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Bracebridge Council expressed community concerns to Muskoka Algonquin Healthcare (MAHC) in a special meeting on July 24, 2024.

MAHC Board Chair, Dave Uffelman, started the meeting by saying, “We are here to assure you the plan we have for the future of the healthcare system is the absolute best plan.”

He indicated that the focus is service delivery, which impacts the quality of care to patients.

He summarized some of the impacts to Bracebridge as follows:

• Provide 9700 surgeries per year (compared to 800 in Huntsville)
• Have 90,000 diagnostic visits annually (compared to 29,000 in Huntsville)
• Have 27 emergency room beds (versus 11 currently)
• Bracebridge will grow to 140,000 patient visits annually (from 60,000)
• The new building will be 30% to 40% bigger than the existing one, and “provide over 90% of all scheduled surgeries in the region, and two thirds of all diagnostic imaging visits will be to Bracebridge.”

Uffelman added, “Bracebridge emergency department will grow by 150% and annual visits to this hospital will grow by a factor of 135%, versus less than 20% growth in Huntsville.”

He continued that changes in Huntsville will focus on improved quality of long-term care patients, which will include those that transfer from Bracebridge for rehabilitation and reactivation services, with the goal to return them home once they are stable.

Both Bracebridge and Huntsville will also have expanded emergency departments and improved mental health facilities, however, they each will have specialized staff and facilities, explained Uffelman. He added, “Duplication of facilities would be too expensive, and we could not staff two programs of specialized care.”

Council concerns included more level 3 ICUs and acute rehabilitation care in Huntsville, alternative long-term care (ALC), and the lack of care to physicians concerns about areas such as patient transportation, doctor retention and recruitment and the long-term sustainability of the Bracebridge site.

Regarding the ICUs, Uffelman advised they support critical care “closer to home.” He added, “By allocating 10 (level 3 ICUs], we can gain funding for valuable supports to improve quality.”

According to MAHC, ALC will begin with rehabilitation and reactivation, and the goal is that this area will also be supported by community homecare programs.

MAHC is currently investigating options for transportation. The potential for visitor accommodations, such as what municipalities like Barrie have, such as the Ronald McDonald house or Rotary facilities came up in the discussion.

Uffelman addressed the concerns about physician retention by saying, “Clinician attraction will be more successful with focused specialized services, rather than two rural cottage hospitals that compete for the same staff.”

MAHC advised that the current redevelopment model will include flexibility for future needs and adaptability to changes, such as having the ability to redesign spaces and the capacity for expansion, and will be data driven, and their consultants have been given permission to continue to work on getting the submission ready for this November.

Councillor, Tatiana Sutherland, expressed concern about the use of data only, rather than feedback from doctors. She said, “There has to be some consideration of the human component of how a hospital functions… We’d all like to sign off on this if our physicians feel that it’s going to work.”

MAHC President and CEO, Cheryl Harrison, advised that it’s essential to start the process with consistent data, which is also what other hospitals across the province use.

Councillor, Don Smith, expressed concern about the sustainability of the hospital, using Niagara as an example, where one larger hospital was built and the smaller one was no longer sustainable, in comparison to more beds and level 3 ICUs in Huntsville making Bracebridge less viable.

Harrison indicated that the ICUs are there because of the stroke program which requires this type of care, and patients may not be strong enough to travel to Huntsville from Bracebridge if they weren’t stable.

Council members also discussed the issue of increased child births of Bracebridge residents being handled in Orillia because of lack of beds, and the potential risk it puts on the hospital regarding sustainability as well.

Councillor, Barry Hammond, expressed concern about the lack of interest in the feedback from over 40 doctors from South Muskoka. Regarding the redevelopment proposal, he asked, “Will you still present that if you still have a list of 30 or 40 doctors not liking the proposal?”

Uffelman responded, “I’d say, likely. Yes.” He added, “To give it perspective, there are somewhere in high 30s physicians who are credentialled who have signed the letter. That’s out of over 200 credentialled staff that’s under MAHC.”

Mayor, Rick Maloney, said, “To put it in the perspective that those 40 signatures are insignificant to the grand scheme of ‘200 credentialed staff’ is a bit tone deaf to the concern.” He added, “They are not some rogue group… Their concern is as valid as the other 160, wherever they come from.”

Maloney also challenged MAHC about why their ALC approach isn’t aligned with that of other hospitals with the goal of zero beds. He inquired about why they are proposing 37 ALC beds if their goal is to push homecare supports.

VP of Integrated Care, Diane George, advised that ALC is high, at 30%, and their goal is to reduce it by half. She added, “It’s an unrealistic target to be at zero,” and referred to the zero approach as “pie in the sky.”

Maloney said, “It’s ‘pie in the sky’ if you don’t put it as a priority, and start by having discussions about it, then it’s realistic.”

Sutherland inquired about whether MAHC can submit the development model without the District’s local share.

MAHC said they could, as long as they have a plan. They added that they would be willing to “tweak” District concerns, however, “if it’s dramatic, that’s different.”

Maloney advised that he’ll continue working with the doctors and MAHC for solutions and “full support.”

He added, “Our community is not a cookie cutter. It’s not GTA… We have a lot of challenges, not just with hospitals but service delivery in general because geographic issues, economics, cultural - regarding differences between Towns… At the end of the day, we can lose the focus of what’s being offered to us, which is a billion-dollar investment in healthcare in our communities.”

He told MAHC, “Whatever efforts you put in now to solve those issues is going to reap ten-fold for the next number of generations.”

Uffelman said, “We think we’ve got a great model… We really think we’ve got something good here but at the same time we’re open to feedback on how we can make it even better.”