Phillippa from CAMPP posted some comment yesterday in response to my post and I tried to post this in the comments of my last post “What’s Wrong with these Graphs” but it wouldn’t work (to long). So I gave it its own post. I apologize for poor writing as I wanted to get this posted to continue the discussion.
Thanks for the comment to respond to some of your comments.
I don’t have an issue with additional consultation but my question to you is would be how much consultation is “far more”? What is the threshold for your approval? As you have said in a number of posts/comments elsewhere there will also be those who are unhappy with a site. In my opinion, there is a fine line between informed questioning and obstinate resistance regardless of facts. To my knowledge I have not seen a post that states if the Hospital Committee provides X, Y, Z that CAMPP will be satisfied or if they consult 3, 5 or 7 more time that will be enough. As I said in my post, I would have liked to have seen the hospital in the city core, but my opinion has changed based on information that I have seen and heard. Under what scenario would you accept the hospital at the location that it is currently proposed?
It comes from that lack of articulation of an “end game” that the perception of “anti-county bias” and rabble rousing emerges in my opinion. The majority of your posts and commentary are about Windsor, there is nothing wrong with that given your position, but given what is being established is a regional hospital system your failure to include county perspective is a fundamental flaw. You say that: “the best location for our new acute healthcare facility is one that balances aggregate city and county needs, access being the most important.” That’s great but your data hasn’t proven that this location is bad or another location is better because you haven’t fully included the county in your analysis. By not including parts of the county for whatever reason, you create the impression that they are not important to your view or that you are selectively not including information because it does not support your hypothesis. That plants seeds of doubt in the minds of those undecided on this issue. It gives the impression that you are just another one of these groups who are looking to rouse rabble over a non-issue – as per that letter in the Windsor Star and give the Hospital Committee an excuse to not directly to respond or disregard your commentary.
I am not disputing the numbers that you presented, I completely expect that for some residents the cost to take a cab to the new hospital will go up and my numbers came within a relatively close margin of error to those that you posted. My issue is using Taxi cabs costs as justification of decision making when the facility is still 10 years away without quantifying it. CAMPP has offered 3 other “potential core sites” on their website what are the taxi costs to those sites in the city from the centre of the wards and county? Where is your threshold for acceptance of costs for low income individuals? An additional $10, $20, $30? If it costs $40 for someone in Ward 2 to get the Ford Test track site, is that too much for them to ask? Where is your line?
What I do completely dispute is your County claim. Lack of transportation is a massive barrier in the County and due the failure to establish some form of regional transit for many a cab is the only way into the City. There is a reason that St Clair College is running its own special shuttle bus to the Leamington and Lakeshore to provide students with transportation options or that Sutherland Global Services is looking to launch a “Job Bus” so it can hire people from the county and bring them into the City. South Essex Community Council, Life After 50 and ACCESS Community Services provide a senior shuttle to Windsor for $25 from Leamington and Kingsville from their own program expenses so County Seniors can access the city for socializing, shopping and other services. I have seen and heard the impacts of lack of transport options in the County as people with low income and no car can’t find work, have trouble accessing nutritional food or getting health care. As far as I am concerned any evaluation of Windsor-Essex County that doesn’t include the entire region is fundamentally flawed. For you to disregard a point of view without offering evidence does undermine your position in my opinion.
Aggregate Distance Traveled
I completely disagree that it is an under representation. The number of Emergency Department visits (from the entire region and beyond) being 128,000 per year do not justify your calculation of total people in each ward multiplied by distance traveled in a round trip than subtracting the nearest hospital from the mega hospital site. That isn’t a statistically controlled method as it doesn’t re-weight any jurisdiction all you have done is divide the population into their respective wards, multiply and add. A way it could be done is taking those 128,000 dividing that number by the population percentages of each jurisdiction and then using those numbers as the basis to calculate for the distance traveled.
