The Ontario government is seizing control of a Windsor hospital after high turnover in the executive ranks and a former senior employee's wrongful dismissal suit that raises troubling new questions about a dysfunctional work environment.
Health Minister Deb Matthews put Hôtel-Dieu Grace Hospital on notice on Monday that she is seeking legislative approval to bring in a supervisor to assume all the powers of the board of directors and report directly to her.
The challenges confronting the hospital are unique. Not only is it at the centre of a scandal over diagnostic test errors, it is also grappling with much deeper problems that have fostered a long-standing atmosphere of distrust and disrespect between medical staff and senior management.
Ms. Matthews said she decided to bring in a supervisor after exhausting all other avenues to get Hôtel-Dieu, which she described as "a bit of a special case," back on track.
"Changing culture is a very, very difficult challenge in any organization," she told reporters in a conference call on Monday.
The McGuinty government has on occasion appointed supervisors to take control of a hospital that is having financial problems. It did so twice in 2009, but this is the first time Ms. Matthews has taken such a step since she became Health Minister 14 months ago.
She did so reluctantly, mainly because the hospital's board members and management have co-operated with the government.
"I think we were all hoping that we would be able to land on a position that wasn't the heavy hammer of a supervisor," she said.
Just 2½ weeks ago, Ms. Matthews insisted a supervisor was not needed.
She would not say what prompted the change, but that it had nothing to do with last week's firing of Hôtel-Dieu spokeswoman Kim Spirou. Ms. Spirou has filed a $3.3-million wrongful dismissal lawsuit, alleging that chief executive officer Warren Chant pressed her to cover up wrongdoing at the hospital.
In a statement of claim filed in Ontario Superior Court of Justice, Ms. Spirou alleges that Mr. Chant did not want to reveal to police that an employee, who was later charged, had embezzled money from the hospital. She also alleges that Mr. Chant ordered her to deny that the hospital had hired lobbyists, but she refused to comply.
The allegations have not been proved in court. Mr. Chant said in a statement last week that Ms. Spirou impugned the integrity of a number of executives after her termination.
"Those allegations are scandalous and meritless, and will be proven to be so," he said.
A Hôtel-Dieu employee who asked not to be named said in an interview that the issues raised in the lawsuit underscore the morale problems at the hospital, where personality conflicts and friction between medical staff and management are common.
"Front-line staff need to see the province taking action," the employee said.
Progressive Conservative health critic Christine Elliott criticized Ms. Matthews for responding to a report released last August that outlined the unhealthy work environment at Hôtel-Dieu with the appointment of only a part-time facilitator to oversee changes.
"The report was clear about the culture and the need for change," Ms. Elliott said in an interview. "It would take more than a part-time facilitator to turn things around."
The facilitator, Malcolm Maxwell, who is chief executive officer of the Grand River Hospital in Kitchener, has spent a couple of days a week at Hôtel-Dieu. He said in an interview that the hospital needs full-time assistance, in part because of high turnover among its executive staff. Several vice-president positions are vacant, he said.
The government launched a probe into the hospital earlier this year after it came to light that a surgeon had performed mastectomies on two cancer-free women, and that a pathologist allegedly made mistakes on tests. The hospital suspended the pathologist last January after launching its own review of her work.