The planned closure of the emergency department in Minden, Ont., is a matter of maintaining existing health services in Haliburton County, officials told Minden Hills Township council on Thursday.
Haliburton Highlands Health Services board chair David O’Brien and president/CEO Carolyn Plummer spoke at council, outlining the board’s “difficult” decision to close the ER in Minden effective June 1. All services and staff will be consolidated at the hospital in Haliburton, 30 kilometres northeast.
READ MORE: Ontario health minister defends HHHS board’s decision to close Minden ER
Both officials reiterated previous statements that the health board’s decision was primarily based on ongoing “severe” staffing shortages over the past few years. They say the shortages have placed existing staff under immense pressure to serve all of Haliburton County.
“It’s not a decision the board wanted to make,” said O’Brien. “But it’s one we had to make to allow for health-care services to be provided county-wide on an ongoing basis.”
Plummer and O’Brien said staff shortages began before the COVID-19 pandemic, which only “exacerbated” staffing at both hospital sites.
“The pool from which we normally recruit has shrunk — it has basically shrunk to zero,” Plummer said. “And we are in competition with organizations all across the province, across the county and around the world for very scarce resources.”
Plummer said HHHS had reached a point where it was “no longer feasible” or “sustainable” to continue to “fight” to keep both ER rooms open and bring in resources to maintain both.
“The pressure on our staff is absolutely tremendous — it’s not something that was sustainable,” she said.
Plummer noted that in 2022 there were over 20 official “close calls” where the Ministry of Health was notified of a possible temporary closure of an ER and “countless” unofficial incidents, most involving nursing sick calls.
When pressed by deputy mayor Lisa Schell on the data, Plummer said the 20-plus official incidents were all due to physician shortages at the Haliburton hospital.
“Our Minden site is now also facing physician shortages. Both sites are facing physician shortages,” noted Plummer.
Delay closure
Mayor Bob Carter said council and residents want the health board to delay the closure until at least November since June will see an influx of thousands of cottagers and tourists throughout Haliburton County. It’s estimated the area population of 7,000 triples during the summer months.
Plummer says while the timing of the ER closure is “not ideal,” she said the health-care system as a whole can’t sustain another summer of near closures of both ERs and the subsequent challenges and risks of having to notify the public on short notice.
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“It really was an operational decision that had to be made,” she said.
“We have grave concerns about the multiple, temporary, unpredictable closures that would have happened otherwise and the significant risk that would take place on the community in unpredictable ways as we would not be able to properly communicate efficiently ahead of those closures — some of those closures could happen with only two hours’ notice, that’s how close we’ve come.
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“And that was going to be a reality for this summer — we were able to make it through last summer but just barely. It was not going to be feasible for us to do that this summer.”
She said the decision to close on June 1 was made to “ensure we can do everything in our power to continue to provide emergency services in this county this summer and beyond.”
“So I take that it’s a ‘no,'” Carter responded.
Carter was also critical of what he says was a lack of consultation with Haliburton County townships prior to the announcement of the closure last week. O’Brien and Plummer say the board made the decision with support from the hospital’s executive team and in talks (formally and informally) with a number of stakeholders, such as paramedics. They noted regular discussions with townships highlighted the ongoing staff shortages.
“It was a difficult decision, but an operational decision that had to be made with the pressures that we had,” said Plummer. “Given the sensitive nature of this type of decision, we needed to make sure that our board of directors was clear on what the path forward would be before we started talking more openly with our staff and others. Because we didn’t want to create more uncertainly and would only add to the tremendous pressures that our staff are already facing. There’s been moments of uncertainty over the past 18 months.”
Queen's Park petition
At Queen’s Park on Thursday, a petition of more than 3,359 signatures seeking a one-year moratorium on the closure of the Minden ER was presented by Minden residents Patrick Porzucek and Richard Bradley.
NDP MPP France Gélinas (Nickle Belt) submitted the petition during question period and asked Ontario Health Minister Sylvia Jones to grant the residents’ request on what she called a “hasty and poorly considered decision.”
“The situation in Minden has escalated to a boiling point,” said Gélinas. “Residents, including their mayor, are incensed at the impending closure of Minden’s local emergency and inpatient services. The looming threat of emergency care being pushed further away has brought fears of insurmountable obstacles in accessing vital medical services. The challenge of recruiting health-care professionals to serve rural communities is already daunting.”
As she said Wednesday during question period, Jones said hospitals are responsible for their day-to-day operations and make the decisions “independent” of the ministry and government.
“We’ve been assured that the HHHS board and leadership have this decision carefully, thoughtfully and understanding and appreciating the needs of their community and their staff,” she said. “And I will let them do that work.”
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