for the Past: An Invitation to "Participate" in Windsor's Worst Planning Mistake Ever

On Monday, March 21, 2022, Windsor Regional Hospital (WRH) will begin hosting a series of virtual public engagements for the new hospital on County Road 42, and the urgent care centre that is to replace WRH’s centrally located acute care hospital on its Ouellette Campus. WRH also has a web portal for submitting ideas in writing. Be warned: The questions revolve around the interior design elements of the hospital, rather than the medical functions and services to be provided to Windsor-Essex stakeholders.

"While we care about all aspects of the hospital, the purpose of this survey is to discuss the physical design of the new hospital. Only related answers will be considered."

Once again, WRH is using a contrived public engagement to bury essential questions that urgently need to be addressed. What is more important to residents: ultra-plush chairs or accessible healthcare? And we don't mean the number of steps to the door from the parking lot. Why is WRH asking the public to commit their time and energy to brainstorm secondary features that are best determined by experts: the experienced designers and architects with knowledge of best practices from other recent hospital builds? Is this just another pro-forma exercise for a Ministry of Health check-box? Because it sure seems a lot like a repeat of the farcical public engagement process from 2015 that led to this, the worst planning decision Windsor ever made. Everyone in Windsor-Essex should have serious doubts that WRH's latest "invitation for public participation" will address any public opinions on the fundamental issues that matter most to residents:

Especially this key problem: How the hospital plan will impact the approximately 100,000 people who live in Windsor's central neighbourhoods - if the new hospital plan goes forward as presented.

This is a new reminder that while the greenfield hospital site adjacent to Windsor Airport is a sore point for many, the decision makers still have no intention of addressing the flaws of this ill-conceived plan, one that was obsolete long before it was announced as a "done deal" in 2015.

The need to provide healthcare where people live has never been more obvious during this time of sharply rising gas prices, heightened geo-political risk and stretched government budgets.

We urge you to remind the hospital planners that all residents, regardless of where they live, need – and deserve – accessible hospital services. Environmental and fiscal sustainability must be key features of the plan for our future healthcare.

Below are some points you may wish to consider before submitting your own feedback.

1. What are WRH's overarching standards for this project? Will they learn from the leaders or repeat the mistakes of the past? Very early on in its own planning process, Toronto's best-in-class Humber River Hospital, which opened in 2015, established "lean, green and digital" as its guiding motto. Its energy efficiency is a model for other hospital projects. In Windsor, where the new hospital is to be built on floodprone farmland, environmental considerations have never appeared to be important to the project's proponents. WRH focused public attention on the prospect of bountiful surface parking and wider access roads to divert public attention from the negative medical and economic impacts of the distant hospital location. Why is WRH seducing us with parking and road construction, rather than promoting better access to healthcare for everyone, including those who don't drive?

2. Hospitals belong where people live. According to the Stage 1 planning documents, almost 40% of all WRH Emergency Department (ED) patients live in the central neighbourhoods around the existing hospital campuses. This is why it is critically important to retain a full range of healthcare services close to these neighbourhoods.

Don’t be fooled by the argument that most ED patients don’t require hospital admission: Is there any reason to believe WRH's grandiose promise that the staff will be able to perform "any and all required treatments on every patient who presents?" What percentage of patients' medical problems are resolved in the ED? Many patients require a specialist referral -- where will these appointments for additional care take place? There have never been any announcements about ambulatory care clinics remaining at the Ouellette site.

If anything, this language suggests the large numbers of patients requiring additional specialized care will be expected to travel to the new acute care hospital after all.

3. By the way, words matter: An Urgent Care Centre and an ED provide completely different services.

WRH continues to describe the planned new downtown facility on the site of the current Ouellette hospital campus as a “Satellite Emergency Department.” Yet the excerpt of WRH's own planning documents submitted to the Ontario Ministry of Health makes it quite clear that what is being designed is a limited hours urgent care centre - definitely not an ED:

“An Emergency Department is, by definition, a 24 hour per day, 7 days a week service which operates in a hospital.”  According to WRH: "A Satellite Emergency Centre is an alternate site for patients with less serious issues who do not require all the resources available in an emergency department." The main distinguishing feature of an urgent care centre is that it is not designated as a receiving centre for ambulance-bound patients. Thus, any CTAS level 1 or 2 [the most life-threatening] patient being transported by ambulance will automatically be routed to an Emergency Department. WRH's planning documents [redacted by WRH without explanation] clearly state that the downtown Windsor facility will be an urgent care centre and not an ED. It will not accept ambulances. So why do they insist on calling it an ED?

4. Meeting our future needs? As a result of Windsor’s successful Economic Revitalization Community Improvement Plan (CIP), the city’s downtown area has been undergoing a resurgence, attracting thousands of new urban residents. Does anyone truly believe this area will be adequately served by an urgent care centre instead of an acute care hospital? How is this compatible with the city's long-term planning vision?

