Open or closed?

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Is health care a subject for open debate or it is an issue for the privileged few?

That, as much as anything, is behind the battle which is being fought in the open this week in a union hall in Wallaceburg as opposed to behind closed doors in a plush Chatham-Kent Health Alliance board room.

The battle is over the Alliance’s plan to eliminate the emergency department at Sydenham District Hospital.

It wasn’t supposed to be this way. Alliance personnel have been trying to sell the concept in secret meetings but didn’t find many takers.

Call it what you will but the plan remained about as secret as it is when a top CKHA official brings in his trash to the Chatham campus so he doesn’t have to pay extra fees at home.

These things just get out. Especially when you’re talking about a move that medical professionals (at least to each other) are saying will cost lives. Especially when you have among the highest administration cost and worst wait times in the province for ER care.

Any one of these things individually doesn’t necessarily bring one to a conclusion, but together, they point out some issues that need attention.

We now have a situation where two of the three hospital boards (St. Joseph’s and Public General) that make up the overall Alliance board have suspended governance procedures because their SDH counterparts wouldn’t “go along to get along.”

Coincidentally (or not) the SDH board is the only “public” board, meaning members of the community (for a $3 annual membership fee) can vote them in or out.

The Chatham boards eliminated that nicety. You can apply to join when there’s a vacancy and if you make it through the vetting process, you get a seat.

Board members aren’t paid, but the Alliance does shell out nearly $200,000 for reimbursement of “out of pocket” expenses and travel, conference and governance costs.

If the plan had been to close the Chatham campus emergency department, (indulge us for a moment), it’s unlikely any of this fuss would have been made public until the Alliance had its ducks in a row.

It’s messy when the great unwashed – those without accreditation, those without years and millions in health care income and without the backslapping fellowship of their peers – express an opinion.

It’s messy when they want a voice, messy when they jump the queue and raise a fuss.

That’s the thing about democracy. It’s messy.

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