A week after Haliburton Highlands Health Services announced the Minden emergency department would permanently close on June 1, members of the Minden community were at Queen’s Park in Toronto to deliver a petition to the Ontario government demanding a moratorium of the decision, while officials from Haliburton Highlands Health Services appeared before both the Township of Minden Hills and Haliburton County councils to explain the rationale behind the decision.
On Thursday (April 27), Minden residents Patrick Porzuczek, Laura Porzuczek, and Richard Bradley led a group that travelled to Queen’s Park with a petition — signed by 3,359 Minden-area residents — asking the Ministry of Health and Long Term Care to place a moratorium on the Haliburton Highlands Health Services decision “for a minimum of one year to allow for consultations with all affected stakeholders to occur.”
NDP health critic France Gélinas (MPP Nickle Belt) brought the petition before the Legislature on Thursday afternoon and asked Ontario’s minister of health and long-term care Sylvia Jones during question period whether she would support the moratorium request.
“I know that the member opposite knows very well that hospitals are responsible for their day-to-day operations and make those decisions independent of the ministry of health and government,” Jones replied. “We have been assured that the Haliburton Highlands Health Science [sic] board and leadership have made this decision carefully, thoughtfully, understanding and appreciating the needs of their community and their staff, and I will let them do that work.”
Much of the criticism from the Minden community about the decision to close the emergency department revolves around a lack of communication and consultation with the community about the closure and the timing of the closure at the beginning of summer.
“Members of Minden’s community are determined to exhaust all possible options to reverse this hasty and poorly considered decision,” reads a media release issued by the Ontario NDP on Thursday. “There were a staggering 13,000 visits to the (Minden) emergency department in 2022, with the number trending upwards. The town’s population triples during summer due to seasonal residents and tourists. It’s incomprehensible that such a significant decision was made without consulting any stakeholders. This community will not rest until their voices are heard.”
VIDEO: Question Period – April 27, 2023 – Minden emergency department closure
Last Thursday (April 20), Haliburton Highlands Health Services announced the Minden emergency department would be closed effective Friday, June 1st, with all staff to be transferred to the emergency department in Haliburton, shocking Minden-area politicians and residents.
Haliburton Highlands Health Services currently operates two emergency departments that are open 24/7, one at 4575 Deep Bay Road in Minden and the other at 7199 Gelert Road in Haliburton, both with on-site heliports. Unlike the Haliburton location, which has 15 in-patient beds, the Minden location does not offer in-patient acute care services.
Most Minden patients requiring hospitalization are transferred to Haliburton or to hospitals in Lindsay or Bracebridge. With the closure of the Minden emergency department, local residents would need to travel 25 kilometres northeast to Haliburton — a 25-minute drive — for emergency medical services.
According to a statement from Haliburton Highlands Health Services president and CEO Carolyn Plummer and board chair David O’Brien, the decision to close the Minden emergency department was made in response to an ongoing shortage of nursing and medical staff.
Both Plummer and O’Brien attended a meeting of the Township of Minden Hills council on Thursday afternoon to give a presentation about the decision and to answer questions from Minden Hills mayor Bob Carter on behalf of members of the community.
“Let me state the reason why this decision was made, and it was made because of the ongoing staffing shortages,” O’Brien said. “It’s taken an extraordinary amount of effort over the last 18 months to keep the team together, to keep it focused, to keep it delivering the services we need. Our staff have made incredible personal and professional sacrifices in order to make that happen.”
“It got to the point that we can’t continue to do that. We’re going to lose people, more than we already lost. We’re going to lose our hospital if we continue to do this — I’m not talking about closing Minden emergency, I’m talking about the broader Haliburton (Haliburton Highlands Health Services) hospital.”
“That was the focus of making this decision,” O’Brien said. “The staff that we have are under extreme pressure. They came to us and said ‘Look, you’ve got to do something because we can’t keep going on like this. The system’s going to fail if we let it go on.’ So that’s kind of the crux of why the decision was made. There are a lot of other things that go into it, but that’s the real important part of the decision.”