To "participate" in WRH's public engagement, prior online registration is required at this link. This process is designed to obtain personal data and elicit cute ideas. It is not designed to obtain key information essential to planning the healthcare services to meet Windsor-Essex's future needs. This is not an anonymous survey: You will be asked to provide your full name, email address and six-digit postal code. The registration process also doesn't require any specific demographic information that would give key insights into whether all stakeholder groups are fairly represented. Typically, professional surveys gather anonymous data that includes age group, gender, country of birth, education and income level. WRH wants to know who you are, but they don't really want to know about you!  What steps will be taken to reach the almost 100,000 residents of Windsor’s central neighbourhoods, among them thousands of newcomers to Canada for whom English is a completely foreign language? What about other stakeholders with barriers to this kind of engagement who stand to lose accessible hospital healthcare services under the current plan? For example, those with mental and physical disabilities, as well as people without internet access? Will an honest attempt be made to engage First Nations stakeholders this time, or is the land acknowledgement on WRH's website just another bald attempt to check a box?

We have submitted CAMPP’s ideas for the community’s emergency and outpatient services. We invite you to use our ideas as a starting point for your own submission.

Click here to read CAMPP's ideas

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In their own words Comments on the issues:

"We should be doing EVERYTHING within our means to preserve land that really isn’t required for necessary growth. In Windsor right now… the Sandwich South (900 acres of zoning amendments devised with public money by our hospital) development is someone’s unnecessary dream. There are MORE than plenty of alternatives to grow in a more sustainable manner and save that land for if and when it’s required in the future. It’s not rocket science…it’s about leadership that understands that quality of life, not just here but on the rest of this planet isn’t about “he who finishes with more wins”."

"It amazes me how many people are blind to the fact of what a disaster this will be. And it has nothing to do with it being in the City Core where it belongs, or it being put out in an inconvenient spot for the majority of people who will be using it, it has to do with the fact that things will only get worse instead of getting better. Right now, Windsor has two hospitals with two emergency rooms between them, and they sometimes have a problem dealing with the number of patients they get. Especially the emergency rooms. How is closing them and opening one hospital with one emergency and the same number of beds in it, going to improve things. Things are only going to get worse. Windsor used to have 4 hospitals for fewer people, now they will have no hospital for a larger population. The smart thing would have been to build a smaller, updated community hospital in the county and the main, bigger hospital closer to the downtown, making it convenient for everyone."

"hundreds of people walk through the front doors of our hospitals. Staff, visitors, and volunteers. Its those that are healthy that could walk or take active transportation to our hospitals. WRH staffs up to 5000. That’s [a] lot of healthy people right there that could walk to work."

"The fact is many people have no other option. At least 16% of the population don't own a car. 36% of millennial don't own a car."

"And we're looking to replace a large chunk of farmland with a hospital that has the same services and same amount of beds that we currently have. But people don't want to question the location (especially those in the county) because it's closer for them."

"It should be illegal to build on farmland. I see this happening daily and it scares the crap outta me. (1) more pavement = more flooding (2) more pavement = higher temperatures (3) we no longer have enough farmland to feed the world"

"We need to build up not out for housing, industry, retail. Think what is was like here in Essex county 200 years ago, I can't fathom what it will look like in 200 years in the future."

"City Planners need to mandate a new to old ratio. For every new development house they must redevelop, renovate or build X number of homes or units in established urban areas."

"There is still room within the city of Windsor for more building. We need more apartments and one-level homes, for seniors who want to downsize in their own neighborhoods. We need more low income housing, apartments and town homes. "

"My grandparents had a beautiful 50 acre mixed farm in LaSalle which is now covered with monster homes. I can’t go back there as I’m reminded of what was lost."

"Paving 60 acres of floodlands is looking smarter every day."

"Pouring asphalt across a flood plain...priceless"

"Ontario is in massive debt why would we pick the location that costs the most? Over 150 million dollars extra just on infrastructure the other sites don't need. Also adding busses to accommodate that location which isn't on current bus routes like the other locations are."

"Hwy 42 & 9th Conc. is right in the middle of the Upper Little River flood plain. Building a 10 storey MegaHospital adjacent to and in the flight path of a busy, existing International airport sound like the script to pending disaster. "

"It is not a done deal until it gets built, until then it is up to the logical members in our communities to convince the leaders and provincial govt that building in the proposed spot would be a grave mistake."

"Right now every mayor in this county, including Windsor are building sprawling or planning to build more sprawling subdivisions as fast as they can, everywhere they can. All the while giving lip service to climate change. All they are accomplishing is to bankrupt their grandchildren before they’re born."