If you recall an amalgamation, forming the Huron Perth Healthcare Alliance (HPHA) in 2003, you would be right.
But, HPHA can take one more step to further merge the Clinton Public Hospital, Seaforth Community Hospital, St. Mary's Memorial Hospital, and Stratford General Hospital.
"Because of changes in legislation, we have to significantly update our alliance agreement to comply with the Ontario Not-for-Profit Corporations Act," said Andrew Williams, president and CEO of HPHA. "In knowing we need to do that, and in recognizing that we already effectively run as an amalgamated organization, the board felt this is the right decision to make for the organization."
Williams said this essentially means is the funding all four hospitals will go into one pot, given to the hospitals as necessary. Money raised by the foundations will still go to the intended hospitals.
The decision hasn't been finalized, but it is in progress. Williams said the approval has to come from the Minister of Health. HPHA is planning to submit a request at the beginning of December.
The amalgamation, however, is raising many concerns about what this might mean for the future of the smaller hospitals.
"In my view, in my experience, if you have four entities of roughly equal size, then you have a partnership," said Dr. Maarten Bokhout, a retired doctor and former chief of staff at Clinton Public Hospital (CPH). "The budget for Stratford Hospital is around $140 million. The budgets for each of the other hospitals are around $12 million. There's a huge discrepancy."
Bokhout said when there's a big discrepancy in funding, it becomes an unequal association.
"Human nature being what it is, the issues that affect the whole single entity will tend to settle towards the largest part of that entity, which in this case is Stratford," said Bokhout. "That has service delivery implications for the smaller hospitals."
Darren Stevenson, chair of the Clinton Public Hospital Foundation, said this is an issue all of the hospitals should be concerned about.
"What we're [CPH Foundation] trying to do is just have the process slowed down," said Stevenson. "We don't necessarily want to stop it, but we have concerns that all the details are not finalized at this point. We would just like a clear, concise, and complete plan."
From a foundation point of view, Stevenson confirms that donations will not be affected.
"Our dollars that we raise from the generous community will continue to support the Clinton Public Hospital and we've been assured that the equipment we purchase will remain in Clinton," he said.
"The difference moving forward will be instead of getting four letters, we'll be getting one with one budget number," said Williams. "The amalgamation does not chance staffing, does not change clinical programs in any way. But does obviously streamline from an accounting and reporting perspective."
There is a meeting being held for each affected area this week to address questions, comments, and concerns, in addition to other topics.
St. Marys' meeting is November 20 at the Pyramid Recreation Centre, beginning at 7 p.m.
Seaforth's is at the Seaforth and District Community Centre on November 21, beginning at 7 p.m.
Clinton's will take place at the Central Huron Community Complex, Libro Hall on November 22 at 7 p.m.
Finally, Stratford's will be on November 23 at the Stratford Rotary Complex, Community Hall A, also beginning at 7 p.m.
"They are not only to talk about the proposed amalgamation, there's a lot of items we're going to be sharing," said Williams. "We're going to update on what's going on in the organization, talk about recruitment and retention, capital investments, provide an opportunity for foundations and auxiliary to give an update, and talk about our patient and caregiver partner program."
Attendees are able to ask questions and join in on the conversation. Williams said part of this proposed amalgamation will include a "Community Council", which will have representatives from varying areas to give input. Numbers and areas representatives will be from have not been determined yet.
"It's important that the HPHA board, our lower tier and upper tier, and provincial elected officials are aware of the concerns that the community has, and to ensure that your voice is heard and continues to be heard," said Stevenson.
"It's important for people to hear what our local people want," said Bokhout. "I think we're all entitled to our collective opinions and if you look at what the history has been, in the last several years, in particular CPH, I think you can look at it saying we haven't been treated the same as other areas. I think there are grounds for dissatisfaction but if the overwhelming response from the floor is that this is wonderful, then I would tend to defer to what the people want."
Much of the dissatisfaction comes from CPH approaching four years of overnight closures for its emergency department.
Further information on the meetings, including location addresses, can be found here.