To pick up from our advance story last week on the future of St. Thomas Elgin General Hospital, President and CEO Karen Davies appeared before city council at Monday’s (May 5) meeting in the first of what she would like to see as regular opportunities to keep you “apprised at everything that’s going on in the hospital.”Davies continued, “And so I’m not coming here asking for money today. It happens to be that the update I’m going to provide you with is really based on our space and capacity, and some of those concerns. It’s not a request for money.”
She reminded members of council that the hospital is over 70 years old, “And so the idea that we need a new building shouldn’t be a surprise really to anybody.”
Davies continued, “We are still one of the larger employers in the region with over 1,300 staff physicians and volunteers. We’re considered a medium-sized hospital, and that designation is typically based on the number of beds that you have.
“The outlier for us is that we’re a high-volume hospital, which means that, for example, our emergency department sees more patients than University Hospital in London, and this year will exceed 61,000 visits to our emergency department.
“We’re the second busiest emergency department in the southwest.”
She noted that the number of births at the hospital is increasing every year.
“We’re aiming to be around 1,000 births. “
Forty per cent of the people who live in Elgin county have visited STEGH’s emergency department in the last two years.
“That’s high,” advised Davies. ” We know that we have a higher use of our emergency department. We also know that we have a lot of people in Elgin county who don’t have a primary care physician.”
About 17 per cent of visits to the Emergency Department every day are from residents of Middlesex County.
“It doesn’t really matter,” stressed Davies. “If you have an Ontario health card, you can go anywhere in the province for care, but that has an impact on a hospital. It’s not built for those types of volumes.
And medium-sized hospitals tend to face more challenges than other hospitals, often related to funding, noted Davies.
“Right now, for us, we know that this region is growing rapidly, and with that rapid growth is the boomer population, the aging population, and certainly, we have a high level of comorbidities in the area.
“We’re really seeing a significant increase in violence and homelessness that’s impacting the hospital. Hospital violence across the country is really ramping up, and you’re seeing different hospitals take different approaches. We’ve really changed our security provision there.”
“And comorbidities really mean people are living longer and they’re having more diseases like diabetes, cardiac issues, congestive heart failure, and mental health. And so people are now coming in with multiple issues, not just the cardiac issues.
“We also have a higher number of patients who do suffer from mental health addictions. And the hospital has traditionally been the backstop for that when there’s nowhere else to go.”
All of which puts financial stress on hospital resources.
“Community fundraising (for equipment like the MRI) has been an issue, and I don’t think that we’re unique to anybody in the world right now, but it’s become harder and harder to get donor dollars out of people.“And hospitals still have to pay for their own capital equipment and all equipment in the hospital. It’s not paid for by the province.”
Referring back to population growth, it is projected that St. Thomas will be home to 79,000 residents by 2051, 20 per cent of that total aged 65 or older.
Introducing problem areas more associated with larger metropolitan areas.
“We’re really seeing a significant increase in violence and homelessness that’s impacting the hospital. Hospital violence across the country is really ramping up, and you’re seeing different hospitals take different approaches. We’ve really changed our security provision there.
“They’re now all STEGH employees. They’ve got cameras on them, same as St. Thomas Police. We probably work most closely with the police than with any other partner that we work with.
“So when I talk about a new facility, it’s really about an investment in our future. And we’re in the long game for this. This is not something that’s going to happen in the next two, three, five, probably seven years.”
“You’ll see London’s just put in a new weapons detection system. A lot of days, we actually have more incidents than they do. If I had the funding, I’d be putting it into your hospital here. It’s actually really needed.”
Davies noted that “550 visits last year were substance-related. That’s up 20 per cent. And the year before, we were up 18 per cent. And I know this year we’re already trending to be up another 30%. And we’ve got mental health outpatient visits that keep escalating as well.
“So when I talk about a new facility, it’s really about an investment in our future. And we’re in the long game for this. This is not something that’s going to happen in the next two, three, five, probably seven years.
” These things move slowly, and we need to be proactive in our planning. And so that’s why I want to make sure that you know we’ve been talking about a new hospital.
“We’re working on our submission right now. And that identifies through the use of consultants, what you actually need. And they do the projections 10, 20, 30 years out as well, which seems a little bit difficult these days. We know how quickly things change, and we’re planning for a hospital 30 years out right now.
“So the aging infrastructure is a critical tipping point right now for us, along with the population growth and then the increase in complexity and care that we’re seeing. And that’s really just with the multiple issues people are presenting with.
