March 19, 1997
(Health)

Review of Health Services in Central Released

Future directions for health services in Central Newfoundland were outlined today by the Minister of Health, Lloyd Matthews. "Government has accepted, in principle, the findings of a comprehensive review of health services in the region," said the minister. Mr. Matthews publicly released the review, undertaken by an independent consultant, today in Gander.

"Overall, this report outlines directions for government and regional boards to consider in planning for the delivery of health services in the region over the next several years," said the minister. "All three boards in the central region have accomplished a great deal since they assumed responsibility for delivering health services. The boards have established a cooperative working relationship that has enabled programs and services to be efficiently organized and responsive to patient needs. This report acknowledges that and outlines directions for enhancing these partnerships."

The review focused on all aspects of health service delivery throughout the region including community based services, primary care, hospital services and long term care. The consultant was asked to make recommendations based on population projections to the year 2005. "We asked for a comprehensive review to determine present and future health needs and to determine how health services could be organized to best meet those needs," said Mr. Matthews. "This review will now serve as a framework for organizing a more collaborative and efficient health system in the region."

"Recommendations to enhance primary and community health services call for greater collaboration between all boards, health providers and the community. For example, gaps in mental health services should be addressed through a long term plan," said the minister. "This plan will involve collaboration between all three boards, the Department of Health and consumer groups."

In terms of secondary health services, the review recommends two regional hospitals for Central Newfoundland. Both the Central Newfoundland Regional Health Centre in Grand Falls-Windsor and the James Paton Memorial Hospital in Gander should continue to provide the specialty services currently provided. A renal dialysis service is also recommended for the region.

The review also states that adjustments to long term care services in the region may be needed in future. "Long term care facilities should provide high level nursing care while seniors requiring minimal assistance should access services in their communities, either through home supports or personal care homes," said the minister. "While there is a need for redevelopment of some long term care facilities to focus more on providing higher levels of care, further study is needed to determine exact bed numbers and levels of care."

Priority areas for redevelopment include the James Paton Memorial Hospital in Gander and the Harbour Breton Hospital. "There is a need for redevelopment to continue at the Gander Hospital, however, some changes must be made to the original plans," said the minister. A rehabilitation unit is recommended for the facility, however an inpatient psychiatric unit is not recommended at the present time given trends toward community based mental health services. The consultant recommends approximately 94 beds for the facility with expanded space for intensive care services, operating room facilities and other specialized programs. "While the recommended bed complement is not as high as originally envisioned, expansion of the facility is necessary to adequately accommodate the kinds of services offered."

The minister thanked the consulting firm of KPMG in the preparation of the report and all health boards for their cooperation during this process. "Government has accepted the overall directions outlined in the report and will now ask the boards to consider these recommendations as part of the future planning process." The minister also acknowledged the high level of public interest demonstrated by organizations and individuals throughout the region.

Contact: Jill Sooley, Department of Health, (709) 729-1377.

_____________________________________________ BACKGROUNDER

KPMG Management Consultants was engaged by the Department of Health to undertake a comprehensive review of health services throughout the Central Newfoundland Region. The review followed last year's provincial budget and the decision to halt all capital projects. The largest of those projects was the redevelopment of the James Paton Memorial Hospital in Gander, a project where planning began in 1989. Since that time there have been a number of changes in the health sector in the region. For example, the amount of day surgery performed has increased to 70 per cent since 1990. At the same time, community health programs have expanded and staffing levels have increased. A review would determine if the planning documents for the James Paton Memorial Hospital expansion were appropriate in light of these kinds of changes and would also determine how all programs, services and facilities in the region could meet health needs in an efficient manner. The consultant was asked to determine present and future health needs to the year 2005 and to make recommendations for accommodating those needs. The review focused on the network of community based services, primary care, secondary health services and long term care. Any opportunities for increased efficiencies and greater collaboration between all three boards was also identified. A summary of findings is presented below.

PRIMARY AND COMMUNITY CARE

• Continued focus on recruitment and retention of primary care physicians is essential. The establishment of community health centres with an extended role for nurses in community settings should be pursued.

  Establish a long term plan to enhance mental health services in the region. All three boards and the Department of Health will participate in the development and implementation of this plan.

  Foster communication links between health providers.

  Enhancement of rehabilitation services.

SECONDARY SERVICES

• Two regional hospitals are required to meet the needs of Central Newfoundland residents.

  Both regional hospitals to continue providing the range of speciality services currently offered at each site.

  Establishment of a dialysis service at one of the two regional sites.

LONG TERM CARE

• Home supports and personal care homes are sufficiently meeting Level I and Level II needs.

  Some long term care facilities will require redevelopment in order to focus more on providing higher levels of care.

  Government feels further study is needed before determining exact bed numbers for the region.

REDEVELOPMENT PROJECTS
The consultant recommends that a number of facilities be redeveloped as part of the future planning for the region. Some facilities are considered higher in priority such as the James Paton Memorial Hospital and the Harbour Breton Hospital. Government feels further study is required before determining exact long term and acute care bed numbers for the region.

1) James Paton Memorial Hospital, Gander

• Redevelopment is required. The recommended role for this facility is similar to the current role.

  An inpatient psychiatric unit for this facility is not recommended at this time; an inpatient eight bed rehabilitation unit is recommended.

  The consultant�s recommendation is 94 beds at this facility, compared with 126 beds outlined in the current planning documents. The hospital currently operates 92 beds.

  Expansion is still required in order to create space for intensive care, operating room facilities and other specialized health programs.

  A contract has been awarded for the enclosure of the new structure. Any further announcements on capital will be part of the budgetary process.

2) Notre Dame Bay Memorial Health Centre, Twillingate

• Planning documents for this facility should be revisited.

  The consultant recommends 8 acute care beds and 31 long term care beds to meet local need as part of the future planning process.

  This is in light of increases in day surgery and a decreased reliance on acute care beds coupled with increases in community based services. Further study is required before determining exact bed numbers.

3) Harbour Breton Hospital

• This facility is in need of replacement as soon as possible.

  20 beds are recommended for the provision of ambulatory, acute and long term care.

4) North Haven Manor, Lewisporte

• This facility has historically admitted a number of residents requiring lower levels of care. Seniors categorized as Level I and II now generally seek care through home supports and personal care homes instead of nursing homes.

  This facility needs some renovations in the future to better meet the needs of residents requiring higher levels of care.

  The consultant recommends 40 Level III and IV beds will sufficiently meet needs into the year 2005.

5) Carmelite House, Grand Falls-Windsor

• Like North Haven Manor, Carmelite House is not ideally designed to meet higher levels of care.

  The consultant recommends this facility be replaced with a 50 bed facility.

6) Fogo Island Hospital

• This hospital should be replaced by the year 2006 with approximately 14 beds flexibly designed to provide both acute and long term care, as is currently provided.

7) Lakeside Homes, Gander

• The consultant recommends this facility remain at 118 beds, designed for higher levels of care.