MUSKOKA - The new foundations of health care in Muskoka will have to be built as much on ingenuity as bricks and mortar.
Muskoka health care needs ingenuity.
Natalie Bubela, chief executive officer for Muskoka Algonquin Healthcare, says “interesting times” are ahead as provision of locally based health-care services will need adaptation, both physically in terms of hospitals, but also in philosophy and tactics.
“We will fight to make sure that health care is here in Muskoka,” she said.
Bubela explained there are changes coming to how hospitals are funded for operation and capital costs.
“Given the financial situation here in Ontario, the ministry (of Health) has put into place some fairly strict budgetary reforms,” she said.
According to Bubela, the changes are being rolled in over the course of three years, starting in January 2012.
“Historically our funding would have come from the Ministry of Health and Long Term Care,” she explained. “It would have been given to the local health integration network and they would have doled the dollars out to all the people they provide funding to.”
The new system will be based on how many patients a hospital or health-care facility provides service for over the course of the year, the type of services provided to them along with a qualitative portion, where funding will be based on “positive outcomes.”
“It’s going to be pretty interesting in the next couple of years,” Bubela added.
She said it used to be that about 98 per cent of a hospital’s funding was base funding. Over the course of the next three years, that percentage of base funding will be gradually reduced down to 30 per cent of the total by the final year. In the base funding’s place will be the per-patient funding and the qualitative, positive outcome funding. Funding will also be based on efficiency, she explained, which could put some of the smaller hospitals at a disadvantage. She added that with the first year of the phase-in almost complete, the organization has already seen a decrease in funding of about $423,000.
“They are going to be holding us to the same funding the most efficient hospitals can do the work at and that places us at quite a disadvantage,” Bubela said. “It (future funding) depends on whether or not we are able to provide good, quality outcomes and at the cost point that the best hospitals in Ontario are doing it at.”
Regardless of changes to funding, Bubela said the aging hospitals in Huntsville and Bracebridge will need to be addressed in some fashion. That could range from renovation or footprint expansion of the current sites or outright new locations.
With a long-term planning horizon of about 25 years, Bubela said the region will have to look at its services and the facilities that provide those and determine what needs are most pressing within the communities served.
“You could be looking 10 to 15 years before you actually get permission to put a shovel in the ground. The board and the senior team are thinking futuristically what do we need,” she said. “We need to plan for our facilities; our current facilities are not what they should be. If we were planning a facility to provide the services we are currently providing at both of our sites, we would need to double the footprint.”
“We have huge space constraints and I would say some safety issues within our organizations because we have jam-packed services into a facility that can’t manage, but are managing somehow,” she added. “And if you’re looking to that 25-year horizon … you clearly need a much larger building at both of the sites than we have now.”
She said one of the first steps of the planning process will be to engage the community to discover their desires and needs.
“It’s going to be huge dollars down the road, so we have to make very prudent choices about what is the best thing for Muskoka to keep health care here in the future,” she said. Despite future needs, there are burgeoning ones now that need to be addressed, she added.
“The biggest concern I have right now is the Bracebridge site. My understanding is that the footprint or the structure will not allow additional floors to be placed on it and there are some issues with the soil there,” she explained. Roof repairs are needed there but funding will only allow for a portion to be fixed.
For future capital projects, Bubela said the organization will have to rely heavily on its hospital foundations, the volunteers and support from the community as capital funding will be harder to come by. She added that hospitals will be 100 per cent responsible for funding their own capital purchases.