Monster job of reorganizing services at Maisonneuve-Rosemont Hospital begins

Maisonneuve-Rosemont hospital is seen in Montreal, Monday, Sept. 11, 2023. THE CANADIAN PRESS/Christinne Muschi Christinne Muschi

With Maisonneuve-Rosemont Hospital set to be transformed into a mega-building site in the next year or so, management is having to implement a major reorganization of its services. If the objective is to maintain all services, then the contributions of the entire Centre intégré universitaire de santé et de services sociaux (CIUSSS) de l'Est-de-l'Île-de-Montréal, will be needed to achieve the goal.

When the project was announced last Monday, Health Minister Christian Dubé spoke of a timetable of eight to 10 years for the work to be completed. Then, in documents filed online on Tuesday calling for bids for architectural and engineering services, they mentioned a "probable completion date ... in September 2037".

Clearly, the Maisonneuve-Rosemont Hospital (MRH) is in for a long period of cohabitation between construction and health-care workers. CIUSSS President and CEO Jean-François Fortin Verreault says he has "already started making room" to accommodate everyone.

The CEO, who has already drawn on his experience with the Centre hospitalier de l'Université de Montréal (CHUM) construction site, is well placed to know that the challenge "is going to be demanding." He insisted on the importance of mobilizing other CIUSSS services in order to relieve HMR.

Family medicine groups (FMGs), Santa Cabrini Hospital and the University Institute of Mental Health will all be involved. There is also a desire to improve homecare services to free up beds.

"Mental health hospitalization is now done at the University Institute of Mental Health. We also recently relocated some of our ophthalmology and general surgery activities, with a call for tenders to the private sector," he explained. "We are operating out of private premises that is being run by our employees at Angus."

This relocation of part of the activities has "freed up clinical volume," added Fortin Verreault, who plans to deploy other similar measures over the coming year.

The palliative care unit at the Rosemont Pavilion is to be housed at the Centre d'hébergement et de soins de longue durée (CHSLD) de Saint-Michel. The Institut universitaire en santé mentale, the private medical center and the CHSLD are all located within a five-kilometre radius of HMR.

In the case of Santa Cabrini Hospital, which is located very close to Maisonneuve-Rosemont, Quebec City has apparently earmarked funds for two additional operating rooms within the next two years.

"We're working on a coherent clinical plan to make sure it works. It's going to be demanding, but we have the solutions to make it happen," assured the CEO.

Thanks to this coordination work, Minister Christian Dubé has taken the liberty of suggesting that "preparatory work" could begin as early as 2024 in the current facilities.

Although very enthusiastic about seeing the hospital modernize, the Syndicat des techniciens et professionnels du CIUSSS de l'Est-de-l'Île-de-Montréal, affiliated with the Canadian Union of Public Employees (CUPE), intends to remain watchful as the work proceeds.

"Between now and its full completion, we'll need to be vigilant," warned its president, Marie-Hélène Brunet, in a press release. In particular, she wants to ensure "that the inevitable temporary relocation of care and services has as little negative impact as possible." She is concerned about a possible "scattering of services."

'PRIVATE MINI-HOSPTAL'

The other relief valve mentioned by Dubé is the government's commitment to build a "private mini-hospital" in Montreal's east end. This project, described by some as a "large FMG" or "private CLSC," has been denounced by defenders of the public network.

Dubé's statement also triggered the SCFP. For the union, it all sounds like "a pretext for privatizing the healthcare network."

According to the union, a greater role for the private sector will "exacerbate staff retention problems" and "siphon off public funds."

However, in the eyes of the health minister, what counts is "access to emergency services" for patients. He gave the example of clinics run by specialized nurse practitioners (SNPs), and points out that these alternative points of service help reduce pressure on hospital emergency units.

According to Dubé, a call for tenders should be launched this fall to find a private partner interested in managing this new service. His goal is to have this future private emergency department welcoming patients by 2025.

Will this service be short-lived and obsolete in a decade's time, once the work has been completed and the focus shifts to a new, ultra-modern hospital? The minister has imagined that, but doesn't believe it. He remains of the opinion that patients in need of care, but whose condition is not urgent, will always need a place to go.

He points out that around 50 per cent of Quebec's emergency department traffic is currently priority 4 or 5 cases, or non-urgent. These patients must be redirected to family medicine clinics, GP's clinics or, soon, private emergency departments.

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This report by The Canadian Press was first published in French on Sept. 15, 2023.