For her part, Plummer said she has “spoken about our staffing crisis in every public board meeting for the past couple of years and I have spoken about it with the mayors when we’ve met with them,” adding that there were more than “20 official close calls” in 2022 and “many other close calls that were not made official” where either one or both of the Haliburton and Minden emergency departments would have to close temporarily.
Plummer said the decision to consolidate emergency services at the Haliburton location was made because, unlike the Minden location, Haliburton already has in-patient acute care beds.
“We considered feedback received from the paramedic services, who highlighted the fact that the Haliburton site is more centralized in the county for ambulance travel times,” Plummer said. “We also looked at the fact that maintaining hospital services close to the Haliburton family medical centre has many benefits, primarily facilitating easy access to primary care physicians to see patients in both the emergency department and the in-patient unit.”
In their presentation, neither Plummer nor O’Brien addressed the criticisms levelled against Haliburton Highlands Health Services for the lack of communication and community consultation prior to announcing the decision or for the timing of the closure.
After the presentation, Carter raised the concern about a lack of communication, noting that previous discussions with Haliburton Highlands Health Services were only about staffing issues and the possibility of temporary closures of one or both emergency departments.
“At no point was there a discussion that one of these facilities would have to close permanently,” Carter said, adding he confirmed this by speaking with the other three mayors and four deputy mayors in the county. “Now in your mind that was perhaps the inevitability of what you were talking about, but there was no clear communication about that … This came as a complete shock to all of us.”
Carter then asked Plummer and O’Brien a question on behalf of the community about the key issues that led to the decision to permanently close the Minden emergency department.
Plummer reiterated that the primary reason is the lack of staff resources to maintain two emergency departments and the pressures on existing staff.
“I can tell you that, heading into this summer, we would be otherwise facing multiple short-term, short-notice, unexpected closures of one if not both of our emergency departments at various unpredictable times, and it would be impossible to communicate properly to all the stakeholders and community members about those closures in sufficient time for them to know where to go in the event of an emergency,” Plummer said.
“We wanted to make sure that we could maintain emergency services in this county, and so we made the decision to consolidate them at a single site where we can bring our staff together to provide a more effective staffing coverage model to meet all the health care emergency needs of the county as a whole.”
Carter then asked why only six weeks’ notice was given of the closure, especially given the lack of prior communication to stakeholders and the upcoming summer season.
“It really was an operational decision that had to be made,” Plummer replied. “We had grave concerns as I said about the multiple, temporary, unpredictable closures that would have happened otherwise, and the significant risk that would place on the community in unpredictable ways as we would not be able to properly communication sufficiently ahead of those closures — some of those closures could happen with only two hours’ notice.”
“That’s how close we’ve come, and that was going to be a reality for this summer,” Plummer added. “We were able to make it through last summer, but just barely, and it was not going to be feasible for us to do that this summer.”
“This was a very, very difficult decision, and we know it’s been particularly difficult for the Minden community, but it was one we had to make in order to make sure that we still have (emergency) health services across the county as a whole and into the summer time.”
In response to another question from Carter, Plummer and O’Brien said the decision was made by the Haliburton Highlands Health Services board, supported by the hospital’s executive leadership team. The decision was communicated to the Ontario Ministry of Health and Long-Term Care, which was already aware of the staffing issues facing Haliburton Highlands Health Services.
After noting the “outpouring of concern from our community,” Carter asked if the June 1st date to close the Minden emergency department could “be pushed back to some reasonable time — November 1st, or later — so we could have a reasonable discussion, including all the stakeholders, and we can properly plan the implementation.”
“This would get us through the busy summer period and allow a transparent public process,” Carter added. “The question is, are you willing to agree, consider, or commit to pushing back this date?”
Plummer did not directly answer the question, but repeated that the decision was an operational one, to avoid “multiple temporary but short-notice closures (of) one or likely both emergency departments, all summer long,” and that it would be extremely difficult to properly notify the community of the closures, resulting in “much confusion, and that would have been unsafe for the community as a whole.”