“And the violence issues. I mean, the hospitals, some of you may recall, when hospitals used to be like the revered church of the community. They’re no longer like that. And so we need to plan accordingly as well.”
Davies indicated, “We have about $42 million in deferred maintenance for the main building and about $15 million for the south building over a 25-year period. Many of you may already know we have a shortage of parking.
“As of today, we have about 80 people who are parking off-site. So we know that we’re already feeling the crunch now, and that is a bit frightening when you think that we’re planning five, 10 years out.”
“One of the things that I think has helped us to be so successful through not just the pandemic, but over the last many, many years, is our culture. And I’ve had a very eventful 10 years of building and designing this culture.”
And now, throw in a measles outbreak, with a hotspot being the Southwestern Public Health region.
“We just built in the last three months, temporary isolation rooms, three in the Emergency Department, one on the fifth floor and three on the pediatric floor to accommodate the measles influx.
“I think we’re in a good groove now of accommodating it, but it’s still an ongoing problem for infection control in an old building. And we’re maxed out for space.
“Some of the data I want to share here with you is if we were to build a new hospital tomorrow, based on the new standards:
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Our NICU, which is where we care for the fragile newborns, would be 93% larger than it is today.
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The Emergency Department would be 42% larger and have 15 more rooms. That’s probably the most striking one because we just moved into that space in 2018.
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Acute inpatient would be 72% larger.
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The pharmacy is one of our biggest issues right now because it’s in the oldest part of the building. And there are a lot of standards for mixing medications now. It would be 61% larger.
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Our complex continuing care would be 138% larger.
“So by 2033, we need 83% more square footage. And by 2053, 159 per cent. And so that’s why this planning is done with the long game in mind.
“You’ve heard over the years, we’ve talked a lot about our emergency room rankings. And despite the high volumes, out of 74 hospitals, we still rank Number 1 in the province.
“We don’t like to advertise that too much. It is part of the reason for the drift from London and other areas. And that’s because we’ve got a really solid, lean operating system. And so even though we have very few beds, we’re still able to pull them through the system because of efficiencies and support from our partners.
“One of the things that I think has helped us to be so successful through not just the pandemic, but over the last many, many years, is our culture. And I’ve had a very eventful 10 years of building and designing this culture.
“And we spend every day making sure that it’s a priority so that everybody who comes to our doors, whether they’re volunteers, staff, physicians, patients, that they all feel comfortable and welcome.”
One of the questions asked after the presentation was directed toward the future of the existing facility, should a new hospital be built on a greenfield site.
Davies said, “There’s a laundry list of potential for that site. It’s very prime real estate. It could be:
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An ambulatory care site.
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A primary care site.
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And we would have diagnostic imaging in place there (the MRI suite).
As to land requirements for a stand-alone new hospital, about 60 acres would be required.
If a hybrid model were employed – using the existing facility along with a new hospital – then about 40 acres would be needed.
As for funding, the province provides 90 per cent of the cost of construction, with the remaining 10 per cent being a local commitment.
As a benchmark, the cost of the Great Expansion of the hospital in 2016/17, with the three-storey addition fronting Elm Street, was approximately $100 million.
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HOSPICE OF ELGIN NEARS COMPLETION
On the heels of the STEGH presentation at last Monday’s council meeting, this Monday (May 12) will see a deputation to members from the Hospice of Elgin.
Executive Director Brenda Fleming aims to update city council on progress at the site overlooking Waterworks Park and “acknowledge the City of St. Thomas for its ongoing support and partnership.”
In a letter to council, Fleming notes, “Hospice of Elgin is a vital initiative for our region, and we are pleased to share that significant milestones have been reached in the development of our hospice home.”
She continued, “This beautiful and comforting facility will offer compassionate, end-of-life care for individuals and their families.”
“Our presentation will provide insight into our timeline, impact, and future plans, as well as express our gratitude for the city’s past and continued commitment to the community.”
STRONG MAYOR POWERS OUTLINED IN DETAIL
Last month, we talked with St. Thomas Mayor Joe Preston on the strong mayor powers afforded to him by the province, which take effect next month.
Preston was adamant that “I certainly would never hope to use the strong mayor powers. We have a council that gets stuff done because it agrees with the direction of the city and look at the big things we’ve been able to do with this council.”
On Monday’s agenda is a report from the clerk’s department outlining in detail exactly what those powers entail. and the duties of the mayor.
Written Documentation
When exercising powers, other than direction to employees, a written record must be provided to the clerk and each member of council and subsequently made available to the public.
