With the race on to save a cottage country ER, officials reveal their case for shutting it

Public health officials behind the move to shutter the emergency department of a small, community hospital in Minden, Ont., are offering their fullest public defence of the controversial decision.

It comes amidst a growing campaign from local residents and elected officials for a reversal of the decision — made with just six weeks’ notice and without community consultation, critics say — that has illustrated the pains and perils of Ontario’s stressed health-care system.

Carolyn Plummer, president and CEO of Haliburton Highlands Health Services (HHHS), says “severe and persistent” nursing shortages over the past 18 months, in addition to physician shortages at the Haliburton emergency department — one of two hospital sites overseen by HHHS — have necessitated the “consolidation” of emergency services in Haliburton alone.

The rationale for the “consolidation” of emergency services at the Haliburton site rather than in Minden, “is largely due to the fact that the Haliburton site is the location of the only in-patient (acute care) beds in all of Haliburton County,” she told the Star in a statement.

“The Minden site is not suitable for permanent in-patient beds. It would require over a million dollars in renovation costs, and likely more, as well as a multi-year approval and renovation process to try to create a permanent in-patient space in Minden,” she said, adding that Minden would only be able to accommodate between six and 10 beds, whereas Haliburton has 15 beds available.

Other factors that led to the decision, she said, include feedback from local paramedic services highlighting that “the Haliburton site is more centralized in Haliburton County for patient transfers.” She also cited its proximity to the Haliburton Family Medical Centre, “which helps to facilitate easy access for primary care physicians to see patients in the Emergency Department and in-patient unit when needed.” And, she pointed to “the fact that there are more space options at the Haliburton site to accommodate the volume associated with a consolidated ED.”

The closure of the Minden ED comes as the provincial health-care system is still reeling from COVID-19 pandemic pressures, staff burnout, attrition and mental health challenges, as well as increased patient demand.

Announced in an April 20 news release, the decision to close the Minden ED on June 1 has enraged local residents and cottagers, prompting a grassroots “Save Minden ER” movement that has collected more than 22,000 signatures, staged demonstrations in front of local MPP Laurie Scott’s constituency office (several messages sent by the Star to Scott’s office have gone unacknowledged), launched a yellow “Minden Matters” lawn-sign campaign, and erected two four-metre by two-metre signs along Highways 35 and 118 to warn cottagers of the impending closure.

Responding to a question Friday about whether there was a chance the Ontario government would try to keep the ER from closing, Premier Doug Ford noted that the hospital itself would be staying open and said his government was “working with the hospitals.”

“They’re the ones that hire nurses … within that community, but we always believe in giving the best service we can when it comes to health-care right across the province. So we are working hand-in-hand with the hospital through the Ministry of Health.”

Meanwhile, on Friday, local resident Patrick Porzuczek, a spokesperson for the campaign, announced a plan to raise $100,000 to fund a legal challenge seeking an injunction and a judicial review of the decision prior to June 1.

Porzuczek, who moved with his family to Minden in 2015, knows how crucial access to emergency care can be. In March, he had to rush his six-year-old daughter, Kinsely, to the Minden ED after she suffered severe heart arrhythmia during a dance recital. Doctors were able to stabilize Kinsley and she was referred to a pediatric cardiologist. Porzuczek says that without the ED, the outcome could have been worse.

He points out that the Minden ED is fully staffed until September, as disclosed recently by the local physician group, whereas the Haliburton ED is still trying to fill shifts.

HHHS told the Star that the July and August schedule for the Haliburton site is now “being populated” by local physicians before unfilled shifts are posted on Health Force Ontario, a government job board that connects Ontario doctors with shifts across the province.

The Minden ED is staffed by physicians from surrounding-area hospitals, such as Peterborough, Lindsay and Barrie, who take on 24-hour shifts. Both the Minden and Haliburton EDs are staffed with one physician per shift.

In 2022, there were 13,000 visits to the Minden ED compared to 9,500 to the Haliburton ED, according to HHHS.

When asked by the Star why HHHS doesn’t keep the Minden ED open since it is already staffed through the summer, Plummer said doctors at that site indicated that if the Haliburton ED were to close as a result of a physician shortage, “It would not be safe for that one Minden ED physician to provide coverage for the entire County — which meant that the Minden ED would also have to close, leaving Haliburton County with no local services.”

NDP health critic France Gélinas doesn’t buy that argument, saying during a Friday news conference to announce a rally taking place in Minden at 1 p.m. Sunday, that it is the job of HHHS leadership to ensure both hospitals are staffed properly.

Plummer said HHHS is trying to recruit and retain staff, but noted that rural areas, such as the Haliburton Highlands, have found this task challenging for many years.

“These challenges were severely exacerbated during the COVID-19 pandemic, when health-care systems across the globe began to experience shortages of qualified staff to fill positions,” she said. “There simply isn’t an available pool of nursing staff and physicians available to hire from, and there is no end in sight for these shortages.”

With files from Robert Benzie

Kenyon Wallace is a Toronto-based investigative reporter for the Star. Follow him on Twitter: @KenyonWallace or reach him via email: kwallace@thestar.ca