Newmarket’s Southlake eyeing second hospital that could cost $2B

U of T expert says it's time hospitals reconsider how much they do

yorkregion.com
Aug. 24, 2021
Kim Zarzour

“When I first arrived here, this was one of the most crowded places I’d ever seen.”

Arden Krystal, CEO of Southlake Regional Health Centre, says she was shocked when she first took the helm of Newmarket's hospital in 2017.

“Walking into the teaching auditorium to see patients on stretchers and makeshift curtains -- it felt more like a MASH unit. That was concerning for me.”

Today, the situation is even more dire.

The communities served by the hospital -- Newmarket, Bradford, East Gwillimbury and Georgina -- are among the fastest growing and aging in Ontario, and Southlake is one of the province's most overcrowded hospitals.

With buildings dating back to the 1960s and 70s, the highest number of hallway beds in Ontario's Central region and highest medical and surgical occupancy among 21 large hospitals, Krystal says the time has come for a new Southlake.

"It takes a good eight to 10 years to build a hospital, so we need to get started now.”

Southlake’s master plan calls for two campuses: the current 19-acre facility at 596 Davis Dr., and another at a nearby 60 to 80-acre site.

The new hospital will focus on acute care with the kind of expensive infrastructure needed for overnight patients, and procedures that require more technology and specialty.

While the location hasn't been determined, it should be relatively close to the current hospital, Krystal says, to allow staff to move between sites, and there are some landowners in the area who have expressed interest in donating land.

'Chronically overcrowded' Southlake unveils new hospital plans

Southlake is aiming for 650 to 700 beds with additional growth capacity and an estimated cost of $1.5 billion to $2 billion in escalated 10-year dollars.

The older campus will be repurposed for a seniors and ambulatory (outpatient) care centre.

Sixty restorative care beds for seniors relocated to North York will be returned to Davis Drive and other ambulatory clinics in the area will also be moved here, Krystal says.

The Emergency department could become an urgent care centre and any extra space in the Davis location will be leased at low rates to Ontario Health Team partners such as home-care, mental health and non-profit care for seniors.

“It will be a great one-stop shopping experience for seniors,” she says.

Health economist Walter Woodchis says Southlake's plan makes sense.

The professor at U of T’s Institute for Health Policy and Management says it’s time hospitals like Southlake re-evaluate what it is we want them to do -- and if we still want them to do it all.

Most hospitals provide an array of services including emergency, surgical, ambulatory care and general medicine. Woodchis believes not all those services need to be in a traditional setting.

Emergency care -- serving those with severe and urgent needs who may require admission for more advanced care -- do belong in a hospital, he says.

Surgical care that requires overnight stays and the intensive care unit -- an in-patient admission for a bypass, for example -- also belongs in traditional hospitals, he says, but other surgeries could take place elsewhere, on an outpatient basis.

Fracture clinics, that focus on diagnoses or treatment, and general medicine (people with complex pneumonia, heart failure or exacerbations of chronic disease), could also be moved out he says.

The COVID@Home program has shown many people don’t need to be hospitalized, can be monitored at home and brought to hospital if their condition becomes serious.

“To me that’s the future,” he said. “With new technologies, new awareness, new standards, a lot of things can be done outside of the most expensive tertiary centres.”

Ideally, Woodchis says, Southlake would eventually transition out of the existing Davis Drive hospital altogether.

“The degree of infrastructure that goes into hospitals on ventilation, oxygen, pipes, electronics and digital backups is enormous and hospitals are very, very expensive.

“It’s all about how do we bring care closer to home? ... There’s a lot of reasons to think that turning to the ‘big blue H’ is not the best strategy ... Maybe we should make it a ‘big red H’,” he said, referring to the big red H as a hospital designed for urgent, acute care, while the big blue H is a more traditional hospital with all sorts of services.

It will discourage people from turning to the hospital first and encourage them to seek community-based, primary health care instead, he said.

“It requires a different mindset and support -- from government in terms of strategy, from physicians in terms of better use of their time, and hospitals being held to account."

Instead of being measured by volumes of patients, he says, there could be incentives for admitting fewer (to any hospital) while maintaining health outcomes.”

Asked about the province's plans for Southlake, Health Minister Christine Elliott's spokesperson Alexandra Hilkene said a project of this size and scale requires careful consideration and review to balance provincial fiscal priorities and community needs.

The government is increasing the hospital's operating funding for the third straight year, she said, with more than $10.3 million in additional operating funding starting in 2021/22 -- an increase of three per cent over the previous year.

“The ministry will continue to work closely with the hospital and Ontario Health to determine how short-term and long-term program and service needs can be met in alignment with capital planning needs.”