A document template is currently being developed and such completed mayoral decisions will be posted on the city’s website.
Direction to Employees
The mayor may direct employees to undertake research, provide advice, or to carry out duties related to the exercise of the power or performance of the duty, including implementing any decisions made by the head of council under the special powers and duties provisions. These written directions are provided to the clerk and the Chief Administrative Officer.
Employment Matters
The mayor can appoint or dismiss the Chief Administrative Officer. This authority may be delegated to council.
The mayor can appoint or dismiss or exercise any other prescribed employment powers relating to division heads, excluding specific positions appointed under legislation. This authority may be delegated to council or the Chief Administrative Officer.
The mayor can determine the organizational structure of the municipality. This authority may be delegated to council or the City Manager.
Committee Oversight
The mayor can create committees, assign functions, and appoint chairs and vice-chairs of committees that are exclusively made up of members of council. Budget Preparation
The mayor is required to propose the budget by February 1st in each year.
Once the mayor has proposed the budget, council can amend it by passing a resolution within a 30-day review period. The Mayor has 10 days to veto any council amendment. council can override the veto with a 2/3 vote.
The mayor can direct staff to prepare a budget for the mayor’s review and adoption and shorten review and override periods.
Bylaws and Matters Supporting Provincial Priorities
The mayor can bring forward matters for council’s consideration relating to provincial priorities.
The mayor can propose a by-law relating to provincial priorities, with support by more than 1/3 vote of council.
Veto Authority
The mayor can veto certain by-laws if he believes that they interfere with a provincial priority by providing written notice to council of his intent to consider vetoing, within two days after ocuncil voted in favour of the by-laws. Within 21 days of the mayor’s notice, council can override the veto, with a 2/3 vote.
By-Election
Should a vacancy occur in the office of the head of council prior to March 31st in an election year, the municipality must hold a by-election in accordance with the Municipal Elections Act, 1996, to fill the vacancy.
In our conversation last month, Mayor Preston concluded, “But I think we work on it by working together rather than by separating powers.
“And that’s kind of what elections are for. When the electorate sent us there with certain messages they wanted us to pay attention to, whether it was dealing with homeless crises or housing crises, we all knew we were sent there to do that.
“If someone sat at that table and chose not to participate, then they would be part of that issue. But we’ve heard the people, we think that’s a better way to go, and we certainly can fine-tune it by our discussions at the council table, not with anyone having special powers.”
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THE ECHO CHAMBER
Following up on our federal election items last week, Kevin Smith offered the following on the Andrew Lawton campaign. We assume he has chosen to ignore the candidate nomination process.
“What a great campaign by the Lawton team. After facing immense negativity by the Liberal protesters and a coordination of message (it would appear) between City Scope, the Liberal Campaign and Vecchio, Lawton still won the riding.
“Consider the following: the last time Vecchio was a candidate, she received 49.9% of the vote; this time, Andrew received 50.1%.
“On the Stand Up to Decency Facebook Page, there was a link posted to a vote-splitting website suggesting that voters in the riding vote Liberal. Clearly, these protesters were an extension of the Liberal Party, otherwise, they would have remained neutral, but they didn’t.
“As for City Scope, check out Ian’s article headlines for his March 22nd and April 5th columns. It’s obvious (it would appear) to any logical person with a functioning brain cell or two that this was a coordination of messages between the scorned Vecchio, the Liberal campaign and City Scope.
“It appears that David Menzies from Rebel News was right about the unfair and sometimes vicious media coverage in E-S-L-S (Elgin-St. Thomas-London South). A big thank you to Rebel News for speaking the truth.”
That reference to Rebel News brought this response from Kyle Yates.
“Rebel News is a disinformation group and not a real news source.
“The fact that you think Vecchio coordinated any part of the Liberal campaign or the protests shows that you are gullible and honestly foolish.”
We’ll leave the last word this week to Dave Mathers.
“Lawton is wrong when he states that, ‘The people saw through a lot of the noise.’ “No, the electorate simply ‘held their noses’ and voted for the party and not him. Lawton was doomed from the start in getting acceptance in the riding.
“When ‘head office’ in Ottawa overruled the local committee and installed him as their candidate, he lost a lot of support.
” I have volunteered for the party for over 50 years, but I wasn’t prepared this time to explain the candidate at neighbourhood doors.”
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And a reminder, I can be heard weekday afternoons as news anchor and reporter on 94.1 myFM in St. Thomas. As always, your comments and input are appreciated.
