CEO defends need for merger between Scarborough, East General hospitals

CEO defends need for merger between Scarborough, East General hospitals. Friends of The Scarborough Hospital co-chairs Ed Castro, left, and Eden Garaj talk to residents Thursday, Feb. 9, at St. Paul's L'Amoreaux Centre about a possible merger between the hospital and Toronto East General in East York. Staff photo/MIKE ADLER

Wright explained his reasoning Thursday, Feb. 9, after doctors at both hospitals voted overwhelmingly to oppose a merger and a group of Scarborough residents demanded any plans be brought into the open.

At a meeting, the CEO, who has been involved in four hospital mergers, said he'd guarantee TSH's smaller Birchmount campus "stays exactly as it is," and added he sees no risk to "any essential programs" at either of TSH's General or Birchmount sites.

Wright said he got the idea last April when Mississauga's Trillium Health Centre announced a merger with Credit Valley Hospital, forming a "huge, powerful" institution west of Toronto.

The move was "absolutely brilliant," he said, because it let the Mississauga hospitals compete with hospitals on Toronto's University Avenue for big capital projects Scarborough has typically failed to get.

"Scarborough hasn't gotten its fair share and has been to some extent ignored," said Wright, adding he doesn't blame the province but feels Scarborough "could be as strong on the east as (the Mississauga hospitals) are on the west."

Adding to its problems is TSH's placement in the Central East Local Health Integration Network, a provincial bureaucracy that funds health-care institutions from Victoria Park Avenue to Peterborough.

The LHIN is moving some services to Lakeridge Health Oshawa, chosen as a centre of excellence for thoracic surgery, "and with them, the money goes," Wright told an audience of least 150 at the St. Paul's L'Amoreaux Centre.

"You in Scarborough, you don't get that service. You're not going to Oshawa. You're going downtown," or to Toronto East General, where 22 per cent of patients are "Scarberians," Wright said.

"We are vulnerable in Scarborough to some of our budget going east while our patients end up getting service (to the) west."

TSH has plans of its own for a cancer treatment centre and wants long-term leased space for its chronic renal patients in a Bridlewood community hub.

But Wright said budget pressures over the next three years could force TSH to consolidate programs between its two sites. While hoping for a one-per-cent budget increase, the hospital may receive zero while its costs rise by almost three, he said, requiring cuts of several million each year "just to tread water."

A merger between TSH and the "culturally similar" East General - its CEO, Rob Devitt preceded Wright as a provincially appointed supervisor of TSH, so for a time Devitt ran both hospitals at once - is meant to "minimize" any program closures, Wright added.

"We want to lever the things he does well and we do well" to improve patient care across the board, said Wright.

The hospitals have jointly paid a consultant as much as $90,000 for a report Wright said is not yet finished.

Dr. Robert Ting, president of the TSH medical staff association, said doctors don't see an urgent need for a merger and are "quite opposed" to the idea. Voting in a staff survey ran 89 per cent against, he said.

Doctors at both TSH campuses feel the merger between Scarborough General and was then Scarborough Grace (now Birchmount) hospitals in 1998 "was very disruptive" and never produced sizable savings, Ting said, noting physician morale at TSH "has been quite bad for some time."

The East General staff is even more opposed to a merger, voting 96 per cent against, Ting noted.

"They like their hospital the way it is."

Wright acknowledged a merger would have little appeal for doctors, but argued they "work with one patient at a time" and are not trained to understand the health care system as a whole.

"My job is to make sure there still is a Scarborough Hospital in 10 years," he said, saying that though the merger of the General and the Grace was not managed well, it was successful because both remain full-service hospital sites today.

A merger with the East General means layoffs but there will be layoffs regardless, said Wright, adding, "there will probably be more layoffs if we don't (merge)."

One of those jobs cut in a merger will be Wright's, he pledged. "I will be gone in a maximum of 18 months. I'll be the first to go."

The TSH Community Advisory Committee first heard of the hospital's interest in a merger in August, and has discussed it several times since, its chairperson Karen Gordon said.

But despite Wright's insistence the advisory committee "is the public" and that anyone can attend its meetings, Friends of The Scarborough Hospital co-chairperson Eden Garaj told the CEO he was disappointed in the hospital's approach, since few residents not on the committee knew about a possible merger until alerted by a report in The Scarborough Mirror.

"A hospital merger is not just a corporate exercise but has real consequences on the services you receive," Garaj said.

Another public meeting on the merger is scheduled for 6:30 p.m. on Feb. 29 at the East York Civic Centre.