The recent recommendation of MAHC’s Capital Plan Development Task Force (subsequently approved by the MAHC board) that both the Bracebridge and Huntsville sites be redeveloped as new buildings has naturally produced reaction – both positive and negative. Our purpose in writing is to respond to the negatives expressed and support the many positives we see from our perspective as physicians.
Firstly, we strongly support the Task Force recommendation for two new facilities. We believe two new rebuilds, with the one in Bracebridge on a new site, is the best redevelopment approach, especially for another 50 years. Collectively we participated as active members of the Capital Plan Development Task Force, alongside our municipal leaders, our Foundations and Auxiliaries, and other members of MAHC’s Administration and Board. Our work was based on fact, expert studies and objective analysis, and in the end we participated in an evaluation exercise to collectively score the five potential building options. We stand behind the results. The criteria used to score all proposed options were as follows:
- the continuation of high-quality patient- and family-centred care and the least impact on patients/staff
- alignment with MAHC’s goals and strategic plan
- the promotion of health and wellness;
- the ability to enable innovation;
- the facilitation of operational excellence;
- the possibility for future flexibility;
- the promotion of community connection and system integration;
- that the plan meets the ‘Quadruple Aim’ of health care (better care, better patient experience, better value and better provider experience);
- the project duration (fastest to build)
- the community’s support (from survey feedback);
- regulatory support;
- the cost to build;
- and the affordability of the plan.
A few points must be made about the costs, as at first blush they do seem daunting. We recognize all the options are expensive and require millions of dollars over time.
The cost difference between the renovation and replacement options is not substantive enough to compromise safety, the provision of high-quality care, and the effectiveness of our workspaces – all of which help us recruit and retain skilled providers. Renovations, especially of an entire hospital, are incredibly disruptive to patient care. Our recent very small, but necessary, renovations to build secure rooms in our Emergency Departments were quite an awful experience. Renovations were estimated to cost marginally less than new builds; however the savings were not significant enough to warrant the disruption and unpredictability of full renovations.
If the Ministry approves the project we are putting forward, the Ministry itself will pay 90 per cent or $430 million of the $560 million construction cost. We believe the local share, which after adjustments for reuse of existing assets and capital campaign commitments by our Foundations is in the $74 million range, is affordable for our communities if we start preparing now.
To conclude, we agree with investing in a future that not only considers the cost to our children and grandchildren, but also the quality and effectiveness of the hospitals we choose for them. We do not feel this is best accomplished by trying to make old buildings work. We believe that to meet current standards, and to incorporate modern technology, while anticipating new approaches to care in the future, new builds are the most cost effective and efficient approach.
Sheena Branigan, MD
Caroline Correia, MD
Jennifer Macmillan, MD
Keith Cross, MD
David Mathies, MD