The maternity ward at the only hospital in the southern Ontario town of Leamington is one step closer to staying open – part of the time, at least – after the area's health authority endorsed pursuing an inventive "turn-on-the-lights" approach to save money at the birthing unit.
The board of the Erie St. Clair Local Health Integration Network voted unanimously in favour Tuesday night of keeping Leamington's maternity ward open while working out the operational details of a new approach to birthing that would see the unit left dark and unstaffed until a labouring woman arrives.
The plan also includes a new "navigation centre" outside the hospital that would co-ordinate pre– and post-natal care for women in the town of 30,000, which is located about an hour east of the border city of Windsor.
The LHIN still has to take a final vote in June after allowing for 30 days for written comments on the proposal, but all signs point to the plan going ahead, especially considering an expert panel concluded that closing the maternity ward outright would pose an "unacceptable" safety risk to mothers and their newborns.
If the closure had gone ahead, Leamington would have been the 43rd Canadian community to lose its maternity ward in the last decade, according to a cross-country survey of provincial health ministries by The Globe and Mail.
Andrea Cassidy, a local midwife who led the fight to save the unit, said Tuesday night that she was "really happy," the ward will almost certainly stay open, potentially setting an example for other small-town hospitals struggling to fund birthing services.
"That said, I have concerns about the proposed solution," she said. "My main concern is that we're doing 370 births a year. I know that births don't happen every day, but that's a significant number of births. We also do 12,000 triage assessments ... when are the lights ever going to be off?"
Like other rural hospitals across Canada, Leamington District Memorial Hospital was "losing" money because it was not delivering enough babies to cover the ward's $1.4-million operating cost. The unit posted a funding shortfall of $740,000 in 2012-2013, the year on which an outside consulting firm based its recommendation to close the ward.
Last fall, the hospital's board reluctantly followed the consulting company's advice and endorsed closing the unit.
But people in the community fought the move, prompting Health Minister Eric Hoskins and the LHIN – which still had to approve the hospital board's decision – to press pause and appoint a 14-member panel of experts to re-examine the proposed closure.
The panel report, released last week, recommended the unit no longer be staffed around the clock by obstetrical nurses; instead, the unit would only be "activated" when a labouring woman turned up. It also proposed the new navigation centre model.
The challenge ahead for the LHIN and the hospital is to figure out exactly how this new model will work, said Martin Girash, the chair of the Erie St.Clair LHIN.
He acknowledged there is some "anxiety," in the community, especially around whether or not there will a properly trained obstetrical nurse in the building at all times, even if he or she is assigned to other duties when the ward is empty.
"Whatever we need to do we will do in order to have the expertise available when it's needed," Dr. Girash said. "This expert panel, one of their primary directions was to assess safety. We're not going to put something in place that doesn't meet that test."