Small Town Week, Episode 2: What happens to a town when its only emergency room closes?

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Jordan Heath Rawlings The stress on Canada’s healthcare system goes back well before the pandemic, but it is fair to say that what Covid did was break the parts of the system that were at the breaking point. And nowhere has our capacity for care in everything from family doctors to walk-in clinics to hospitals been tested, more than rural areas and small towns. The past couple of years have seen emergency rooms in smaller areas, cutting back hours or even closing their doors temporarily, often due to a lack of either doctors or nurses. But the closures had been temporary emphasis there on had. Minden Ontario’s emergency room is gone. Despite a desperate fight from residents to save it, and now a community that relied on it for everything from medical emergencies, access to necessary care, and to handle the overflow of summer residents, has nothing to fall back on. A drive down the highway is the only option, either in their own cars or in an ambulance. Is Minden’s ER the first of more to come? What happens to a town when its primary center of medicine evaporates. What other options exist for care in Minden and in other communities like it is, small town medicine in this country dying. I’m Jordan Heath Rawlings. This is Small Town Week on The Big Story. Emily Stonehouse is the editor of the Minden Times. Hello, Emily.

Emily Stonehouse Hi, how are you?

Jordan Heath Rawlings I’m doing great. Thanks for joining us.

Emily Stonehouse No thanks for having me.

Jordan Heath Rawlings Why don’t you start, since you’re talking to an audience across the country now who may not be familiar with Minden, tell us about it. Where is it? What’s it like? How many people?

Emily Stonehouse Oh, I could talk about Minden for a very long time. It’s a tiny little town. There’s about 6,500 people, but that population does triple in the summertime because we’re about two hours north of Toronto. We’re known as cottage country, but the cottage country that’s a little bit different from Muskoka, we’re the unheard of cottage country so far. So it’s just in the process of really kind of growing a lot that kind of happened during the pandemic, but it’s a great little community and it’s my home.

Jordan Heath Rawlings You mentioned that Minden, is quote unquote cottage country. How do the people in the community feel about that? Does it, is it resentful? Are they proud of it? Is it just the way things are?

Emily Stonehouse Yeah, I think that’s a great question. The people of the community here know that tourism is absolutely our number one industry. So I think at times there is a bit of a love hate relationship. All locals know that you know, we don’t go into town between nine and five on a Saturday. But I do think that we rely on it heavily for our industry, for our economy here, and particularly with a closure like this it has really offered the opportunity to kind of extend an olive branch and, and work with these different voices that have access to different platforms in different communities and make sure that the issues of this ER closure is reaching more and more people farther than we could ever do that locally. So, so far, so good.

Jordan Heath Rawlings And now tell me about, the hospital and emergency room there. How big is it? How long had it been around? How busy is it? And also just maybe first, did you ever use it? Were you ever inside the ER? Can you tell us what it’s like?

Emily Stonehouse Yes. So I myself have used that emergency room a number of times, unfortunately. More times than I could count. I also have two young kids who have used it many times. My husband’s been in and out a few times. it was right in the heart of the community, so it was very accessible to a lot of people. I’ve even walked there myself before. It’s not a huge facility. It kind of had one to two full-time physicians at any given time, but a lot of trained nurses and things like that, and they were able to do a lot of different things. I did have x-rays there. There is a helipad there. And it was in the community, established in that location for about 28 years before it was officially closed on June 1st.

Jordan Heath Rawlings And this is why everybody across the province of Ontario has been talking about Minden recently. So that ER closed. And unlike some emergency rooms that we’ve seen in Ontario and other, provinces that have had to shut down for a period of time or cut their hours, I understand this ER is gone permanently. Why?

Emily Stonehouse So that’s the real question. It was originally cited that this was closed permanently. It was announced on April 20th in the form of a press release, so there was no prior consultation with the community in that sense. And it was announced that it would be closed June 1st permanently. And the reason behind that was cited specifically as staffing. And that is an issue post pandemic. That’s something we’re seeing a lot of apparently across the country, that there’s a shortage of staffing, particularly nursing staff. So I think a lot of people weren’t really surprised. But then as we started digging a little bit deeper into it, I think some more questions started popping up about whether that was the actual reason or whether there was some ulterior motives in place.

Jordan Heath Rawlings We’ll get to that actual reason, or perhaps not in a second. But first, what was the reaction like in the community? You know, this was, I guess just a little over a month between the announcement and the actual doors shutting.

