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Canadian Rural Partnership
January 23-24, 2001
Chapleau, Ontario
ANNEX B COMMUNITY ORGANIZATIONS' PRESENTATIONS
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Presentation 7 Chapleau Health Services
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Representatives: | Gail Bignucolo, Financial Officer
Richard Bignucolo
David Bronicheski
Mary Boucher (Sudbury and District Health Unit) |
| Date: | Wednesday, January 24, 2001 |
Chapleau Health Services has a catchment area of approximately 3,500 people, and it is the only health care provider for Chapleau residents. The Chapleau General Hospital was built in 1976 to replace an aging existing facility. In April 1994, the hospital assumed responsibility for long-term care and formed SSCHS (Services de santι de Chapleau Health Services). In April 1995, SSCHS was designated as a "Multi-Service Agency".
Currently SSCHS has 39 beds 20 acute and 19 long-term and a total budget of $6 million ($3 million for the hospital). Funding is currently received from 11 separate sources, eight from the Ministry of Health and Long Term Care as well as the Ministry of Community and Social Services, the Ministry of Housing and the Northern Diabetes Health Network. SSCHS is a major employer in the region, employing approximately 100 people.
The hospital has developed a number of partnerships:
- Sudbury Regional Hospital (computer information system; radiology services)
- Sault Area Hospitals (pharmacy services)
- NE Ontario Regional Cancer Care Centre (chemotherapy clinic)
- Sudbury and District Health Unit (healthy babies program)
- University of Toronto (geriatric program)
The community issues affecting the health status of the population include:
- Geographic isolation
- Aging population
- Limited recreation facilities
- Limited social and cultural amenities
- High cost of education due to travel requirements
- Lack of public transportation to major cities for access to major health centres
The following are five specific challenges that SSCHS faces:
Accessibility of service. Chapleau's isolation makes residents' access to full range of medical services difficult. All specialized services are out of town. The community needs visiting specialist clinics.
Provision of cost-effective services. Higher operating costs in the North (heating, hydro, travel, training and education) are coupled with a lack of economies of scale (economic order quantities, optimal staffing ratios, regulatory reporting requirements - very detailed; must meet same reporting requirements as large urban medical centres). In addition, the lack of specialized consultants results in longer hospital stays, since diagnosis and treatment may take longer in many cases.
Implementation of new technology. Tele-health was launched in 1999 to facilitate physician education and specialist consults. Unfortunately there is a lack of operating funding for higher speed connections. SSCHS purchased PACS (digital imaging technology) equipment with funding from NOHFC. However, operational funding is required for connection to a major centre.
Physician recruitment. The community is designated for four physicians but has only two. The loss of one of them would likely result in the loss of both, since the remaining physician could not possibly be available seven days a week, around the clock. The current fee-for-service compensation system has not helped retention, especially for emergency or on-call services. An alternate payment plan for emergency services seems to be helping. Generally, there is a lack of available funding for recruitment incentives (i.e. salaried physicians, signing bonuses, etc.)
Health professionals recruitment (nursing and allied health). Chapleau is not attractive to new graduates and is usually only considered by those born or raised in the area. Due to the small number of health care professionals, there is a lack of peer support, further heightening isolation. Professional development opportunities are extremely limited and there is a severe shortage of attractive rental housing.
The SSCHS put forth a number of possible solutions:
A streamlined funding process. Block funding for all health care services provided by Chapleau Health Services would eliminate excessive bureaucracy. The transfer of funding from Sudbury CCAC for Chapleau to SSCHS would improve local case management and assessment. Transfer of funding for an Addictions Counselor for Chapleau from the Algoma Health Unit was also proposed. This service is presently contracted out of town because of the funding arrangement.
Improved medical staff recruitment. Since it is extremely difficult to recruit graduates from Southern Ontario or other parts of the country, creating a medical school in the North would be an excellent tool in attracting future medical professionals to Northern Ontario. It would also allow Northern Ontario youth interested in medical careers to remain close to their home communities. This would greatly enhance the chances of attracting and retaining much needed medical health professionals.
The representatives suggested that something like a "Northern Allowance" should be made available to allied health professionals who are willing to work in under-serviced areas. Additional funding for visiting specialists was also requested. This would cover the costs of visiting specialist clinics, surgeon(s) and anaesthetist(s) for elective day surgery and non-medical specialists and locums (i.e. geriatric psychologist, rehab professionals, etc.)
Improved linkages to other communities. The SSCHS requested additional funding for improved and expanded tele-health services and improved transportation links (public ground transport to Sudbury and Timmins and continued air transport in Chapleau).
Small hospital funding formula. The funding formula needs to address the lack of economies of scale and the increased costs associated with isolated, small rural communities. The funding formula needs to ensure all factors are taken into account, including recognition of native issues.
The SSCHS acknowledged that much of their concerns are under the jurisdiction of the Ontario Ministry of Health but felt that the Northern Rural Team would benefit from a complete background on the state of health services in Chapleau. It is the hope of SSCHS that the Team could possibly effect changes on the indirect issues such as telecommunications and transportation that affect the delivery of health services in the Chapleau area.
Mary Boucher, the Sudbury and District Health Unit representative, profiled some of the factors that are affecting public health in the Chapleau area. Specifically, she addressed the lack of adequate public transportation facilities, lower rates of computer usage, high rate of tobacco usage, lower education rates and limited recreational opportunities for youth.
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