I was once told that the job of a public health practitioner was to “put hospitals out of business”. To some extent I agree with that goal.
But we humans are, well, human, and it turns out we all need good medical care at some point. When that time comes, we need a well functioning health care system with the right infrastructure to support it.
We know that Mills Memorial Hospital has served out its time. Shabby corridors, lack of privacy, inadequate equipment, and an ambiance suggestive of the Soviet Union in the 1950s contribute to work environment that can no longer be considered acceptable.
But when we say we need a “new hospital” and the game becomes a political one, pitting one community against another with an eventual “winner,” we are falling into an old pattern that promises little improvement in either care quality or patient experience.
We may get a shinier edifice that will be more comfortable but it will be essentially the same: a factory style building that attempts to house a variety of services using core ideas that have changed little since the industrial revolution.
Is there another way? It’s certain we need a unit to provide the most acute and most expensive services: emergency care, operating suites, critical care including enough beds for recovery and intensive medical monitoring.
But what about some of the other services: kidney dialysis, cancer care and treatment, diagnostic imaging, obstetrical care, and sub acute routine care for people who need more than home care but less than intensive care.
Do we have to locate all of these under one roof subjecting all users to the same infection and medical error risks as well as high user costs regardless of their actual care needs?
What about a modular approach in which some of these services are provided in separate buildings either on the same site or in some cases on another site altogether?
What about separating the hotel functions like food and laundry from the care functions?
People used to stay in hospitals for weeks and months at a time, but stays are much shorter now. Why should our overstretched health budgets be expected to include free room and board?
Rather than turn our health care system over to the private sector, why not privatize food and lodging?
Our medical care may be excellent but the same can’t be said for the food!
There is a lot of innovative thinking to bring to bear, but in my view, the key opportunity we have as a community and as a region is to plan in a way that doesn’t simply assume it will be business as usual.
Most importantly we have an opportunity to ensure that patient voices and the lived experiences of what is called the patient journey are brought into the planning process.
Northern Health has done a good deal of this kind of thinking at the executive level, but they need our help to create and endorse a process that doesn’t assume we just need something bigger and with more beds.
Integrated seamless care from preventive programs through to the most technically demanding medical interventions is a much talked about goal these days.
We should be thoughtful about what kind of bricks and mortar we want to invest in to try to approach this important ideal.
Rather than asking the government what they will do for us, we should tell them clearly what we want based on an inclusive planning process. Its something we might well undertake in collaboration with Northern Health.
Healthier people in a healthier community would be wonderful outcomes well worth the investment in time and energy it would take to clarify exactly what infrastructure could best support these goals.
Sooner or later a new “hospital” will be built in Terrace. Let’s make sure its the best health resource it can possibly be.
Terrace resident Dr. David Bowering is a retired senior public health care official with the Northern Health Authority.
(Editor’s note: More information at this link.)
