After decades of talk and countless meetings, it's finally happened. The provincial government's James Bay General Hospital and the federal government's Weeneebayko General Hospital have come together to deliver integrated health-care services to the 11,500 residents of the Hudson and James Bay coasts.
The new Weeneebayko Area Health Authority, better known by its acronym, WAHA, formally came into being October 1.
According to WAHA president and CEO Jim Harrold, the integration of the two organizations will lead to better health-care service for the widely scattered communities in the region.
"With two organizations, someone would go for treatment in Fort Albany and their record would be struck. Then they'd come down to Weeneebayko General Hospital and there'd be another record, but they wouldn't necessarily flow back and forth, and there was no way to access them if people didn't tell you about them."
There was also a considerable amount of overlap, particularly in support services such as finance, materials management and administration.
12,000 people
"There are only 12,000 people up here," said Harrold. "You don't need two CEOs and two boards of directors to manage that."
Health-care gaps also existed in some areas because each organization sometimes looked to the other to provide a service.
The Weeneebayko General Hospital on Moose Factory Island opened in 1950 as a 200-bed tuberculosis sanitarium. Currently approved for 32 beds, the hospital has full surgical capability, a lab, X-ray equipment and digital mammography. It houses a family practice clinic with 12 family physicians and has the equivalent of a full-time surgeon and anesthetist. It also provides support to two federal government nursing stations in Kashechewan and Peawanuck. Visiting specialists fly up from Kingston, which has a long-standing relationship with the communities along the James Bay coast.
The James Bay General Hospital in Moosonee, a stone's throw from Moose Factory Island, functions as a clinic with an emergency trauma room. It also operates two 16-bed facilities in Fort Albany and Attawapiskat primarily serving complex continuing care patients. The two facilities have some X-ray capacity and can take lab samples, but aren't equipped for lab analysis.
Distance
"The distance between Moosonee and Moose Factory Island in winter is a three to five minute drive on an ice road," said Harrold. "In summer, it's a five to 10 minute boat ride and in spring and fall, it's a 10-minute helicopter ride. We have people commuting daily to the island because this is the only place there are inpatient acute care beds."
Moosonee and Moose Factory have a combined population of approximately 5,000, split almost equally between the two.
In addition to delivering health-care services to six communities spread out over close to 1,000 kilometres of wilderness, WAHA is responsible for managing an inventory of 150 houses and a small fleet of boats to house health-care professionals and provide transportation to and from the mainland. It also spends a bundle on air charters and medivac services, ferrying patients, doctors and other health-care providers between Kingston and Moosonee and up and down the coast.
While big changes are in store for health-care services in the region, they will be markedly different from the changes that occurred as a result of a similar integration in Sioux Lookout, where a new 41-bed acute care hospital, the Meno Ya Win Health Centre, replaced two aging hospitals – one federal, one provincial.
Sioux Lookout serves 30 remote First Nation reserves, so the model there is based on federal nursing stations in each of the communities and a core facility for patients requiring additional care.
"Because we only have six communities, our model will be to try to provide as much service as we can in each community, so we aren't going to just have nursing stations," said Harrold. "We'll have inpatient beds in the communities to match the population and our ability to support them. This way, we'll be able to cut down on travel and taking people out of their community."
However, there will likely be some new facilities – Kashechewan will be at the top of the list, said Harrold - and some upgrades, which will be up to WAHA's board to recommend as part of a capital facilities plan.
Public health
Other changes affecting the delivery of public health services and tertiary referrals are also on the agenda.
"Management of immunizations, education and the social determinants of health fall outside the typical mandate of a hospital, but we think there's a need to strengthen public health and try to provide more resources and support in each community," said Harrold. "Right now, we're served by the Porcupine Health Unit in Timmins and the First Nation and Inuit Health branch in Ottawa and I don't know if that's the best model, so we will sit down with Ontario and Canada and figure out what's the best way to structure public health services in our area."
Reliance on Kingston as a referral centre for advanced care will also be reviewed in light of increased health-care capacity in Northern Ontario communities such as Timmins and Sudbury.
"Our mandate is to do what has to be done to make sure we provide the best service possible to improve the health of the people we serve," said Harrold. "If that means stepping into areas of public health and managing tertiary referrals, that's what we'll do."
