Nova Scotia

Premier booed in Cape Breton over decision to close 2 hospitals, expand 2 others

The government says both the Northside General Hospital in North Sydney and New Waterford Consolidated Hospital will close, while Glace Bay Hospital and Cape Breton Regional Hospital will be expanded.

'This is a great day in Cape Breton,' says department head for internal medicine at Cape Breton Regional

The premier was met with boos as he announced the changes coming to Cape Breton region hospitals. (CBC)

Premier Stephen McNeil had to shout over heckling and a chorus of boos on Monday at an announcement that the province will overhaul how it provides emergency health care in the Cape Breton Regional Municipality.

The government said both the Northside General Hospital in North Sydney and New Waterford Consolidated Hospital are outdated and will close, while Glace Bay Hospital and Cape Breton Regional Hospital will be expanded.

The province announced it would close the Northside General and New Waterford Consolidated hospitals and replace them with new community health centres. (Google Maps)

Some doctors welcome plan

The decision is being welcomed by some of the top doctors on Cape Breton who said revamped facilities at the two remaining hospitals will provide better overall care and help attract much-needed physicians.

But the announcement in Sydney was greeted by anger from some area residents attending the event. As he tried to speak, McNeil was called a "clown" and some yelled "shame."

"You're looking to use Cape Breton as a guinea pig," said one person.

McNeil defended his government's decision.

"That's what these announcements are about today is how do we best ensure that when an emergency happens in your community, that you have certainty on which emergency rooms are open and to ensure those emergency rooms are equipped and staffed with what they should be," said McNeil.

Nova Scotia Health Authority CEO Janet Knox speaks to the crowd of more than 200 people at Sydney’s Joan Harriss Cruise Pavilion. (Tom Ayers/CBC)

The premier later told reporters it's not surprising that some people are upset when the health-care system changes, but others are not.

"While you did hear some noise, you also saw some people that were actually interested in what was happening," he said. "They want to learn more about what the new integrated health-care plan will look like for CBRM. That's an encouraging sign for us."

Northside and New Waterford Consolidated will be replaced by new community health centres, but they will not be equipped with emergency rooms. The new centres will include spaces for collaborative family practice teams.

When introduced by Dr. Paul MacDonald, department head for internal medicine at Cape Breton Regional Hospital, Nova Scotia's premier began delivering an announcement about emergency health care overhauls in the area to a frustrated crowd. 1:21

According to a government briefing document, the Cape Breton Regional Hospital emergency department will be about 40 per cent bigger after the expansion. The Glace Bay Hospital emergency department will be expanded by 30 per cent.

Dr. Paul MacDonald, a cardiologist who has worked in Cape Breton for more than 20 years, is department head for internal medicine at Cape Breton Regional Hospital.

"I know that Cape Breton is the most warm and welcoming place in the world — except when we are threatened," he said. 

"And when we are threatened, as you can see by this gathering today, we will stand together and fight against that. But I don't see this as a threat, I see this as an opportunity, as a growth, as an investment in our future."

Dr. Paul MacDonald, a cardiologist who has worked in Cape Breton for more than 20 years, is department head for internal medicine at Cape Breton Regional Hospital. (CBC)

MacDonald said even the relatively new Cape Breton Regional Hospital — which opened in 1995 — is out of date.

"This a major improvement to help us take care of patients. I have a number of new specialists coming to our community who are going to practice critical care, pulmonary medicine, and if I bring them into a facility that's out of date, that doesn't have the equipment and the resources that they need, they're not going to stay," said MacDonald.

He said he's "excited" for the changes and said he didn't think the day would come. 

"I think this is a great day in Cape Breton."

The government also plans to build new long-term care facilities in North Sydney and New Waterford, along with a new central laundry facility in North Sydney.

However, officials said how many of the acute-care hospital beds from New Waterford and North Sydney will be relocated — and whether they will go to Glace Bay or Sydney — will be determined by a consultant over the next nine to 12 months.

