Reader offers more information about the CT scanner for Kincardine hospital

To the Editor:
RE: “New CT scanner selected for Kincardine hospital”

I know some background to this “good news story” and I want to share what I know with you, and your readers.

Your platform has served as a source of public accountability and I have to openly vent about the information of which I am aware. I may be compromising some level of confidence among previous colleagues and acquaintances, but I just cannot understand “how” or “why” some information can easily be optically distorted.

The CT scanner project is a decision that we – as a community - need to live with for the next 15-plus years. The decision needs to have the best interests of the Kincardine community at heart, and I feel nauseous about how this process has unfolded and what I view as underhanded gamesmanship on the part of Michael Barrett (president and chief executive officer of the South Bruce Grey Health Centre).
 
This is a contentious matter and there is history that I feel I need to provide for added context.

Approval for this CT project did not come overnight. This has been an arduous process that has been led by the Kincardine Physicians Group, specifically Dr. Gary Gurbin. It is no secret that the physicians have been advocating and endorsing a CT scanner at the Kincardine hospital – it makes sense on so many levels and locally, the business case has been sound.
 
If history serves me well, my recollection many years ago while Mr. Barrett was CEO of the South West Local Health Integration Network (LHIN), he was not supportive of a CT application for Kincardine. When he arrived at the South Bruce Grey Health Centre (SBGHC) after parting ways with the LHIN, he found himself at the final stages of the ministry’s CT scanner approval process – for Kincardine!

Shortly after Mr. Barrett arrived as interim-CEO at the SBGHC, in a February, 2019, press release, he stated ‘Kincardine has the highest demand for CT scans from emergency department visits and inpatients across the four sites of SBGHC. In addition, SBGHC is currently incurring significant costs to transfer patients between Kincardine and Walkerton when a CT is required.’

The community appreciates the hard work of the Kincardine and Community Health Care Foundation – it has a healthy reserve fund from a generous community – again, mostly raised by the local community. The foundation is not a political organization. It does amazing work, and it should not be for the foundation to have to take a side on the preferred option – it needs to remain neutral and supportive of any approach from an arm’s length and financial perspective.

In some of my conversations with members of the hospital foundation, they have said the foundation will support the CT project on any level for Kincardine – they just need to understand the business case, community need and the financial request. They want to work co-operatively with the hospital board and also recognize clinical decisions should be left to those who depend on the specialized equipment to provide the best images and results for the physicians so they can provide appropriate and timely diagnosis, care and treatment.

My understanding from some members of the Kincardine medical establishment is that they are appreciative of a CT scanner for Kincardine – it has been long overdue.

The current approach Mr. Barrett and the hospital board have decided, would expose a patient to a CT scanner that would not provide as much detail in terms of dissection quality when using dye-contrast (100 images versus 200-plus) and would emit a bit more radiation than would be necessary for the same test under the preferred option being recommended by the physicians (CT-Drive) versus the model Mr. Barrett and the board have just approved (CT-Edge).

What was mentioned to me by some members of the diagnostic departments across SBGHC, is that the CT scanner Mr. Barrett has recommended to his board to purchase would be of acceptable quality if Kincardine were looking for a short-term CT solution, pending a different model. What I mean is that the CT scanner just announced, would be great for use if we needed a CT for not much longer than five years, while the model the physicians are recommending would provide minimally 10 years.

When I had conversations with the hospital staff about the CT scanner, it was mentioned the CT-Edge is a lesser model than what is in use in Walkerton – a less busy site than Kincardine.

At the Dec. 7 Kincardine council meeting, a resolution was approved, stating that council supports the Kincardine Physicians Group, and encourages the SBGHC board to respect the understanding of council and the physicians in the discussions that have surrounded the Kincardine site CT to date. To that, the broader community has been aware of this approach from presentations by the medical community to Kincardine council.

At the Dec. 14 council meeting, mayor Anne Eadie, in response to councillor Bill Stewart’s request for an update on the CT project from the hospital board – following a letter the municipality sent to the hospital board - Eadie shared with council that Michael Barrett reached out to her, requesteing a delegation to council to provide his side of the story related to the CT scanner project.  

The mayor went further to add salt to the wound, mentioning she learned of the request within the previous week, didn’t have time to update members of council before the meeting and actually forgot to pass along the information for follow-up to the clerk’s department. Such a classic case – YET AGAIN – of the mayor gatekeeping information from council and acting in her own vacuum. This was clearly a surprise to members of council.

A few days later, the hospital issued a press release announcing the "good news story" of the hospital’s decision to move forward to acquire the CT-Edge – the option not being recommended or endorsed by the medical community locally.

I can also add that the hospital board’s recent decision was not done in consultation with the physicians leading this initiative and research, and has caused concern over accountability of the hospital’s CEO. This project has been led by the Kincardine physicians and supported by specialty physicians consulting on the CT application.

Drs. Gary Gurbin, Jason Murray and Daniel Soong and other specialty physicians have been leading reviews of best CT scanners and consulting with the CT vendors and academia, to understand the best CT approach for Kincardine.

The decision for Mr. Barrett to move forward with a recommendation to the hospital board over such a significant expenditure that has been in the works for more years than he has tenure, is unbelievable. He initially supported the preferred approach and against the grain, and at the last minute, took it upon himself to advise the hospital board to proceed with the ET-Edge – knowing full well that this has been a contentious matter, locally. This aggressive action did not need to occur and could have been paused, pending more discussion to understand the rationale to counter the CT-Drive in a transparent manner.

It is disappointing that the hospital board would have approved this approach, knowing transparently that this was a deviation from the general understanding of the community, the municipality and the physicians group over the past year or so.

I call on the hospital board to intervene and pause the recommended approach and engage in a meaningful way with the physicians leading this approach, who are best positioned to advise on the best treatment outcomes and needs of our community.

At the end of the day, this very well may just be the position of the hospital board, but the responsibility of advocating for our OWN health care and health-care needs is not the board’s role, that is our role as members of the community.

I really just cannot convey my level of disappointment with the hospital board and Mr. Barrett over this underhanded and short-sighted decision that feels as if it has slapped everyone in the face.

I support Kincardine council – as a local stakeholder in the hospital redevelopment process, who has provided funding to the hospital to advance the hospital’s redevelopment application plans, to try and get involved on behalf of everyone. Clearly, the hospital board is not representing the community very well - so how do we influence local political pressure?

I hope this helps provide some clarification from my perspective and I hope you are able to share this with your readers.
 
Marta McBride
Fergus
Seasonal resident of Kincardine