Ontario community battles to keep emergency department from closing for good

The emergency department in Minden, Ont. is slated to close for good June 1, but residents in the town and surrounding area are prepared to head to court to try and save it.

The announcement of the ER closure by Haliburton Highlands Health Service came April 20, just six weeks before the closure and right as the area begins to swells with summer residents.

"This is a plan that is going to cost lives," said Patrick Porzuczek, a local businessman who is spearheading a campaign called Save the Minden ER.

His grassroots group has held rallies and gathered a petition with more than 24,000 signatures. They've also raised more than $75,000 to cover legal fees as they prepared to file a court injunction.

"We're not numbers, we're not part of a morbidity and mortality rate, we're human lives, and this has to stop," Porzuckek said.

Haliburton Highlands Health Services, which runs the hospital, said all services would be transferred and consolidated at its Haliburton site, more than 20 minutes away from Minden.

"Staffing shortages is the biggest driver for this, without doctors and nurses we can't run an emergency department," said Carolyn Plummer, president and CEO of Haliburton Highlands Health Service, adding, "We were facing multiple frequent closures over the coming months if we didn't do something."

A critical shortage of nurses and physicians has sent a ripple effect across the country. Temporary ER closures have become routine practice in dozens of rural communities, shuttered for hours or days at a time.

"We can't be doing this on an ad-hoc basis nationally, this is a national problem with common root causes that needs national discussion, a national dialogue, a national approach," said Dr. Alan Drummond, an emergency room physician and co-chair of the Canadian Association of Emergency Physicians. "I think the way to go, is to sort of define rural Canadians what is a reasonable expectation and how we might best serve their needs in terms of reasonable access to quality care."

The Minden ER has never implemented a temporary closure and is the only emergency department in the country to close permanently in the last year.

Nova Scotia transitioned some of its rural ERs to urgent treatment centres (UTC) with reduced hours. These UTCs are often open eight or 12 hours per day, four or five days per week.

"I think it would be worthy of consideration in the Minden situation to maybe trial the Nova Scotia model to see if it works," said Dr. Drummond. "Because there's going to be other communities facing this very same situation in the coming years and we need an approach—particularly in Ontario—and we need to know how to handle this."

Residents in Minden have been calling on the local MPP Laurie Scott to step in and they have taken their pleas to Ontario's Legislature.

In a statement to CTV National News, a spokesperson for the Minister of Health said: "Hospitals are independent corporations who are authorized to direct their own operations, including decisions respecting services that they provide and in what locations, the Ministry of Health is not involved in these decisions and to suggest so is false."

Part of the public outcry has been for more transparency and communication with the community. The hospital says it launched a campaign last summer, encouraging people to call ahead to ensure the ER was open, but members of Save the Minden ER say there were no warning signs the emergency department could face a permanent closure this year.

"This came as a complete shock to the community, the doctors and nurses were told 15 minutes before announcement to the public," said Porzuczek.

Doctors who work at the Minden site have stated their schedule was full for the summer months, until September.

Carolyn Plummer, President and CEO of Haliburton Highlands Health Services, speaks with Heather Butts. (CTV News)Plummer told CTV National News it wasn't entirely full: "there were still gaps in the schedule."

When asked about the Haliburton staffing schedule and the risk of temporary closure there, she confirmed "the risk isn't entirely gone, but this move that we're making is doing a lot to mitigate that risk in a way we wouldn't otherwise be able to do."

Hospitals across Canada have tried to recruit staff from other provinces and other countries. Plummer says they have been working hard on recruitment for many years.

"We have tried recruiting internationally-trained health care professionals, unfortunately we haven't had the same luck that others have had in attracting people here," she said.

When asked about the future of the Minden site and if a UTC was considered, the hospital CEO said once the consolidation process is complete they will turn their attention to what services they're going to provide there.

"We have certainly been hearing messages from people in our community about how people are using our emergency department services. We have a shortage of primary care physicians, a lot of people use it for primary care. That will be top of mind when we look at options for our Minden site," Plummer told CTV News.

The grassroots campaign Save the Minden ER is hoping a court injunction will stop the process and they intend to keep fighting for health care services in that community beyond June 1.