The province's new plan includes doubling the cancer centre at Cape Breton Regional Hospital, and adding a new community paramedic service that is expected to be up and running in the next six months at an estimated cost of $900,000 annually. The new community paramedic program that will add a vehicle and staff that will make house calls.

Chris Milburn, an emergency doctor and ER chief for the health authority's eastern zone, says the regional hospital in Sydney can't close, but being short-staffed puts extra pressure on remaining doctors. (CBC)

Chris Milburn, an emergency doctor and ER chief for the Nova Scotia Health Authority's eastern zone, said the proposed changes make sense for patient care, but if the changes are intended to retain and recruit doctors, the province will have to do more than build new facilities.

"We certainly need to have competitive pay rates for family doctors here in Nova Scotia," he said.

"Cape Bretoners need to be welcoming and positive about their care and about their doctors, which we aren't always, and we need to just do more as a community to attract these doctors here."

But not all local doctors are pleased.

Dr. Stephanie Langley said she is angry over a lack of local consultation on the proposed changes and plans to quit her post as site lead at the Northside General.

"It's really hurtful and it's disappointing that nobody really had the insight and the fortitude to come and try and talk to the people," she said.

"This is going to change the way we practise, it's going to change the way we teach. It has big impacts in the community, and to not have that consultation ahead of time is just really disappointing."

Nurses' union promised no job cuts

Janet Hazelton, president of the Nova Scotia Nurses' Union, said she has been told there will be no job cuts when the hospitals are replaced with collaborative centres.

Hazelton said she was shocked when she was told about the plan just minutes before it was announced but said the changes will modernize health care in the region. 

Hazelton said the New Waterford and Northside hospitals are outdated, creating unnecessarily challenges for the staff. 

"They were made in a different time. So sometimes the doors aren't as wide as they ought to be, the equipment certainly isn't as modern as it should be. The hallways are more narrow than they ought to be, and you can see by going into a new facility, like Cape Breton Regional, Colchester hospital, Amherst — they're newer facilities, they have nice wide corridors," she said.

"You can get stretchers in and out and around, a lot easier."

In 2016-17, Northside General was closed more than any other emergency department in the province, according to provincial statistics. New Waterford's ER was the third-most closed on the list, just behind Musquodoboit Valley Memorial Hospital.

The closures were often due to a lack of doctors or nurses.

Tammy Martin, the NDP MLA for New Waterford and her party's health critic, said she was shocked by the news.

"So what's New Waterford hospital going to become?" she said in an interview. 

"What is happening with that — I would like to know. I'm sorry, I'm so furious right now it's unbelievable.

PC health critic Eddie Orrell, whose Northside-Westmount riding includes the North Sydney hospital, was also angry at the proposed changes.

"I think it's disgusting," he said. "They're going to take health care out of North Sydney and New Waterford and put it in Glace Bay and Sydney.

"We've needed to fix the health-care system now for three or four years, and that fix would have been to bring more family doctors to the area."

Northside General Hospital and New Waterford Consolidated Hospital are expected to be closed. (CBC)

According to the province, Northside opened in 1954. It currently has 45 acute care beds, 14 transitional long-term care beds and 22 beds on Taigh Solas, a licensed community long-term care unit.

New Waterford Consolidated opened in 1963, according to the province. It currently has 21 acute care beds and 24 nursing home beds on Waterford Heights, a licensed community long-term care unit. NWC has 123 staff.

Planning for the overall project is expected to take place over the next nine to 12 months at a projected cost of $500,000. 

It's not clear yet about much all the changes will cost. The province said those costs will be made public after tenders are awarded. 

The collaborative model that will replace New Waterford and Northside hospitals is meant to bring together a variety of health-care professionals — a family doctor, nurse, nurse practitioner, dietitian, psychologist and others — to provide better care and free up doctors to spend more time with patients who need to see them, the health authority has said.

In 2016, Nova Scotia Auditor General Michael Pickup questioned the number of hospitals in the province, suggesting hospitals within 30 minutes of each other should be reviewed for possible closure.

All four hospitals in CBRM are no more than about a 40-minute drive of one another.

Read more articles from CBC Nova Scotia here.

With files from Gary Mansfield