Mental health beds moving from Ajax hospital
Thu Mar 27, 2008
By: By Kristen Calis
DURHAM -- Mental health patients have become victims of the Rouge Valley Hospital System's deficit elimination plan, says the co-chairman of the Friends of Ajax-Pickering hospital. "Again, everything moves to Centenary," Bill Parish said. The RVHS Board of Directors approved the Deficit Elimination Plan and Hospital Services Accountability Agreement yesterday. A December, three-member, peer review report criticizing financial mismanagement in RVHS prompted changes to both of RVHS's Ajax and Scarborough sites, especially with RVHS's $78-million in long-term debt and capital deficiency. Letters were circulated last month warning staff of upcoming cutbacks. RVHS plans to cut up to 220 jobs over the next three years - 60 from the Ajax site - to help get it back on financial track. RVHS president and chief executive officer Rik Ganderton said the ball has to get rolling right away.â?¨ "We need to do it quickly," Mr. Ganderton said. "We can't afford to do this by death by 1,000 cuts." Board chairman Tom Atkins said during the past eight years, RVHS has accumulated huge deficits by spending more than it receives. "On top of this, our projections show that if we did nothing we would run up further huge operating losses, which we simply do not have the cash to support," he said in a press release. If nothing was done, projections in the report showed the hospital system would run up a net deficit of $21 million in fiscal year 2010/2011. RVHS will have a $6.5-million deficit for 2007/2008, but officials believe the changes will lead to a balanced budget by the fourth quarter of 2008/2009. Mr. Ganderton acknowledged hospitals that run efficiently receive more government dollars. He said running the hospital more efficiently will include increasing the average occupancy of beds in service and discharging patients earlier who are ready to go home. "The reason we're able to cut jobs is because we're cutting beds," Mr. Ganderton said. Twenty mental health beds will be transferred from RVAP to Centenary hospital in Scarborough to have one consolidated mental health in-patient unit, something Mr. Parish sees as a disservice to Durham residents. But out-patient mental health staffing will be increased at RVAP and mental health crisis coverage will now be 16 hours per day at the east site as opposed to the previous 12. Mr. Ganderton explained Centenary was chosen simply because "we don't have further bed capacity to consolidate it at the Ajax site." Dr. Steve Fishman, RVHS chief of psychiatry, supports the plan, saying it will enhance the quality of care for the mental health patients while improving access for outpatient mental health services. "There will be some inconveniences for families who have to travel to visit in-patients, but since fewer and fewer mental health patients tend to be hospitalized this impact should be minimal," he said in a press release. The hospital hopes to save about $25 million over the next three years, with the majority of positions cut through early retirement and voluntary exit incentives, elimination of vacant positions, redeployment to vacant positions and retraining, explains Mr. Ganderton. "My hope is virtually nobody will be leaving us involuntarily," he said. He explained RVHS plans to eliminate 72 full-time and part-time nursing positions over the next three years and, as of Feb. 28, 150 nurses were eligible for early retirement. In total, 13 non-union management positions, 12 non-union staff positions and 195 union positions will be cut. In total, RVHS will eliminate 36 beds over the next three years. In Ajax specifically, two will be removed from the women's and child program, one from surgery and 20 from mental health. However, eight medicine beds will be added to RVAP, so that means the total loss at RVAP is 15. The Emergency Room will remain open at all times at both hospitals, and obstetrics and pediatrics will continue at both. Mr. Parish criticized the lack of consultation with the community on the process, saying public town hall meetings should have been held in Ajax, Pickering and Whitby. He also criticized the timing of the town hall staff meetings. "Having town hall meetings (for staff) after the decision is made is not enough," he said. David Brazeau, RVHS director of public affairs and community relations, explained Mr. Ganderton has been vocal about the hospital's situation for the past year. "Our staff actually are not surprised by what was announced today," he said. Mr. Ganderton explained the town hall meeting with staff is only being held after the decision on the plan is made because "a decision has to be made before you announce it." As for a town hall meeting for the general public, Mr. Ganderton said, "we're looking into that right now." The plan still has to go to the Central East Local Health Integration Network Board of Directors this Friday for its final approval.