Hospital Professionals Division
 

News Release Backgrounder

July 10, 2008

The Ontario Public Service Employees Union (OPSEU) has applied for a judicial review of a decision of the Central East Local Health Integration Network (CE-LHIN) approving the closure of the 20-bed in-patient adult acute mental health unit at Ajax Pickering Hospital and its replacement with five locked psychiatric intensive care beds and a new 15 bed medical/psychiatric unit to be located a the Scarborough Centenary Hospital. In addition, the hospital has cancelled nine new acute care mental health beds under construction at the Ajax site.

Both hospitals make up the Rouge Valley Health System.

OPSEU is arguing the LHINs have an obligation to consult with the community before making changes to the delivery of health services within the region.

The Central East LHIN has made public promises about community engagement, including statements that “people who are impacted by a decision or course of action, have the rightful opportunity to shape and form the decision before it takes place.”

The decision also conflicts with the Central East LHINs own Integrated Health Service Plan (IHSP) for the region, which includes increasing access to mental health services.

The change to the delivery of mental health services at RVHS is one that engages every aspect of the LHIN’s statutory mandate. It is a health service integration that alters the services available in the LHIN and the accessibility of those services.

The Local Health Integration Networks were created in 2006 to plan, fund and integrate the local health system. The LHIN Boards are appointed by the provincial government and are accountable only to the Minister of Health.

Timeline

December 6 - Peer review reports on recommendations to address RVHS deficit and debt. RVHS is $78 million in debt, $38 million from accumulated deficits. Its deficit for 2006/07 was $2.5 million, about one per cent of the hospital’s operating budget. There are no recommendations around specific cuts to mental health services. In fact, the Peer Review recommends that the board, senior leadership and medical staff redefine the strategic direction for RVHS with other key stakeholders. The process will need to define the core primary and secondary services to be provided at each site as well as the resources to support these services.

January 15 - RVHS presents its deficit reduction plan to the CE-LHIN and representatives of the Ministry of Health and Long Term Care. There is no mention of a new medical/psychiatric unit.

February 22 and March 14 - the LHIN improperly meets in camera with Rouge Valley to discuss its deficit reduction plan, including changes to mental health services. Committees of the LHIN must meet in public, especially with regards to changes in health service delivery.

March 20 - RVHS CEO Rik Ganderton replies to the Friends of the Ajax-Pickering Hospital, who write to express concerns about the potential of the hospital to cut mental health beds. Ganderton refuses to divulge their plans, but writes “there are always inaccurate and unfounded rumours and speculation.” Five days later the Friends found the rumors to be true.

March 25 - RVHS approves a deficit reduction plan that includes cuts to beds at both hospitals.

Ajax-Pickering will lose 20 mental health beds plus a surgery bed, and a maternity bed. Nine new mental health beds under construction will instead become eight general medicine beds.

Scarborough Centenary Hospital will lose three general medicine beds, a pediatric bed, a maternity bed, 10 surgery beds, 12 cardiology beds, and 14 complex continuing care and rehab beds. They will get 15 new medical/psychiatric beds, anticipated largely for geriatric patients who have a medical condition and suffer from dementia. In addition, it will get a new 5 bed psychiatric intensive care unit. This is in addition to 40 acute care mental health beds that already exist at the hospital.

March 28 - The LHIN Board approves the RVHS deficit reduction plan, including the cuts to mental health beds in Ajax. It does so without any opportunity for public input. The deficit reduction plan is part of RVHS’s Accountability Agreement with the LHIN. The LHIN review Accountability Agreements of 10 hospitals in about an hour of the meeting. The LHIN had originally blocked 30 minutes to review all of the Hospital Accountability Agreements.

After the decision is made, the LHIN agrees to a 30 day public consultation on the implementation of the plan, not on the decision itself.

April 10 - About a thousand residents crowd into the Ajax Community Centre to express their outrage at the decision and their exclusion from the process.