What about the County?
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Clearly any practical plan for hospitals in this region considers the patients in both the county and the city, but the plans did not even mention county residents. In fact the plans and site criteria seldom considered patients at all. There is some mention of where current patients come from, but the location was not determined accordingly.
The city vs county argument seemed to be trumped up in the media to justify the location, that it was somewhat closer for county residents that will still require vehicle access. Any real or created concern for the county patients shouldn't sacrifice the concern for city residents, many of whom can currently walk to the hospitals or take a reasonable bus ride.
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The primary concern for county residents should be increased services for the hospital in Leamington, Erie Shore Healthcare. Even the new name no longer includes the word 'hospital' as though to hint at changes to come. In recent years the fight to keep obstetrics was finally won because of the distance to Windsor hospitals.
If the proposed hospital is closer to Leamington by a few minutes, the loss of services are more likely, as decribed in the following paragraph from a 2009 study:
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"While the hospital is only 42 km from Windsor Regional Hospital in Windsor, owing to the fact that the highway is two lane and referral centres in Windsor are located in the city, but not on the outskirts, driving time is estimated to be 46 minutes..... Thus, despite the relatively low absolute numbers of CTAS level 1 and 2 patients (818 in total), given that the time required to transport patients from the community to the next closest 24 hour Emergency Department, and particularly from areas east of Leamington, approximates an hour, there is a strong argument to maintain a 24 hour 7 days a week Emergency Department at the hospital. "
(Small Community Hospital Emergency Department Study Final Report, by Hay Group Health Care Consulting, January 26, 2009)
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So with the proposed hospital on the outskirts, and if highway 3 ever gets twined, the low caseload for the Leamington ER would justify it's closing.
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Low caseloads is the reason county hospitals can't support a range of services. The more patients that rely on hospitals in Windsor, the less likely county hospitals will have increased services. In addition, most county municipalities don't have the population to support and house a large hospital staff, the infrastructure needed, or doctors wiling to take up residence nearby.
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There is a case to be made for the consolidation of some services. For example Windsor only has four neurosurgeons, four plastic surgeons, etc. In specialties with a limited number of physicians, it is reasonable to have them all under one roof, living near one particular hospital, the trauma centre. Yet for other services with more trained staff it is reasonable to distribute them closer to where people live. Even for treatments requiring limited specialists, before and after care not requiring the doctor to be present should be available in the county.
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Many people, including opponents to the current plan, have suggested there should be more be at least one other hospital in the county. This could be justified by the fact that Canada averages about one hospital per 100,000 people. Yet having a hospital in the county large enough to serve 100,000 would be unlikely to make a significant improvement in accessibility. There aren't 100,000 people living within a close radius outside of Windsor. Leamington hospital only serves 70-75,000 people and that is one of the highest population density areas in the county, second only to Windsor.
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A new hospital for the county is a nice idea, but what is the point if it isn't much of a hospital. The existing hospital in Leamington though might be able to support increased services rather than being reduced as patients are increasingly referred to Windsor.
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Small Community Hospital Emergency Department Study Final Report,
by Hay Group Health Care Consulting, January 26, 2009
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