Superhospital: elective procedure or necessary surgery?

>> The main opponent and main proponent of the MUHC state their case

PRO: Nicholas Steinmetz, associate executive director of the McGill University Health Centre

Mirror: What are the main motivating factors behind the superhospital proposal?

Nicholas Steinmetz: Scientific and technological progress demand that we we make it possible to treat people in a different way, and that primarily means treating people closer to home.

M: So, because the new hospital would reduce the total number of beds from 1,200 to 700, the issue of home care figures prominently in this debate?

NS: Certainly. The hospital of the future, the one we are turning ourselves into, will have to be part of what we call a network of services. Building a new facility is only a small part of a much larger scheme of things, but it is an essential element. We want to use our resources, particularly money, in the best possible way and free up funds for other things like home care.

M: In your opinion, is there no alternative to the superhospital?

NS: No. It's quite clear, from the studies that architecture experts have carried out on the current hospitals, that it doesn't matter how much money you put into them. Even if we spent $900 million fixing up our buildings, we would end up with something which is just barely adequate and which doesn't solve the fundamental problems.

M: Why does this all have to be in one location?

NS: It's impossible to have all the services in one place at the moment. They are spread out between different buildings. We're not like a car that can have the muffler fixed in one place and the radiator someplace else. All our biological systems are linked and you have to have the best support close at hand.

M: Are there similar megaprojects being undertaken in North America?

NS: I can't give an example here.

M: Can we expect this project to be realized?

NS: In 2004. We are involved right now in creating a functional program [ironing out the details]. Then we will make our applications to the provincial government for the hospital and the federal government for the research centre.

CON: Dr. James Farquhar, psychiatrist at the Douglas Hospital

Mirror: What are the main motivating factors behind the superhospital proposal?

James Farquhar: From my point of view, this is not an evil plot brewed up by some people who would like to siphon off money or anything like that. There is a core group of people who want to build a really great hospital and provide the very best care, and for that I say bravo. The bad side of it is that they are going at it with an undercurrent that says, "We want to build the best hospital and that is the number one most important priority for Quebec health care right now." And that is where I beg to differ.

M: How does the issue of home care figure into this debate?

JF: [Steinmetz] and I have the same viewpoints when it comes to home care. We both like it. But he has some blinders on about how his project is going to save enough money from the budget for home care.

M: What are the alternatives to the superhospital?

JF: They could add to the Montreal General something like a new pavilion that/ will solve a lot of the current problems. I can say with confidence that a project like that would cost between $160 and $200 million, and for a few million they could improve access by public transportation.

M: Are there any disadvantages to having only one location?

JF: You can definitely save money consolidating things like the laboratories. However, why not just consolidate all the labs at the Royal Vic? Perhaps the building doesn't serve the needs of the patients well enough any more, but it's good enough for labs.

M: Are there similar megaprojects being undertaken in North America?

JF: Nowhere. And Dr. Steinmetz will be the first to agree with that.

M: Can we expect this project to be realized?

JF: The weakest point in this plan is the $200 million in federal funding for what they call the research centre. I think that it will be very hard to get funding because it's just not what the federal government is spending money on.

Something has to be done about the present situation, but I don't think it will be Dr. Steinmetz's vision and it probably won't be mine either. After the people planning all this get a rude dose of reality in terms of being turned down for a big grant, I think we will get more realistic projects that will be much to the satisfaction of everybody.

--Dominique Ritter