The local health authority has concluded that there are insufficient staff to properly operate Minden’s emergency room. (Patrick Porzuczek/Facebook)
As the long weekend of Victoria Day approaches, I have been following the news reports about a small hospital in central Ontario with interest, thank you. Located (as you can imagine) in Minden, Minden Hospital is a local health center for Haliburton County, an area that sees a significant influx of tourists and part-time residents during the warmer months. For those unfamiliar with Ontario cabin traditions and norms, the warm season is believed to last roughly from Victoria Day to Thanksgiving, regardless of the actual temperature.
In other words: It starts now. And Minden’s emergency room closes. If everything goes as planned, this will already happen at the end of this month.
Rural health care in Ontario is particularly challenging for every reason imaginable. Population density is low, the areas where services are needed are vast, and the population has complex health needs. Recruitment and retention of staff are constant challenges; Many recent graduates prefer to live in more populated areas for family reasons or simply for lifestyle reasons. Of course, not everyone prefers the city. The more rural areas have many, many advantages, as anyone who spends time there knows. But the trend towards a more urban lifestyle is such that it is becoming hell for many rural systems. Recruitment is a major challenge, as is retention. Even if you find a doctor, nurse, or other doctor who is able and willing to work in a rural area, will this also work for their family? Are there employment opportunities for spouses? Educational and cultural offers for children?
I want to reiterate that our rural areas are not waste lands. They are beautiful and full of wonderful communities. But they’re not for everyone, and that’s okay. You still need to hire enough people to fill some key positions. And they fought for it.
For this reason, the Minden Clinic will close its emergency room. (The rest of the hospital remains open.) The local health authority has concluded that there are not enough staff to function properly, and the available doctors and nurses are being gathered in an emergency room in the close by in Haliburton, about 25 minutes away. “Proximity” is of course a relative term. If you live 20 minutes from Minden, across the street from the Haliburton ER, you are now 45 minutes from an ER. In an emergency, when seconds count, this can be of great importance.
I neither dispute nor support the need to close the emergency room in Minden. I honestly don’t know enough about the local system to say that, and I’ve been around the sun enough times to know that sometimes dire decisions are announced precisely to trigger a public reaction, which then creates the necessary political attention. to free up resources and fix the problem. Maybe the Ford government will see the bad press and voilà, the money and resources will show. It has happened before and it will happen again. This can happen here.
In the meantime, I will follow this with interest, both professionally and privately. The situation in Minden reflects the overall state of our health care system, which is still struggling to recover from the COVID-19 pandemic and in some respects appears to be going in the wrong direction rather than towards stability and a return to balance. This is my professional interest. As for my personal interest, I spend most of my summers near Minden. In case of a medical emergency, Minden is not the hospital we go to – there are two others that are closer. But in the general public, Minden’s emergency room had a really good reputation. No one ever wants to need an emergency room, but if and when one is needed, Minden is one of the places to go.
Agenda segment, May 11, 2023: Can Minden’s emergency room be saved?
The timing of the announcement of the imminent closure of Minden’s emergency room is… interesting. The announcement did not go down well with residents and local officials, to say the least. A recent public meeting required the presence of the OPP, the tension was so great. There is never a good time to close an emergency room in a community, but there are particularly bad times, and right at the beginning of the summer season is about the worst possible time imaginable. People who don’t spend a lot of time there probably don’t realize how different the warm weather seasons are from the cold weather seasons.
The pandemic has somewhat upset the usual order; People who would normally make Snowbird stayed home, and some Toronto residents moved up north on a full-time basis. But typically the population in these rural areas can explode in the warmer months. I remember talking years ago with a representative of the local chamber of commerce in one of the small towns of the country, and she guessed that the summer population was twenty times the full-time population. This is not a small seasonal increase. For example, this could mean the difference between a January population of 2,000 and a July population of 40,000. Or more.
Those 38,000 extra people essentially do not need extraordinary health care during the summer. Anyone who suffers from a chronic illness or observes a minor illness can seek medical care from the usual team of doctors (if available) close to where they live. But you can’t drop tens of thousands of additional souls into an area and avoid surprises—emergencies, so to speak. There are some heart attacks and strokes, some accidents, some babies who choose to be born early, and everything else. And these people need an emergency room.
There’s a pretty good one in Minden. At least they did. It is not improbable that the political reaction will result in an ad hoc solution being found to get the hospital through the summer. But when the staffing situation is so bad that local officials are contemplating closing the ER – when they’ve actually concluded that closing the ER is necessary – then that’s a red flag for all of us. Closing Minden’s emergency room will be politically painful and could cost lives. If the situation is that bad, and we have to accept that, we also have to accept that Minden’s emergency room will not be the last to close. Stay tuned.
