Scarborough health care divide deepens after Birchmount cuts approved
A long-standing divide over hospital care in Scarborough just got worse.
On Jan. 24, Scarborough Health Network’s (SHN) board voted to cut Women’s and Children’s services at its Birchmount campus in Agincourt.
The decision was opposed by thousands of residents, and by hundreds of doctors, nurses and other staff.
SHN, which assumed its new name last November, has two other, larger campuses south of Highway 401: the General – which merged with the former Scarborough Grace Hospital in 1999 – and the Centenary, which joined through merger in 2016.
People at Birchmount, everyone seems to agree, are suspicious about their place in the larger hospital, particularly after what were seen in 2006 and 2013 as attempts to cut services at their campus.
CEO Elizabeth Buller acknowledges this “history of not having trust,” and that reviewing Women’s and Children’s services ahead of all other programs was “unfortunate” timing.
Hospital officials, however, say they dealt with the program – deciding to handle births and base pediatricians only at the General and Centenary – out of a “sense of urgency” and to address years of concerns over deliveries at Birchmount.
They have since released a 241-page report whose conclusions the community is unlikely to accept.
Jim Karygiannis, local councillor, is telling constituents the plan means the Birchmount Emergency Department will close, and he’ll try saving the hospital with a grassroots protest campaign.
Aris Babikian, Scarborough-Agincourt’s MPP, calls the process leading to the decision “a sham,” like something in “a totalitarian country.”
The board was set to examine the report privately until Chairperson Maureen Adamson put it on the public agenda two hours before the meeting, to counter, she said, “misinformation swirling around the community.”
“It’s important to debunk the myth that the Emergency Department is closing,” she added last Thursday.
When Babikian, who wanted to delay a decision, demanded to speak, Adamson refused.
“They claim to have done consultations with 300 people. What about the 10,000 people whose voice was denied today?” the Conservative MPP, referring to constituents who sent him emails and signed petitions opposing the cuts, said afterwards.
SHN’s medical administrators, however, defended their research into the Birchmount and its conclusions.
“The outcomes were not safe enough, the quality was not sufficient, the numbers (of births) weren’t sustainable, and we have multiple reports which said that,” said Chief of Staff Dr. Dick Zoutman.
“Our motivation was out of concern for quality and safety. This had nothing to do with money.”
Birchmount also has problems recruiting and keeping staff, and a falling “market share” for births – actually, that’s true of all three campuses, but the report says only a quarter of mothers in Birchmount’s catchment area choose to deliver there.
Zoutman said incidents involving patient safety are more common, calculated over a decade (22 births out of 100,000) at Birchmount, than at General (zero) or Centenary (four).
The decision means plans will be worked out over six to 12 months to transfer Women’s and Children’s patients to other campuses, or send pediatricians and other specialists to Birchmount when required.
Dr. Dov Soberman, Medical Staff Association vice chairperson, said the community wants care comparable to other Greater Toronto “peer hospitals,” all of which have pediatrics and obstetrics on site.
Speaking of safety concerns begs the question of “why can’t we provide quality at the Birchmount,” he said.
On Tuesday, Dr. Haidar Mahmoud, a former Obstetrics chief at Birchmount, said he joined the Grace in 1997 during the program’s “golden era,” when the campus handled at least 3,400 deliveries a year and drew patients from as far away as Mississauga.
The program was “a beacon” because the hospital provided strong support, which has since been chipped away, he said.
Scarborough-Agincourt MP Jean Yip, meanwhile, said the cuts “will leave a vacuum” in North Scarborough, and wondered why SHN can’t provide staff at Birchmount with more training and support instead.
May Ye Lee, founder of the Chinese Outreach Committee, which raised funds for the hospital, said her group is outraged by “a cruel manoeuvre to deny women and children the right to safe local health care.”
Reviews of other SHN programs launch in February.
Buller said the public can see options for future SHN facilities, including a possible new hospital campus, on Feb. 19.
Asked to comment on Birchmount, Mitzie Hunter, Scarborough-Guildwood’s Liberal MPP, said change is difficult, but Ontario’s former Liberal government “identified funding for Scarborough to get a new hospital, as part of long-term planning.”
“The expectation is improved health care for the people of Scarborough,” she said.
Scarborough Southwest MPP Doly Begum, a New Democrat, said both Liberals and Conservatives neglected care for Scarborough families. Changes to pediatrics and obstetrics, she added, “must prioritize quality of care, and not make it harder for women and families to access these vital services.”