Save South Muskoka Hospital Committee continues to raise concerns about health proposal

July 14, 2024

The Save South Muskoka Hospital Committee (SSMHC) letter expresses its full support for recent efforts by community representatives and officials to subject the MAHC Hospital Redevelopment Plan to greater public accountability by the Town of Bracebridge and the District of Muskoka. Particularly given the significant municipal tax dollars currently being allocated to the hospital redevelopment, community support from our community representatives is meaningful and an essential requirement for any redevelopment plan process.

Local equity financing must be subject to public accountability

The financial commitments for the “local share” accumulated for the MAHC Made in Muskoka redevelopment model amount to the incredible sum of US$225 million.¹The rehabilitation of hospitals in the province depends partly on funding from the local population.²While provincial funds make up a significant portion of the renovation costs, it is the local residents and seasonal residents who are funding the hospital’s renovation, and we have every say in the matter.³

The municipal funding commitments in Muskoka were presented to MAHC before the currently proposed Made in Muskoka model was known. It is reasonable for the public, and by extension our municipal representatives, to demand that local funding commitments be subject to appropriate public accountability. The urgency and need for this accountability arises from MAHC’s failure and refusal to apply any notion of respectful and fair treatment in its dealings with the public. For example, the sudden agenda change and the Board’s decision to move forward with the current model on July 2, 2024 surprised many. This has clearly demonstrated that the hallmarks of fair dealing, such as advance notice, are absent and of little concern to MAHC.

SSMHC notes recent discussions of the MAHC model at the council table: a discussion will be held in the District of Muskoka on Monday, July 15, 2024, and the Town of Bracebridge addressed this issue at its July 3, 2024 Planning Committee meeting.

City Council meeting on July 10, 2024.⁴ The SSMHC advocates the following conditions as essential for the expansion of local equity funds:

• The Made in Muskoka health system will be supported by two new, state-of-the-art acute care hospitals serving the entire region and communities surrounding the district such as Almaguin and East Parry Sound;

• that the concerns of health professionals are adequately addressed through two separate consensus resolutions of physicians who are accredited and predominantly practice at either the Bracebridge or Huntsville sites, with each site having a separate vote;⁵And

• That there is a fair distribution of intensive care beds between the Huntsville and Bracebridge sites in relation to the local population in the catchment area of each hospital site

The number of beds is important

SSMHC maintains that the number of acute care beds at each hospital site matters. Acute care beds ensure the long-term sustainability of hospital sites. Across Ontario, smaller hospitals struggle to survive in the regional model. SSHMC advocates for a hospital site in Bracebridge that is viable in the long term and includes sufficient acute care services to attract and retain specialists and surgeons to the Bracebridge site. Without this, the Bracebridge site could fail without primary care, emergency care, or robust specialty support. SSMHC does not support the assumptions suggested by MAHC that physician recruitment or retention is not affected by bed count.

SSMHC is aware that MAHC received support from the City of Huntsville General Committee on June 26, 2024. While SSMHC is disappointed with this outcome, we know that many citizens in Huntsville and surrounding areas are concerned about the impact of the Made in Muskoka model on health care. The reality is that the discussion in North Muskoka is different than the discussion in South Muskoka because the current model does not present the same challenges in every part of the region. However, SSMHC believes that a comprehensive Muskoka solution that works for all communities and is supported by the public and local health professionals is the way forward. SSMHC has advocated: “Keep

Disappointment with Huntsville City Council support

“The Promise” is a central slogan that refers to previous commitments by the cities of Huntsville, Bracebridge and others for two acute care hospital sites in Muskoka.⁶

MAHC’s responsibility to share information for detailed input

SSMHC has also recently been criticized by MAHC representatives about the poor quality of the feedback it has received. In particular, the feedback on the model was criticized for not being sufficiently fact-based.

MAHC does not have the right to be so critical of the public’s feedback and comments. MAHC alone has the responsibility to provide quality, local health care to the community through the redevelopment model. If MAHC requests detailed feedback, SSMHC again requests MAHC to voluntarily share information on the metrics, assumptions and details that support its modeling for the Made in Muskoka approach. SSMHC also requests MAHC to provide its study of the physicians’ Care Closer to Home model so that SSMHC can understand the alleged $700 million increase associated with this model.

SSMHC has produced several insightful and impactful reports on its position on the content of health care in Muskoka. We would welcome feedback from MAHC on these statements, which have not yet been provided. SSHMC will continue to engage with the content of the recovery plans because we must. We have a hospital board that seems more annoyed by the prospect of public feedback than interested in fostering an actual culture of engagement. The public can see that clearly. This is not a successful model.

MAHC cannot ignore public accountability. Kudos to our elected community representatives and officials in the Town of Bracebridge and District of Muskoka for ensuring appropriate public accountability in this process now and in the future. SSMHC will continue to provide reliable, factual information and grassroots support on this important issue.

¹The breakdown of local contributions from October 2023 can be found in the appendix below. ²Ontario Health. Hospital Capital Planning and Policy Manual. https://www.ontariohealth.ca/sites/ontariohealth/files/2022-12/HospitalCapitalPlanningAndPolicyManual-EN.pdf ³The SSMHC has over 4,000 signatures on a petition calling on the District of Muskoka to withhold funding for the local share until District Application 158/2015 (September 21, 2015), which calls for two acute care hospital sites in Muskoka to be fully supported by the Redevelopment Plan.

⁴In this context, the SSMHC has sent delegations to the following municipal councils: Bracebridge (July 10, 2024), Muskoka Lakes (June 12, 2024), Gravenhurst (June 18, 2024), District of Muskoka (May 23, 2024) ⁵That is, a physician who practices more than 60% of his or her time at a particular MAHC hospital location.