Emily Stonehouse Yes. It was about six weeks and it was, I don’t know how to say terribly, like worse than terrible as a response to the community. It was definitely taken as a surprise, I think for many people, like I said previously, like a lack of consultation, a lot of people were just caught off guard. And it’s one of those things that the staff found out the same time the rest of the community found out as well, so there was some internal turmoil at the ER as well. So yes, the immediately though, within a matter of hours there was Facebook groups popping up saying, you know, Save the Minden ER. There were rallies being planned. There was, you know, points of action being taken. So it was a huge response with some dedicated people kind of behind the scenes facilitating that along the way.

Jordan Heath Rawlings So let’s talk about the reasons then. The official reason giving is staffing. That is, certainly something plausible that we’ve heard as we’ve covered healthcare shortages across the country. But you and the team at the time started digging in and what did you find?

Emily Stonehouse Well, we started, we were hearing a lot of different reasons through the community. It’s a small town, so things kind of circulate around on social media and, and we saw it popping up kind of repeatedly saying, it’s not staffing. It’s not staffing. That’s not the truth. So we did reach out to the doctors and we kind of inquired for an interview and the doctor said, no, we’re not comfortable for an interview this at this point in time. So we did some more digging. We kind of waited. We let the community come to us. And then after a few weeks when it was fairly clear that this decision would not be reversed, the doctors did approach, the media and said we would request an interview and we will give a tell-all interview. And it was during that interview that it was confirmed that the doctors had said that the staffing was not the issue at the Minden ER. They were fully staffed and had the full schedule completely in place until September, which is a very key time in a small community, particularly in cottage country, a lot of camps and things like that over the summertime. So the Minden ER is absolutely critical to be able to maintain the huge influx of people that come to the community each summer. So the Minden ER was prepared for that and said, we, we had everything in place. It’s not staffing.

Jordan Heath Rawlings So who made this decision? Who oversees healthcare there? And, what did they say when you brought those claims to them?

Emily Stonehouse Well, it’s a bit of a multi-step issue kind of thing, and as much of healthcare is. So the first kind of approach is Halliburton Highlands Health Services, they’re referred to as HHHS in our community. And they were the ones that made the formal announcement saying the ER is closing. That is run by a CAO and a board of directors. and they were the ones that made that in announcement. So once I kind of brought it out to the public saying, it’s not staffing, now we have the doctors on record saying that they did give me a rebuttal saying, well, there’s issues with nurses and things like that. So I still think through my investigating and through hearing different people, because being a reporter in a small town is really unique because part of it is you digging and part of it is you just listening. But a real answer hasn’t completely been, been uncovered yet.

Jordan Heath Rawlings As you keep digging in, I’m sure more stuff will come out as this gets further in the rear view. What’s happening to those patients now? You know, as you mentioned, you’re just heading into super busy time of the year. Where are they gonna go?

Emily Stonehouse So, the closest ER, it really depends on the location. So we’re kind of in a unique, location there is the Lindsay Ross Memorial Hospital that is about an hour and a bit from here. There is Peterborough, which is an hour and a bit from here. And then Halliburton is the closest from downtown Minden, which is about 20 minutes on a good day, depending on traffic and how many deer you see on the side of the road. So that’s kind of what people are doing right now. It’s quite interesting right now at the Minden ER, the doors are locked and there is just a telephone that says, if you are in distress, call this number and it will get you directly to Halliburton. And there’s a map to Halliburton site.

Jordan Heath Rawlings How equipped is the Halliburton Hospital to support those extra patients, especially during the summer months?

Emily Stonehouse That’s a a really good question. I personally don’t think that they’re entirely equipped. One of the major concerns was parking on that site. They have kind of set up some alternative spaces, some alternative rooms, things like that. And another thing that they have mentioned is the paramedics in the community, they’ve upped those right now. So right now there’s more ambulances circulating around the community and those ambulances are actually better equipped to be able to treat people on the spot. So in terms of space, they’re not, they’re not where they should be right now. But in terms of potentially staffing and things like that, I think they’re working to try to get to a point where they can be comfortable, but nobody can really anticipate what’s going to happen on any given day in the summertime.

Jordan Heath Rawlings What about the logistics of transferring those services? You mentioned paramedics. I mean, the phone outside the ER saying if you’re in distress, like when somebody needs to go to urgent care, it’s often actually really urgent. What difference can the extra travel make and how does, and how will the local health services handle that problem?

