Health integration looks good on paper...

Some things look good in theory, but can only be put into practice by a process resembling carnage.

A case in point is the concept of regional health care integration Paul Huras, chief executive officer of the South East Local Health Integration Network (LHIN), put forward at an open house last week.

“We want seven hospitals working in a viable way but working as a regional system of integrated care,” said Huras.

When asked what that could mean for Brockville General Hospital, Huras was understandably vague, but reassuring.

“There may be changes to the hospital, but we expect it to be vibrant. We expect it to be a major component of the health care system in the Southeast and a major component of the hospital system,” he said.

“There could be changes to the services, but it’ll be as strong as it was, as it is today and hopefully stronger.”

Regional health care integration is a tidy concept in theory. Provincial health funding is either not increasing at all or not increasing enough, depending on how you break it down, yet the health needs of an aging population are increasing and will continue to increase.

The solution, then, is for hospitals to pool their resources and work together.

It looks good on paper, as I said, but then there are plenty of things that look good on paper, including, at least to some people, the Minsk ceasefire accords.

But the coming months will dredge up the messy details of the work needed to move that reality from paper to practice. And people will soon realize that, to make a regional health care omelette, you have to break some eggs.

A small but significant detail of last week's open house was Huras again confirming that he had heard talk about reducing BGH's maternal-child unit. (It's at 2:53 in the video, although, to be fair, Huras does not specify whether reduction or elimination was proposed.)

That was before the maternal-child issue broke out onto social media and BGH officials had to reassure the public they were not shuttering the maternity ward.

For any integrated regional plan to work, however, there will have to be reductions in services here as well as in other hospitals – if not maternity, then something else.

Will it mean changing the concept of a “full-service hospital,” caring for people from cradle to grave, into something resembling a full-service regional hospital system?

If so, will regional economic development, which considers a full-service hospital critical to luring jobs and people here, be able to adapt this vital piece of infrastructure to a broader definition?

Or will communities have to fight harder to draw red lines around local services, such as maternal-child, that they refuse to see eliminated?

The lack of provincial funding will place some significant limits on where those red lines can be drawn, but there will likely still be some drawing of lines. A greater level of participation at last week's meeting would have been a helpful start.

Because, as we have stated before, the time to start talking about those red lines is now.