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It’s Time for a Judicial Review of the Minden Hospital Closure

Haliburton Highlands Health Services (HHHS) decision to permanently close Minden Hospital (“Minden ER”) with only six weeks’ notice and no stakeholder consultation has severely impacted Haliburton County.

The decision was made by a very small group of people with little regard for those most affected: the patients, residents, and communities of Haliburton County and surrounding areas. This isn’t just about losing an essential health service; it’s about the decision-making process and whether it adhered to proper protocols.

A judicial review is not just needed; it’s necessary.

A judicial review involves a legal examination of the decision-making process. It’s like asking a referee to review a questionable play. Did the decision-makers at HHHS follow the rules? Were they fair? Did they consider the impact of their decision on our community? A judicial review can help answer these questions.

One of the biggest concerns is the lack of community involvement in the decision. The recent Ontario Ombudsman Report, which deemed an April 27th meeting between HHHS and Haliburton County illegal, is one of many glaring examples of a broken process. The meeting was intended to discuss the rationale for the closure. By holding this part of the meeting behind closed doors, Haliburton County broke the law — as per Paul Dubé, Ontario’s Ombudsman.

The closure of Minden ER wasn’t just poor communication; it was a failure in governance. In a democratic society, people affected by such significant decisions have a right to be consulted. As the NDP’s France Gelinas has pointed out, there are laws in this country for a reason. The Ontario Not-for-Profit Corporations Act, the Excellent Care for All Act, and the Canada Hospital Act come to mind in particular.

Furthermore, there are questions about the financial management at HHHS. The deficit trend in FY23 cannot go without scrutiny. Additionally, board meeting reports of funding delays and their impact on the hospital’s finances must be examined closely. Our team has written extensively on these topics.

From our year-long, 10,000-hour volunteer research, analysis, and advocacy effort on the permanent closure of Minden ER and the financial health of Ontario hospitals, we discovered alarming trends:

  • For FY22, 25% of Ontario hospitals (33) posted a deficit, with an average deficit of $545,000 and a total deficit of $17.9 million.
  • For FY23, 75% of Ontario hospitals (102) posted a deficit, with an average deficit of $5.9 million (992% increase) and a total deficit of $610 million (3330% increase)
  • FY24 projections indicate the number of hospitals in deficit will increase to 90%. FY24 ended March 31, 2024, but financials typically take until June/July AGMs to come out. Early indications show six hospitals with 40% of the deficit level ($221M) of FY23 – which is quite concerning.

Was the permanent closure of the ER the only solution? A judicial review can investigate these issues, analyze the numbers, and determine if other viable options should have been considered. This is especially relevant given that Minden ER is one of the few hospitals worldwide, let alone in Canada, to close permanently.

Another critical aspect is the role of the CEO, Board, and Ministry in this scenario. Did they fulfill their responsibilities? Were they transparent and accountable in their decision-making process? A judicial review can uncover these crucial aspects.

West Grey Files for Judicial Review of Durham Hospital Closure

A similar situation in West Grey underscores the necessity of a judicial review. West Grey has filed an application to the Ontario Superior Court of Justice, asking for a judicial review of South Bruce Grey Health Centre’s decision to move Durham Hospital’s inpatient beds to other communities.

The municipality has also declared a State of Emergency, with Mayor Kevin Eccles emphasizing the critical need for immediate provincial intervention to maintain essential healthcare services.

The application for a judicial review by West Grey argues that there was no consultation before the decision to reduce the emergency department’s hours and move the beds. It also claims poor management and recruitment led to the severe nursing staff shortage. The arguments presented highlight the procedural unfairness and unreasonableness of the decision, strikingly similar to the concerns we have with the closure of Minden ER.

Ultimately, this is about more than just an ER closure; it’s about our rights as citizens to have a say in decisions that significantly affect our lives. It’s about transparency, accountability, and fairness in our public healthcare system.

As a community, we deserve answers regarding the decision-making process to close Minden ER permanently. At this point, a judicial review appears to be the only way to get them. It’s our society’s only chance to learn from these mistakes collectively. Perhaps what would be best is to join forces with all communities experiencing healthcare facility closures. We’re all in this together, and we all matter – or none of us do.