Emily Stonehouse I think it really is dependent on the situation itself. There’s already been some talk in the community based on the number of protests, the number of rallies, the number of initiatives kind of taken under, under a lot of people’s wings to kind of bring this back is. There’s already talk about potentially getting something like a, a private walk-in clinic, an urgent care unit, things like that. So I know there’s been attempts for funding to try to get that in place to try to alleviate some of the more minor injuries that could be going to emerge. But I mean, if it’s a life or death situation, there will be challenges. I think something’s going. I think something bad will happen and that 20 minutes could potentially be the difference between life and death.

Jordan Heath Rawlings In terms of the non, urgent, urgent care staff. You know, another one of the things we’ve discussed while covering healthcare shortages is that often in those situations, an ER can become the only option for people without a family doctor or access to a walk-in clinic. What is that situation like in Minden? Are you guys set with family doctors? I guess there’s no clinic since you just mentioned, perhaps getting funding for one.

Emily Stonehouse There is no clinic right now. There’s no walk-in clinic. that is absolutely something that I think would really help because the rate people go into emerge all the time with, there’s a lot of jokes in the community with fish hooks in their ears and stuff like that. Those are a lot of the kind of injuries we see that people obviously need to be treated. But it’s not necessarily a life or death emergency situation. Very few people, so I’ve gone to a series of meetings and things like that. Very, very few people have access to a family doctor here. The wait list is years. So that’s something that’s just not an option. And, and like you said, a lot of people were utilizing the ER as that outlet for, for any sort of medical care.

Jordan Heath Rawlings I know that the staffing might not be the true issue here, but I do want to talk about it since it applies to doctors and nurses and you know, to your point, family doctors as well. How hard has it been in Minden, in the community to recruit physicians and nurses to come here and work there and settle down?

Emily Stonehouse That’s one of those multifaceted questions and answers. There is currently, in terms of the county of Halliburton, so Halliburton County is one large county and then there’s four small municipalities within that county. So Minden is one of those municipalities. So the county of Halliburton has a staffing position in place that’s specifically dedicated to physician recruitment. That’s trying to get people, encouraging people to come to the community, seeing where they are, offering, you know, alternatives to housing, things like that. But for the longest time, particularly during the pandemic, this housing market was more expensive than Toronto. It was one of the most expensive places to live in all of Canada. So that’s one of the biggest struggles, is a total lack of housing. There’s a complete lack of public transportation. So a lot of the features for coming to the community aren’t really there, particularly for younger families or, or, or retired people who need access to that. And now not having an ER is actually one more reason that people aren’t really inclined to come to a small community. So I think there’s a lot of issues recruiting anybody here, but particularly physicians and things like that. It’s a beautiful community. It’s a, it’s lovely people, but it is difficult to recruit physicians for sure.

Jordan Heath Rawlings I know you can’t speak to the specifics of other communities, but I also know reporters talk and, and as you said, reporters listen. Do you feel, based on what you’re hearing from around the province, that your situation is particularly unique? I mentioned that, you know, as far as I know, this is the only one that is closed permanently, but like, it seems like you’re on the vanguard of a trend and not a good one.

Emily Stonehouse Yes. it’s, it’s been interesting to watch as this has kind of unfolded because as we saw this one happen, and you’re right, this was the first kind of permanent final closure, a series of other communities as well. I’m watching it, you know, they’re closing down part-time or they’re losing access to different, different kind of medical treatments and things like that. So I do think that this is something that will continue. Unfortunately. I also think that this is something that people are starting to get more mindful of their politics. So historically a lot of those communities have have voted blue in the past, and maybe this is not something that is necessarily working for them anymore. So it’s been interesting to watch that shift in these small communities who have always historically stuck to their guns politically, they’re starting to be impacted by some of those decisions right now.

Jordan Heath Rawlings What is the community doing, in reaction to that? You mentioned, trying to figure out funding for a clinic. But what other solutions are possible, or I guess, you know, what could have happened instead here?

