Horizon Health announced on Saturday that it would maintain the labor and delivery unit at Upper River Valley Hospital, despite announcing it was closed less than 24 hours earlier.
Still, obstetric staff at the hospital and residents in the area want an additional explanation for this weekend’s troubles.
In an update to its Friday night announcement of the unit’s final shutdown, Horizon Health issued a statement on Saturday afternoon reversing the decision.
“As a result of yesterday’s statement, Horizon Health Network will continue to provide labor and delivery services at Horizon’s Upper River Valley Hospital (URVH) in Waterville,” the update said.
However, the Horizon update extended the unit’s temporary shutdown, with no schedule for its reopening.
“As a temporary measure, due to COVID-19, pregnant women in the Upper River Valley area will have access to reliable, safe and quality care during labor and delivery at the Dr. Everett Regional Hospital Chalmers d’Horizon in Fredericton. ”
Horizon’s announcement Friday night to permanently close the obstetrics unit at Waterville Hospital met with a huge wave of reactions from residents of the Upper Saint-Jean Valley. The health authority released the public announcement hours after Horizon Health Interim President and CEO Dr John Dornan broke the bad news to URVH staff late in the afternoon. noon on Friday, November 5.
Locals quickly drew up plans for large protests against the decision.
“We appreciate the public’s understanding, patience and flexibility during this time,” read Saturday’s Horizon statement. “Services are expected to return to the Upper River Valley region in the coming weeks. ”
The surprise decision to shut down the unit seemed to take local MPs by surprise.
Ahead of Horizon’s publication on Saturday announcing the cancellation of the shutdown, Carleton MP Bill Hogan said in a brief statement that the decision was pending.
Hogan emailed the following statement to the River Valley Sun at around 2:40 p.m. on Saturday, November 6.
“Like many of you, it was a surprise, and I was shocked by the announcement about the URVH yesterday. I am happy to see that Horizon has found a way forward to keep labor and delivery in our hospital, ”Hogan wrote.
New Brunswick Agriculture, Aquaculture and Fisheries Minister and Carleton-Victoria MP Margaret Johnson also released a statement on social media on Saturday afternoon.
“People, as I mentioned before, I was shocked and appalled when I heard about the changes at Horizon regarding labor and delivery services at URVH,” she wrote. . “I am delighted to see that Horizon has given more consideration to finding a new way forward to sustain learning and development in our hospital. ”
While welcoming Horizon’s abrupt change in leadership, Dr. Allison Boyle, chief of obstetrics at Upper River Valley Hospital (URVH) in Waterville, said concerns remained.
Boyle said he received a personal email from Dornan on Saturday afternoon, asking him to meet next week to review his concerns and discuss possible solutions.
“I’m going to meet him and I’m grateful that he’s at least open to dialogue, but that doesn’t mean it’s over,” she said.
Boyle said it looks like the URVH labor and delivery unit won’t open until Horizon’s CEO has had a chance to discuss options with her and the team. of obstetrics of the URVH.
“I’m afraid he’s still trying to push his agenda forward, but I won’t know until we meet,” she said.
In a letter sent late Saturday afternoon to Dornan, Minister of Health Dorothy Shephard and colleagues, obstetric doctors at URVH question the CEO’s actions.
“We are writing to express our serious concerns about the misinformation presented by our CEO, Dr. Dornan, regarding the Upper River Valley Hospital obstetrics program,” the doctors wrote to open the letter obtained by the River Valley Sun . .
They said the CEO, when asked, failed to provide “direct evidence” that the URVH did not meet the standard of care.
The letter noted that Dorman’s first line was that the URVH did not meet the required “standard of care” without an obstetrician or neonatologist on staff.
“You didn’t post a job offer for an obstetrician at URVH because you thought it wasn’t feasible,” the doctors wrote to the CEO.
The letter questioned Dorman’s comparison of URVH and urban centers, which have both family physicians and obstetricians on call.
“It was your first mistake,” read the letter. “The Upper River Valley is made up of rural communities. We have a different standard of care. You cannot compare a low risk center to tertiary centers.
The letter described the “well-established” standards governing low-risk birthing centers.
“A low-risk center should have a trained delivery professional (i.e. family doctor), a doctor with the privilege of performing an emergency Caesarean section, anesthesia, and duly trained nursing staff. trained, “wrote the obstetrical doctors of the URVH. ”
Under these standards, they wrote, an obstetrician and neonatologist are not needed.
“URVH has a full complement of competent staff,” they wrote.
The letter questioned the CEO’s survey of urban New Brunswick physicians as to whether they would practice rural obstetric care, saying many responded that they would be “uncomfortable.”
“It was your second mistake,” said URVH doctors. “You again compared urban and rural centers. You did not ask rural family medicine providers if they were comfortable with obstetrical care.
Suggesting that the CEO said he was not aware of any Canadian hospital operating the same as the URVH, the letter listed more than 50 rural communities with a standard of care similar to that of the hospital in Waterville.
The letter added that some of these hospitals are located more than 300 kilometers from the nearest obstetrician and neonatal intensive care unit.
The URVH doctors asked Dorman to review the Society of Obstetricians and Gynecologists of Canada joint position paper on recommendations for rural maternity care. They explained that the position paper recommends that women living in rural and remote areas have high-quality maternity as close to their homes as possible.
They said the document also cites evidence of good performance within an integrated perinatal care system with local access to operative delivery and when women are not forced to travel far from their communities.
A complete copy of the letter is attached.