FFWD Weekly
Copyright © 1997. All Rights Reserved.


Election day is just around the corner and for some people, the impending closure of the only hospital left in the inner city is a major issue. D-day is fast approaching for Bow Valley Centre, better known as the General Hospital, with emergency services slated to close in early April and other programs to follow, while some have already moved.

Is it too late? "Absolutely not," say members of the Keep the General Hospital Open Committee, who are making a desperate attempt to save it. But so far the Calgary Regional Health Authority (CRHA) is not caving in to pressure.

Committee members represent a broad spectrum of interests. One of the most recognized is Dr. Harold Swanson, a retired radiologist seeking the Liberal nomination in Calgary-Elbow to challenge Ralph Klein over health care cuts - he previously gained national media attention after challenging Klein for the Conservative nomination. Other key members are founder Clancy Tetslenko, head of CUPE Local 8, representing support workers at the General; Gordon Chistie, the committee treasurer and New Democrat candidate for Calgary Mountain View; Dr. Tim Hall, who attends the meetings out of his own interest; Elizabeth Crane, representing Calgary General Hospital nursing alumni; Victoria Community Association president Anne Kurpe; Rebecca Aizenman, who lives in the Rockyview Hospital area; and Alderman Bob Hawkesworth.

They are united in their belief that the decision to close the hospital contradicts common sense and will jeopardize the well-being of Calgarians as well as others in Alberta and B.C. who access its services.

If the the closure proceeds, Calgary will be the only city of its size in North America without a downtown hospital - the Holy Cross and the Grace were both closed within the past two years. Approximately 100,000 people live in Calgary's inner city and another 100,000 come into the downtown to work, shop or attend events, which equals about one quarter of the city's population. Aizenman says it will be difficult for those residents and workers to get emergency care, especially during rush hour.

The downtown also has a high population of seniors, mentally ill and homeless people. "The population that accesses health care the most is seniors - they're (CRHA) taking away their most valuable resource," says Chistie.

Due to its location on the doorstep of the downtown and its proximity to several major roadways, the committee says the General is an ideal destination for emergencies. According to statistics, the downtown generates the highest percentage of emergency calls and Emergency Medical Services (EMS) transports about 60 per cent to the General. "One out of six of all lights-and-sirens calls... that the ambulance system responds to... are in the two square miles comprising the downtown core," says Hawkesworth.

The downtown area is also the most likely location for a multi-victim accident, such as a high-rise fire or LRT crash. "The city is not in any position to handle any kind of disaster," Aizenman claims, questioning how it will manage after the closure. "They're spending most of their time in damage control."

Once the General's emergency closes, the committee expects serious problems due to overloading at the remaining acute care hospitals - Rockyview, Peter Lougheed and Foothills. "If you go to the Foothills and it's overloaded, they will send you to another hospital where you may not be able to see your own doctor and where there may not be a specialist available," says Swanson. Tetslenko adds that when the CRHA claims there will be just as many beds in the system after the closure, it is not taking into account the beds already lost from the Grace and the Holy Cross. "Those beds are not being replaced (and) our population continues to grow at approximately two per cent per year."

Members are also concerned about health care workers. "Doctors are being spread so thin because we no longer have (site-based) physician care," Tetslenko says. "Who is going to be accountable to the family and... for the loss of life?" Hall adds that the closures have resulted in the loss of some top physicians and nurses. "That's a tragedy because that is not reversible," he says. "Those people aren't transferred to Foothills or any other site - they're gone."

According to the CRHA spokesman Barry Kowalski, chairperson of the Bow Valley Centre Transition 1997 Committee and project development officer on site at the Peter Lougheed Centre, the issue is very complicated.

Kowalski says the age of the General was one of the major motivators in the decision because the cost of rebuilding it would be about $180 million. "If we were to keep the building we would have to invest a lot of money into it." He acknowledges that some buildings at the Foothills are older than the newest buildings at the General, but says overall the Foothills is superior. Financially, the CRHA expects to save at least $17 million per year by closing the General. Kowalski says the direct costs associated with closing the facility will total about $9.4 million, including moving costs, minor renovations at other sites, etc., and estimates the cost of the capital project at the Peter Lougheed is approximately $35 million. "It doesn't take you long to figure out that you'll be saving significant dollars fairly quickly."

However, he stresses that the decision has more to do with restructuring than buildings and finances. Kowalski explains that Calgary no longer requires as many hospitals due to changes in surgery which reduce recovery time. He adds that in the past facilities such as the Peter Lougheed have been underutilized. "We will, at the end of the day, have three very good modern acute care hospitals very strategically located in the city to deal with all of the problems."