Emily Stonehouse That’s a great question. A lot of it was, I don’t think anybody thought the clinic would actually close. I think it was announced. And just so much was done. So during those early days, people were raising money to try to get a lawyer to fight this. And now the, the most recent kind of project that people are behind right now is a, the court and north family health team has stepped up to offer an urgent care clinic, which is kind of a bit of a middle ground between a walk-in clinic and an emerge. They can’t, they can’t do emergency stuff, but it’s not an everyday kind of walk-in. They do things that are pressing but not life threatening. That’s the next step that people are waiting to hear about funding for that project. But it’s also, people aren’t stopping. Like people are going to everywhere. They’re driving to Lori Scott. Scott is our MPP. They’re going to her office every day to try to still rally against this. They’re still going to count local councils. They’re not stopping. Facebook groups are still crazy active. They’re not slowing down. So it’s been fascinating to watch.

Jordan Heath Rawlings Is there a consensus in the community about this? I know a, a lot of stuff that comes, well you mentioned the blue and red divide. I know a lot of the stuff that comes down from the provincial government can be pretty polarizing. Is there any difference in political feeling in the community or even maybe in terms of people who are only there for the summer versus year-round residents?

Emily Stonehouse This is really impacted the community as a whole. So it’s been really interesting to watch at a lot of these rallies. So the one rally that they held was over the May long weekend, which was historically when Cottagers come up and open up the cottage, they held it on the Sunday of that weekend. So, And there was thou over, I’d say well over a thousand people there. Many, many of them cottagers. So this actually doesn’t really seem to be an entirely polarizing topic. I’m seeing signs pop up, you know, people are posting in Toronto that they’re like, oh, we have the yellow signs that save, save them Minden ER all through Toronto now as well. So it is spreading out. It’s, they’re all through Lindsay as well. And while it’s a challenging and trying topic, it’s very, it’s humbling to watch an entire community come essentially behind the same cause.

Jordan Heath Rawlings In terms of the situation on the ground, I know it’s only been a couple of weeks, do you have a sense for, for how it’s going for, what people are dealing with? Have you heard from people who have made that, one of those drives that you described?

Emily Stonehouse It’s been a bit mixed. So I have received quite a few letters to the editor about topics. Like, you know, I went into the ER at four o’clock in the morning. I just was never seen. People are quite vocal about that, but then I see somebody else say, oh, we were seen right away. So I truly think it depends on. Right. I think the nature of any sort of emergency room is totally just kind of on the fly all the time. There’s not really a lot of structure to it, and you can’t plan what’s going on around you. I do think that, you know, having only one emergency room as the entire medical facility for an entire county is…you know, people are going in with a sore throat right. And that’s something that, you know, could maybe be alleviated by having some alternative clinics along the way instead of just everybody funnelling towards one ER. So I have heard, I’ve heard more challenges than positive experiences, but it’s still quite early and I’m hoping that it kind of settles out a little bit over the summer. But the summer hasn’t even really started yet, so it’s one of those things that time will tell.

Jordan Heath Rawlings And what will you be watching for over the summer? Funding for the clinic but in terms of the situation on the ground, how will you know if it’s not working?

Emily Stonehouse Because everybody talks in, in small towns. So I think that’s one of those things that we’ll be very, very, acutely looking for that funding. If that’s in place, then I think a lot of energy will start going towards that. And then again, in a small community, people utilizing their local newspapers is really, really powerful right? Like we were the ones that broke that story that came out from us. And people really are starting to rely on us more and more for that kind of information. So, leading up to this, this big, big news, I would get a few letters to the editor here and there. I get consistently letters to the editor every week that fill up pages of my paper, sharing their stories and telling what they wanna say. And I made a promise when this started, that I would run every single one of them because the people of the community that are writing in, those are the hearts and souls and the real stories of the community that are coming out. So yeah, I think people are reading it and people are sharing and that’s how, that’s how we all know.

Jordan Heath Rawlings It is really tough that it takes the closure of such a vital resource to, make people understand how important journalism is, especially local journalism. But I’m glad it’s happening. And Emily, thank you for taking us to Minden and sharing what the community is dealing with.

Emily Stonehouse Oh, absolutely. Thanks for the opportunity.

Jordan Heath Rawlings Emily Stonehouse editor of the Minden Times, that was The Big Story. For more, you can head to TheBigStorypodcast.ca and you can find us on Twitter @TheBigStoryfpn. You can always toss us some feedback by emailing us at hello@TheBigStorypodcast.ca, or calling us and leaving a voicemail, 416-935-5935. We always like to know what you think about theme weeks like this, and which ones you’d suggest we look at covering next. Thanks for listening. I’m Jordan Heath Rawlings. We’ll talk tomorrow.