The haze in Guelph this week was not from the humidity, it was from the fuming. The Government of Ontario announced the selection of a site for the new hospital in Kitchener-Waterloo, and now the people of K-W will eagerly countdown to the ribbon cutting… for the next decade.
But hey, progress is progress, and if there’s one thing that people in Guelph want to see, it’s progress on getting a new hospital. It’s hard to talk about any other issue of local importance, especially on the topic of building stuff, without someone telling you that we desperately need a new hospital.
So let’s talk about that for a minute.
First, would it surprise you to learn that there’s a government document called Hospital Capital Planning and Policy Manual? The manual is a little less than 80 pages long and is meant to guide stakeholders though all steps of the capital process, the necessary legislative and administrative compliances, how to submit an application, what factors are considered when reviewing an application, and the standard design features.
In the manual, all the hoops are lined up including project type, primary factors, secondary factors, planning principles and more. And if you think that this just a deal between the hospital and the Ministry of Health, you’re wrong because Ontario Health, Infrastructure Ontario and the local governments all must have their own seat at the table too.
Now, I'm not an expert on these things, but it’s safe to say that the process is more complicated than choosing a site, writing a billion-dollar cheque and sticking a gold shovel in the ground.
It’s also safe to say that these complications, which are largely outside the control of the local council, make other types of construction easier to proceed with than a new hospital. So yes, building a new library, or a rec centre, or a bus barn, is not stopping the City of Guelph from building a new hospital tomorrow.
The hospital has become a cudgel for anyone that hates a project, and that’s a two-way street because last week Mayor Cam Guthrie said again that he can’t get behind a National Urban Park at the OR Lands because a portion of that property could be a good future hospital site. If that’s really a consideration, I’ve got to wonder why the city didn’t put up a fuss when Fusion Homes bought their portion of the Guelph Innovation District Lands.
And look, I concede that there are not a lot of big portions of open land inside the Guelph city limits, so is the old IMICo site on Beverly Street being considered as a possible site? Or the old Lafarge lands in the west end, which is presently in front of the Ontario Land Tribunal for a decision about residential/commercial mixed development? Or does the “What about the hospital” line only work when it’s a project you don’t want to get behind?
Now none of this is to say that we don’t need a new hospital. Next year, Guelph General Hospital will mark its sesquicentennial. Although the present hospital building is closer to 75 years old than 150, there’s no doubt that time has gotten away from the building; the population of Guelph in 1951 was 27,350 people, which is now the approximate number of people living in Ward 6 alone.
So size does matter, but what about service?
Earlier this year, I had a bit more hands-on experience being at Guelph General Hospital then I would like, first in the emergency department and then the intensive care unit. Why make the distinction? Because I think most people’s immediate experience with the hospital is in the E.D., and if that is the case, then they’re presented with the epitome of hallway medicine, and if I may coin a new term, “care by chaos”.
In the E.D. I saw how doctors, nurses and staff try to manage with high demand and limited space. Patient management is a complicated Tetris game where the right piece is moved into the right slot at the right time or else you risk a pile up where all control is lost before you have the capacity to realize it.
Things weren’t perfect several floors up in the I.C.U., but there was a more leisurely pace, plus more room and time to think. The staff were still overwhelmed with the number of patients, all the ICU rooms were full, but there wasn’t the urgency or the patient load that existed in the emergency department.
These observations are anecdotal and idiosyncratic, but they did put in context where the urgency lies. For five years, the City of Guelph’s been putting aside $750,000 per year for upgrades to key hospital departments, including emergency, and that project was initiated in 2014. It should finally break ground sometime later this year, which speaks to the glacial pace in which we get progress on these improvements. I wonder if by the time the new E.D. opens it will already be out of date.
During the pandemic we became familiar with the expression “lagging indicator” and that’s what an emergency room is. Yes, there are medical emergencies when people must get medical help in a hurry, but it’s also a catch-all for basic medicine, chronic conditions, and mental health and addictions, things that might get caught before a trip to emergency if everyone had, say, access to a family doctor.
A new hospital doesn’t solve our healthcare woes. I remember a presser involving healthcare workers demanding more provincial funding where one hospital worker remarked that no sooner had the new Oakville Trafalgar Memorial Hospital opened in 2015 that every bed there was full. Like Guelph’s case, this was supposed to be a larger, more state-of-the-art facility meant to take the pressure off the old hospital, but those new beds were all full just the same.
Having said that, and this is worth saying again, we do need a new hospital, but it’s not going to solve all our local healthcare issues, and neither is yelling at people excited by the prospect of a new library or a new rec centre about how “they just don’t get!” Yelling at people period just doesn’t work, but in this case the situation is just so complicated that saying “Do it!” doesn’t do it.
In the case of hospitals, for better or worse, the government thinks in decades, and perhaps the first step is getting on the same page and to suspend that idle speculation. Not mention the hospital envy.