Health care system is not broken, but there is waste – Paul Collins

city_scope_logo-cmykIn a lengthy interview on Paul Collins‘ penultimate day as president and CEO at St. Thomas Elgin General Hospital, he dwelt on the Great

Expansion, the facility’s designation as a regional stroke centre and a greater role for STEGH as a regional player.

We’ll pick up this week with the suggestion the health care model in this province is broken.

“I don’t think the system is broken,” asserted Collins. “But I think there are some elements of the system we need to be paying attention to. How does the aging population affect this hospital. We talk about alternate levels of care. These are folks who come to the hospital because they need care, but then when it’s time to be discharged, the question where is the safest place for them to be discharged to – long-term care, in their own home or a nursing home?

“Those are all things that have to be organized and, of course, there’s a limit in that kind of resource so what happens is those folks end up staying in the acute care hospital. Which is not ideal for them because it’s not the best place to get long-term care. For the people in the community who are needing those beds for acute care, you suddenly have an occupancy problem.”


While construction crews work outside on the expansion of St. Thomas Elgin General Hospital, outgoing president and CEO Paul Collins spent his last week bidding farewell to managers and staff ahead of his final day at the helm Oct. 28.

For Collins, it’s a case of how do we ensure the care is available for these individuals out in the community.

“I’m hopeful there will be more opportunities available to strengthen the community care side for the elderly because people are suffering from chronic disease ailments . . . very complex conditions that cause them to come back to hospital frequently.”

Then there is the whole issue of primary care.

“You know the emergency department here is extraordinarily busy and part of that is people know the reputation of the emergency department. The other part is people’s frustration with the ability to access primary care. We have a lot of people who come to the emergency department who, if they had access to primary care, wouldn’t need to come to the emergency department.

“So that needs to improve and I think this government now is trying to focus on that. I think there needs to be a lot of strength put in there. Part of this is the question of finances. Certainly reallocation of some money to where it needs to be. But at the same time you can’t reallocate all of the money from hospitals into primary care and then starve the hospital. There has to be an important balance.”

Speaking now as Paul Collins the citizen, he added “We ought to be very careful about simply throwing more money into the system. I do believe there’s waste in the system. I think leaders in this system are responsible to understand where that waste is and to remove it so that there is not duplication and there’s not money being spent on resources that are not required.

“And to take that money and put it in the right place. I think that’s the first thing we ought to be doing really, really well. And being able to demonstrate that before you go to the bank and say now I need money because I think the problem is some times when you throw money at the problem you’re not actually improving what could have been improved. You are creating more waste. I don’t think the system is broken, there are a lot of good things about the system . . . but I don’t think we focus enough on the patient experience.”

He may be closing the book on his stint at the helm in St. Thomas, however Collins is not ruling out further involvement in the province’s health care system.

“It’s been a great run here, it’s been a long run as CEO . . . 15 years is good. There’s lots for people to be proud of in the community. The hospital has a great future in store. It’s been wonderful to be a part of and I look forward to opportunities in the system down the road.”

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A lengthy report for council’s consideration Monday – the Fire Service Strategic Plan – is the result of a comprehensive review of the city’s fire services, undertaken by the firm of Emergency Management & Training of Barrie, Ont.

According to their website, their function is to “assist Fire Services and Emergency Medical Services, and their governing agencies to reach their performance goals by providing comprehensive consultation . . .”


A total of 42 recommendations are contained in the strategic report covering everything from facilities and apparatus to administration and dispatch.

One far-reaching recommendation, in particular, warrants close attention by city council.

Number 3 states, “The City of St. Thomas should encourage the Ontario Association of Fire Chiefs or the Association of Municipalities of Ontario to undertake a comprehensive review of the impacts of 24-hour shifts including the different impacts on large and small career fire departments.”

The city and the firefighters union have locked horns on this in the past.

Two other recommendations have considerable financial implications.

“The Department should consider and enter negotiations with the Association for the addition of part-time firefighters who would be called to replace vacancies in the shift schedule.”

In conjunction with the above, “The Department should consider hiring up to four additional firefighters (1 per platoon) to be assigned to the Suppression Division to provide more flexibility with staffing and to reduce the reliance on overtime.”

There is much in this report for mayor and council to absorb.

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