Kowalski also contends that day-to-day inner city needs will be better met through the new Eighth and Eighth Health Centre. "It's not a substitute for the emergency room at the Bow Valley. It's there to provide an accessible, drop-in type of primary care service," he explains. The centre is at the corner of 8th Avenue and 8th Street S.W., a site chosen for its downtown location and proximity to transportation, and will provide care for patients whose conditions are not life-threatening. The centre will also offer on-site access to mental health, continuing care and other public health services. The cost of the centre was estimated at $600,000 to $800,000 in renovations and $2.5 million per year for operation.

In cases of emergency, Kowalski says ambulances are the priority. "It's like an emergency room on wheels." He adds that people are not automatically transported to the nearest hospital, they are taken to the site most appropriate for their needs. "That's the way it's been for years and years." He disagrees that the General has the best access, noting some people downtown are closer to the Foothills and in the northeast, the Peter Lougheed has "superb" access.

Committee members do not buy the CRHA claims that the General is too old and too costly. "I'd like to be around when they bulldoze the Foothills Hospital if that's their philosophy," Swanson jokes. In fact, they think health care costs will rise due to increased hospital transfers, ambulance calls, re-admissions caused by early discharges and other factors.

The committee also scoffs at the new health centre, saying it will be inadequate for the needs of people who use the General.

In the political arena, city aldermen appear divided on the closure. The committee says it has support from some city council representatives, including Hawkesworth, John Schmal and John Ceci, but the majority appear to accept the closure. "More effort has gone into Expo 2005 than protecting the health care system in Calgary," says Aizenman.

Hawkesworth, whose ward includes the hospital, says the last of the inner city hospitals is needed. "I think that's very important for emergency service especially, but also for day and outpatient programs." He considers the financial argument behind the CRHA's decision to be overstated. "It would be feasible, in my view, to operate a smaller General Hospital using the core buildings in the middle of the complex that were built in the 1970s. Those buildings are newer than the Foothills Hospital and need very little in the way of renovations." He adds that the existing facility is functional and is also one of Canada's best health care organizations. "They have achieved that in the buildings that are there."

Alderman Jon Lord, who represents Ward 8 in the downtown, says the decision has been made so the focus should be on the city's EMS fleet - which he also describes as "emergency rooms on wheels" - because when someone is injured, it's more important to be near an ambulance than a hospital. "I think that's the best that we can do from here."

The issue will likely have the most impact in the provincial riding where the hospital is located, Mountain View, due to the upcoming election.

Progressive Conservative candidate Mark Hlady, the incumbent MLA, says the closure is necessary. "I think what the health authority has come up with now is a plan that will work best for the city - I think it's effective and efficient.... The purpose of all this restructuring is to make sure that the services are available to the people and that we can afford to have the health care system that we have today." Hlady says if Calgary is compared to any other major city, Foothills and Peter Lougheed would both be considered inner city hospitals. He assures residents their health will not be compromised. "People keep forgetting that we have a major EMS system. It's like a hospital on wheels," he explains, echoing Kowalski and Lord.

Chistie, the New Democrat candidate, argues that the authority should not have the power to close hospitals because its members were appointed by the province - not elected. Chistie explains that the system enables the government to cut funding and pass the buck to the authorities, which cannot be held accountable at election time. "The reality of it is... (the authorities) are really a barrier, or a smokescreen."

At a recent rally, Liberal candidate Pat Ennis also pledged her support for the hospital, stating the Liberals would not close the facility. She points out that the closure will not only hurt patients and workers, it will also impact surrounding businesses and lead to higher residential and commercial vacancy rates. "The government told us from the outset that they weren't going to blink, but they didn't say they weren't going to listen." she says. "We must speak up."

Even if Calgarians do create a fuss, Kowalski says there is no turning back. "It's too late. We're at the point now where in terms of the physical structures, we've invested almost $100 million in other buildings," he explains, adding not all costs were related to the closure. According to the CRHA, the building and land will be transferred to the city, which has not finalized any plans for the site.

Still, the Keep the General committee will not give up. Hall says if Calgarians don't address this issue now, they are giving up their right to the principle of universal health care. "Sooner or later it's going to come back to haunt just about every single family in this community."

Ultimately, the fate of the hospital is in the hands of Calgarians and they will make that decision at the polls on March 11.

"It's like a prisoner on death row - we're appealing to the governor for a stay of execution and at midnight on some day in April they're going to pull the noose on the General Hospital and open the trap door and that will be it," Hawkesworth says.

"Unless the public votes to save the General, the only thing we can rely on is the premier giving a stay of execution. And so far he hasn't agreed to do that."

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