In the normally quiet Niagara Region, emotions are running high with proposed changes planned for Niagara Health System’s $370 million hospital system. Ironically called the “Hospital Improvement Plan” (or HIP for short), the very wheels of progress developed by the health authorities threaten to balkanize the very region of some 500,000 people it was set up to benefit.


In Ontario, health care services are planned by 14 Local Health Integration Networks (or LHINs) that are composed of health experts and ordinary citizens appointed by the province to consult and develop the most effective health care services for the population base they serve. Niagara Region is served by the Hamilton Niagara Haldimand Brant LHIN.

After the Niagara Health System (NHS), which is the centralized administration of several local hospitals across the region, reported a looming $17 million deficit, the LHIN asked it to come up with a plan to not only become more efficient in the delivery of its services, but to provide for “centres of excellence” which would allow Niagara residents to obtain most of their health care services within the region, as opposed to having to travel to Hamilton or Toronto for specialized services.

The proposed HIP was the result of internal consultation between executives of the NHS and its major stakeholders, including senior physicians, nurses and other health care teams. However, when the HIP was released to the public in early summer, sparks began to fly across the Region, particularly in the southern most parts of Niagara, where its two hospitals will lose their emergency departments to the other hospitals in the major cities of the region.

The City Council of Niagara Falls passed a resolution against the HIP as soon as it was discovered that all maternity and pediatric services will be removed from all NHS hospitals and relocated in the yet to be built new hospital facility being in St. Catharines, the largest city in Niagara. There was considerable talk about how taxi drivers should take a course in delivering babies, as the number of roadside births will increase considerably.

Although the NHS explained in its consultation document for the public that several enablers are needed to make these changes work, such as the development of a region-wide transit system and a better coordinated primary care system, people still panicked. Over 5,000 people packed an auditorium in Fort Erie to protest the loss of their emergency department and similar numbers showed up at a Port Colborne school to oppose the same thing.

The Niagara Medical Staff Association, which includes physicians that have hospital privileges across Niagara, voted against the changes in a well-publicized “non-confidence” vote against the proposed HIP. The concerns many expressed is with services being moved to particular communities, specialists would be forced to move their offices to that location in order to practice efficiently, thus making their offices less accessible to the people in the communities they normally serve.

In response to the explosive public response to these proposed changes, the LHIN hired Dr. Jack Kitts, CEO of the Ottawa Hospital, who dealt with similar changes in his home healthcare community. He was asked to speak to community representatives to “listen” to their concerns and come back to recommend changes to the proposed plan. After his consultation, his report proposed little change, except to turn the Fort Erie and Port Colborne hospital emergency departments into 24-hour “urgent care” centres. It appears the LHIN is going to approve this slightly revised plan, despite continued concerns expressed by the community.