What's Wrong with Healthcare?

Thinking inside and outside of the healthcare box. After 41 years of family practice, what's happened to Canada's healthcare system?

Saturday, July 21, 2007

Building Shrines, Calgary's South Health Campus

A few weeks ago I attended a presentation pertaining to Calgary’s “South Health Campus”. Now for those of you that are not familiar with Calgary’s hospital history, a hospital was planned for Calgary’s South East Quadrant at least ten years ago. This hospital was to be less than 400 beds and would come in at an estimated cost of less than 400 million dollars. Since that time, there has been much in the news media about the soaring estimated cost of this health facility, some reports estimated as high as 1.2 billion dollars. The blame for this has been attributed to Alberta’s overheated economy and rising construction costs. I was considerably enlightened by the presentation (I suspect much of the increased cost has been from expansion of the “vision”)!
Firstly, as one might surmise from the politically correct title “South Health Campus”, this “hospital” has turned into a shining example of the province’s and the Calgary Region’s vision of healthcare, and of course, a reflection of ego and the need to build edifices unto one’s self. The concept itself is quite acceptable. Calgary is in dire need of both out patient services and more hospital beds. However, this proposal has a very aggressive out-patient intervention facility, educational component, research component, and an in-patient facility that covers a broad range of services in a location that for most aging seniors, the poor, and many of the chronically ill, is not accessible. The concept is commendable; the location of the outpatient services and some of the other services, disastrous. The hospital aspect of the project is great, with a wide range of in-patient services suitable for a growing community. In particular they have provided for in-patient pediatric beds, an active maternity department and in general, everything that was once considered to be a “general hospital”. Kudos to the planners with regards to the acute treatment facilities; strike one on the large out patient aspect for the infirm and chronically ill in a location that is unaccessable.
Let me re-iterate. My problem primarily lies with the huge resources and facilities for out-patient services IN THAT LOCATION.
The presenter listed the “drivers for change”:
1) Growing and aging population
2) Increasing chronic disease
3) Safety issues
4) Workforce shortages
5) Emphasis on wellness
6) Patient and family expectations
7) Public expectations
The goals of this project were then listed:
1) Enhance capacity
2) Develop new models for care:
a) Patient and family centered
b) Quality and safety
c) Efficient and sustainable

3) Integrate care across continuum
4) Promote wellness
5) Attract outstanding professionals
6) Build a versatile/flexible infrastructure
7) Create a culture of innovation
8) Centre for education and research
9) Empower and connect the community.
From my perspective gathered from years of community practice, the aged and the patients with chronic disease have the greatest need for out patient and in patient healthcare services. Unfortunately, they are also among the most IMMOBILE people within our society.
The Deerfoot Trail is the major roadway servicing the proposed “South Health Campus” from the rest of the city. The Deerfoot trail was designed for 100,000 cars a day. My understanding is that, at present, 150,000 cars a day are on the Deerfoot Trail. The facility is projected to be completed in 3 to 4 years. By then the Deerfoot will probably be handling 200,000 cars a day. Any suggestion of help from a leg of the C-Train is at least 20 or more years away. Access to health care in Alberta and Calgary has been the number one problem to date. In order for our aged and chronically ill to access these new innovative resources at the South Health Campus, they will have to traverse the Deerfoot Trail. Is this some kind of “survival of the fittest” scenario? Good Grief!! And how do we envision the poor accessing transportation to this facility? Will the city expand its handibus resources tenfold?
The Region justifies the location of these out-patient services by declaring “availability of land”. News flash!! There is even cheaper land farther out!!!
The bottom line is that, like all successful ventures, it is location, location, location. Without access to these out-patient facilities, the development becomes a government shrine of their “vision” of healthcare, but a “white elephant” to the people that really need the services. Out patient services are essential part of our healthcare system, but they must be located as close as possible to the communities that require them.
Educational services can be very helpful to specific groups within the city of Calgary; however, education needs vary (as other needs do) tremendously from community to community. The ethnic and new immigrant communities of Calgary would benefit from many of the services proposed at the Health Campus Site. Could some of these resources be placed at the Peter Lougheed? It is certainly more accessible than the extreme South East Quadrant of the city.
Many of our nursing homes are located in older communities. How aggressively have we looked at forming public/private partnerships in providing these services from these sites (Lacombe Home also has abundant land)? There has been talk of public/private partnerships in Acute Care, Education, etc. How about out-patient care at nursing home locations, or perhaps some of the old school sites that have been abandoned (they are in aging community locations).
Review again the drivers for change and the identified goals as stated previously; and then apply each to extensive-out patient facilities at this location. Surely we need to rethink that aspect of development before another healthcare blunder is made in the Calgary Region similar to selling or demolishing existing facilities before replacements are built. Strike two on the planners.
I understand research is important. I understand also that Edmonton is building a “Mayo Clinic” type facility at a cost of ONE BILLION dollars (and I’m told this will only add 125 acute treatment beds). How much overlap is occurring between these two facilities? Is Edmonton also putting the needed community services in the wrong location (out of reach) for those that need them? One of the goals listed is “empower and connect the community”. You can only do that within the community.
In a previous blog I stated (with tongue in cheek) that we save enormous healthcare costs by outsourcing all our surgeries and other expensive procedures to India. I apologize to the people of Calgary if, somehow, this idea was taken up by the South Calgary Health Campus planners and the provincial government, who seem to be outsourcing all those services that should occur in communities, to the extreme Southeast corner of the city. Strike three for the new “vision”.

4 Comments:

Anonymous Brian said...

Hello. There's a plan to build a more expensive white elephant than this in Oakville (just west of Toronto). Can you refer me to updated information about the Calgary 'hospital', especially cost, size and how it is funded (did the City of Calgary pay a chunk?)? Brian
brianhopkins2@sympatico.ca

13/4/10 9:04 AM  
Anonymous kamagra said...

Interesting, This remembers me once when we wanted to make a urban legend in the campus and we made a little research about some kind of fact, at the end we made but the story that we "invented" seems to be truth...

14/4/11 8:16 AM  
Anonymous Buy Generic Viagra said...

this looks fantastic and I can't wait to try it out. Also just wanted to say that I love your blog and have been reading it a lot recently!I think that this city is really good!

7/6/11 8:51 AM  
Anonymous Anonymous said...

Are you high? This project has an estimated 44 acres of needed land. do you have any other suggestions where this type of land is vacant and avvailable. Also if the deerfoot is the main vein of the city what's the problem?

2/8/11 10:20 AM  

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