I did select only discharges because the admission (and subsequent discharge) count many of the items that you list in your rebuttal. You must be admitted for almost any surgery, critical emergency cases or severe broken bones i.e. things that require acute care. Many of the minor fractures a broken arm or ankle; or going for an blood work, diagnostic tests or other basis treatments that don’t require admission could very well be provided by a visit that the downtown Urgent Care centre depending on its exact size or scope. Yes the regional cancer centre will be at the new acute care centre but I would point out that there is currently only one cancer centre in the city. If we are measuring the distance to cancer treatment you should recalculate all of ward distance calculations to the Metropolitan campus location rather than the nearest hospital. Also for cancer patents, there is a $100 dollar volunteer shuttle service that will pick you up at home, bring you to your treatment and then drive you back home for your entire cycle of treatment. The main issue is that because you are not specific enough about what service we are measuring you seemingly are listing statistics and services that people MAY need to access at some point in time at that site without taking into account other factors. As a result it does not justify the statistics that your graph presents.
Frankly I think the best statistic that comes from the Windsor Regional Hospital stats is the length of stay after Acute Treatment/Surgery – 5.9 days.
Distance from City Hall
First if you had population density information that is properly cited and presented than it doesn’t matter if it appears biased it is potentially powerful piece of information, assuming your methods are sound.
From a planning standpoint I understand why you did it, City Hall is a “central point” in most cities but not in Windsor. As our local politicians and WEEDC like to say Windsor has a unique geography, and if you are going to use planning principles to justify your measure than you should be taking that geography into account. Either compare us to other border/water side community so you are comparing apples to apples or use another measure.
Yes some of the 4,000 jobs will move out to the airport site but again there will still be 3 other sites that will be staffed by hospital staff in the city. The Tayfour campus footprint will be expanded for the dialysis unit (with new hiring) and the Urgent Care Centre and Mental Health facility on Ouellete will keep a presence (in fact an enhanced presence in the downtown. Beyond that the Land swap (Grace for Met.) will likely see commercial/residential infill on Tecumseh road in South Walkerville. Overall to estimate the impact of those changes are impossible at this stage in the game, we are 10+ years out from all of the facilities being open, probably another 5 before all of the ripple effects move through the region, if you can predict what the region will look like afterwards, I think you should by a lottery ticket.
It cost $45 to be moved by land ambulance for medically necessary services for an Ontario resident with OHIP, with low income individual being able to have that fee waived. Sickeningly in some cases it may actually be cheaper to wait and get sick to the point that an ambulance is needed rather than take preventative steps of going to the hospital (assuming they had to take a cab). Whether people actually do this I can’t and won’t assume but to make the claim that for profit Taxi cab cost bare any relation to the cost of a publicly funded service that saves lives is not a valid claim in my opinion.
If you want to figure out what ambulance services cost you can, but you will need to do some leg work to do it. Most of the data is freely available it is just a question of tracking it down. If you aren’t willing to, than don’t make associations that you do not have facts for.
This biggest issue in my opinion with everything that has been discussed here and beyond is that your use of data has been flawed, lacking proper clarity and vague assumptions. Even here your arguments have been contrary: you state that the Cab Costs calculation is justified by the fact that low income individuals may not have cars to drive to the new hospital. Then in the next section you calculating the mileage assumes that every person in the city will drive to new hospital site. These flaws undermine your overall argument and position.
The problem is, that the hospital issue will not be settled on Facebook with a graph and two paragraphs, it will be settled in a formalized manner. The hospital committee has sent its plan and recommendation to the province for approval. Now yes as private citizens we don’t have all of the information that the committee had access too, unfortunately they aren’t under any obligation to share it. We will never get patent data as medical records are some of the most tightly controlled data in Canada. But there is a wide range of freely available data from Statistics Canada, Health Agencies and Research organizations to engage on vital issues and force responses.
If CAMPP wants to truly change minds it needs to formalize its process. What is needed is an alternative plan. Social media is a tool to rally action but not a tool to carry out change in the face of institutional barriers. What this means is some sort of plan that outlines CAMPP alternative to the Mega-hospital site. What site do you suggest as an alternative? How does it stack up to the Mega-hospital site? What about to potential obstacles (NYBISM, helicopter landing needed, infrastructure improvements required) does the alternative location need to overcome? Can you estimate possible socio-economic spinoff benefits from your choice of alternative locations? In other words can you take the majority of arguments that can be made about the existing plan and in a single cogent document and provide a viable alternative there might be something to stand on.
I unfortunately can’t and won’t speak to my employers’ position or their willingness to share data on my personal blog. You are more than welcome to submit a request and I am sure a discussion can be had.