In solidarity,

Minden Paper

Additional links:

http://mindenpaper.com/hospital-funding
http://mindenpaper.com/standing-committee
http://mindenpaper.com/deficits-ontario-hospitals-and-you
http://mindenpaper.com/letter-to-ontarios-auditor-general/


8 questions for the Conservative government

Our team has 8 questions to ask Conservative MPPs, especially Deputy Premier Sylvia Jones, our Minister of Health:

  1. How many hospitals posted a deficit in FY22, FY23 and FY24? What was the average deficit in each year for hospitals in deficit, and what was the total deficit for hospitals in deficit?
  2. How many budget waivers were issued in FY22, FY23 and FY24? Was each budget waiver request accompanied by a recovery plan?
  3. Can you explain why one hospital has a greater surplus than every other hospital with a surplus combined? Moreover, how can Mackenzie Health post a nearly 94-million-dollar surplus (enough to cover the deficits of 67 hospitals with money to spare) while so many other systems are literally bankrupt?
  4. Why do 42% of boards not post their minutes online? Additionally, of the hospital boards that do post their minutes online, why are so many out of date – and why do they all use different formats with different levels of disclosure? (note: we audited every hospital’s board minute pages to determine their due diligence in this context).
  5. Why is there no financial reporting standardization across hospitals in Ontario? Our analysis of every hospital’s audited financial statements indicates tremendous variance in how monies are accounted for / reported on. This makes comparison across hospital systems essentially impossible as the data is basically “apples to oranges.”
  6. Does the Ford government feel that hospital deficits do not affect operational decisions?
  7. How much did each hospital accrue in advance of Bill 124 failing?
  8. Has the Conservative government repaid hospitals that accrued monies in case Bill 124 failed?
How many hospitals posted a deficit in FY22, FY23 and FY24? What was the average
deficit in each year for hospitals in deficit, and what was the total deficit for hospitals in
deficit?

How many budget waivers were issued in FY22, FY23 and FY24? Was each budget waiver
request accompanied by a recovery plan?

Can you explain why one hospital has a greater surplus than every other hospital with a
surplus combined? Moreover, how can Mackenzie Health post a nearly 94-million-dollar
surplus (enough to cover the deficits of 67 hospitals with money to spare) while so many
other systems are literally bankrupt?

Why do 42% of boards not post their minutes online? Additionally, of the hospital boards
that do post their minutes online, why are so many out of date - and why do they all use
different formats with different levels of disclosure? (note: we audited every hospital's
board minute pages to determine their due diligence in this context).

Why is there no financial reporting standardization across hospitals in Ontario? Our
analysis of every hospital's audited financial statements indicates tremendous variance in
how monies are accounted for / reported on. This makes comparison across hospital
systems essentially impossible as the data is basically "apples to oranges."

Does the Ford government feel that hospital deficits do not affect operational decisions?

How much did each hospital accrue in advance of Bill 124 failing?

Has the Conservative government repaid hospitals that accrued monies in case Bill 124
failed?

Our statement before the Standing Committee on Finance and Economic Affairs

Our team was selected to appear before the Standing Committee on Finance and Economic Affairs. As volunteers, patients, and residents, we appreciated the chance to provide feedback on Bill 180, Building a Better Ontario Act (Budget Measures), 2024.

Our feedback addressed Schedule 1 of Bill 180, as it sets out the framework for the Building Ontario Fund, formerly known as the Ontario Infrastructure Bank. We spoke to Schedule 1 in the context of healthcare planning and provision with recommendations meant to ensure financial management, governance, and community engagement were embodied in the legislation.

View our statement to the Standing Committee on Finance and Economic Affairs

Our letter to Ontario’s Auditor General

On November 14, 2023, we sent a letter to the Acting Auditor General requesting a public audit of Haliburton Highlands Health Services (HHHS) financial management and decision-making processes and funding delays prior to Minden ER’s closure. The Auditor General responded on March 19th, 2024. We replied on April 2nd, 2024.

View our letter to Ontario’s Auditor General

Ontario Hospital Analysis

View total funding, deficit/surplus, year-over-year changes, political riding, nearest MPP and more for each hospital in Ontario

Our 2024 pre-budget submission

View our 2024 Pre-budget submission as a web page

Our letter to Ontario’s Integrity Commissioner

View our letter to Ontario’s Integrity Commissioner as a web page

Who is Minden Paper?

Contact:
team@mindenpaper.com
media@mindenpaper.com

  • We’re a diverse team with lived experience in healthcare, board governance, digital strategy, operations management, financial analysis, nonprofit management and community advocacy.
  • We’re deeply concerned about Haliburton Highlands Health Services (HHHS) decision to close the Minden Emergency Department (ED) permanently — with six weeks’ notice.
  • We’re committed to seeking and ensuring accountability and transparency from the CEO, Board Chair and Ministry of Health.
  • We hope to raise our collective understanding of healthcare planning and provision so that more people can help ensure key decision-makers understand the socioeconomic repercussions of these decisions — and the need for effective stakeholder consultation and governance.
  • We’ve researched the decision-making process behind the Minden ED’s closure and its impact on Minden and surrounding areas.
  • Our work reflects growing concerns about ED and Urgent Care Clinic closures nationwide.
  • We feel it’s incredibly important to ensure key decision-makers and stakeholders understand the criticality of access to safe, reliable, accessible public healthcare.
  • We believe the closure of the Minden ED serves as a microcosm for what’s happening across Ontario, if not the entire country.