Carter asked what would happen, with the Minden emergency department closed, if the Haliburton emergency department has to temporarily close.
“This gives us the opportunity to shift all of our resources into one location, to help reduce the risk of that kind of closure happening,” Plummer replied. “The risk is always there, but this reduces that risk.”
Carter pointed out the decision to close the Minden emergency department in six weeks would have an unplanned impact on other emergency services in Minden, including paramedics and volunteer firefighters, who would be responding to medical calls, with an impact on cost — especially at the busiest time of year during the summer.
Deputy mayor Lisa Schell asked Plummer to confirm which location almost closed 20 times due to staffing issues, adding “keep in mind I know the answer. I would just like to hear your honest answer to everybody in this community, because most of us know what it is.”
“Those were all related to physician shortages at our Haliburton site,” Plummer replied. “Our Minden site is also now facing physician shortages. Both sites are facing physician shortages. What isn’t included in that 20-plus official notifications is the countless times that we’ve had nursing sick calls … it could be Haliburton, it could be Minden, it could be both. Depending on the situation, both emergency departments could be closed. We have faced that near possibility many, many times in the last 18 months — far more than 20. It happens probably weekly, maybe more often than that, but it happens regularly with our nursing sick calls and shortages of nursing staff.”
Schell then asked Plummer to name the stakeholders that Haliburton Highlands Health Services consulted with about the decision to close the Minden emergency department.
Plummer replied that the operational decision was made by the board, supported by the executive leadership team, “but informed by conversations with staff.” She added that the board has done “reach-outs with regard to our strategic plan” that involved anonymous surveys, interviews, and focus groups. (On Friday, in an interview on CBC Radio’s Ontario Morning, when host Ramraajh Sharvendiran asked if Haliburton Highlands Health Services consulted about a permanent closure, Plummer said “We did not ask about that specific question.”)
Later on Thursday afternoon, Plummer and O’Brien attended a special meeting of Haliburton County council to explain the rationale for the decision to close the Minden emergency department. While that meeting was closed to the public, council issued a statement the following day.
“Council remains extremely concerned and dissatisfied in their decision and the timing associated with the closure,” the statement reads. “We also continue to be disappointed in the absence of communication between county council, the community and (Haliburton Highlands Health Services) over the last number of months while this step was being considered.”
“We will continue to advocate on behalf of our residents to ensure that (Haliburton Highlands Health Services) responds to questions about reorganization and ongoing service delivery in the county, including identifying and attracting services to work out of the Minden site. To that end council will be requesting that (Haliburton Highlands Health Services) present their implementation plan to combine emergency services at a special meeting in May.”
While Haliburton-Kawartha Lakes-Brock MPP Laurie Scott has not issued an official statement about the decision to close the Minden emergency department, Haliburton-Kawartha Lakes-Brock MP Jamie Schmale addressed the issue in Parliament on Thursday evening during a debate on the second reading of Bill C-47, the Budget Implementation Act.
“Let me be clear, the decision made by the Haliburton Highlands Health Services Board of Directors is something I oppose,” Schmale wrote on Facebook. “We have been told that this decision, which I have no doubt was very difficult to make, was not based on financial considerations but was solely due to inadequate staffing levels.”
“As someone who grew up in Bobcaygeon and has used the Minden ER more than once, I join with residents and echo concern for their community hospital. While the decision was a local one, I recognize that the federal government has a role to play in facilitating the immigration of qualified nurses and doctors to address labour shortages not just in Minden but throughout the country.”
Posted by Jamie Schmale, MP on Thursday, April 27, 2023
A Facebook group called Save Minden Ontario Emergency Room now has over 3,900 members. A online petition called Help Save the Minden Hills Emergency Department has far received more than 5,800 signatures.
Minden resident and former Minden firefighter Patrick Porzuczek, who was at Queen’s Park on Thursday and also established the Facebook group and online petition, has also created a GoFundMe campaign that has raised over $4,600 to help fund community efforts to stop the closure.
Minden residents have also set up a new website called Minden Matters at mindenmatters.com.
