It is our pleasure to present to you the annual report of St. Mary’s Hospital Center for 2003-2004. This has been a turbulent and exciting year for the health and social services sector, as well as for St. Mary’s Hospital Center.

After the election of the new government in April 2003, a new health minister was appointed. Shortly after his nomination, Dr. Philippe Couillard announced that the healthcare sector would undergo a major reorganization starting with the abolishment of the regional health and social services boards.  This caused uncertainty within the healthcare network. 

Following this announcement, three bills were tabled in the National Assembly and assented in December 2003. 

•     The Act respecting bargaining units in the social affairs sector and amending the Act respecting the process of negotiation of the collective agreements in the public and parapublic sectors which aims at reducing the number of bargaining units in the health and social services sector (Bill 30); 

•     The Act amending the Labour Code which aims at modifying section 45 of the Labour Code and introducing sub-contracting (Bill 31); 

•     The Act respecting local health and social services network development agencies which seeks to bring services closer to the population and make it easier to move through the network. It also created the local health and social services network development agencies, replacing the regional health and social services boards. The mission of these new agencies is to propose a plan to the Minister for the reorganization of the healthcare services within their respective region (Bill 25). 

Considering the impact of Bill 25 on healthcare, the Montreal region, our institution and the community we serve, the Board of Directors and Management of St. Mary’s followed this issue very closely. Under the leadership of the Director General and CEO, St. Mary’s prepared a brief underlining serious and well-documented facts explaining why St. Mary’s had to be excluded from a local health and social services network (local authority) and remain autonomous. In this endeavour, St. Mary’s was strongly supported by its various boards, physicians, staff, volunteers, as well as its many partners in the community.  McGill University also demonstrated its unanimous support, along with the members of the McGill University RUIS (réseau universitaire intégré de santé) – McGill University Health Centre, Jewish General Hospital and Douglas Hospital. An awareness campaign was launched to inform decision-makers of our reality and to defend our position.

Because of its vast experience in entering into service contracts and agreements with its many partners and its membership with the McGill RUIS, St. Mary’s was well-positioned and very confident from the beginning that it would be excluded from a future local authority.  Following the public consultation period of the Agence de développement de réseaux locaux de services de santé et de services sociaux de Montréal (the Agency), the decision-makers recognized St. Mary’s unique role as a university-affiliated hospital serving a broad and geographically dispersed community,  and its partnership with the McGill University teaching hospital network. Therefore, its final recommendation to the Ministry of Health and Social Services was that St. Mary’s be excluded from a local authority.  

The Minister also announced the creation of four RUIS: McGill University, University of Montreal, University of Sherbrooke and Laval University. These new organizations are chaired and co-chaired on a rotational basis by the deans of the Faculty of Medicine and the directors general of the university health centres. Each RUIS was given the mandate of identifying orientations and informing the Ministry of Health and Social Services on:

•     University hospital centre specialized and superspecialized services, university institutions, and the areas of excellence of the university-affiliated centres;

•     Teaching of university health disciplines;

•     Research and evaluation of healthcare technologies and intervention methods;

•     The manner in which specialized and superspecialized services are organized; and

•     The corridors of services to be established with the other components of the health and social services network.

In addition, the RUIS will be required to bring their activities in line with health services plans and the complementarity of medical services in the health and social services administrative regions they encompass. 

The establishment of a RUIS adds an element of complexity to the identification of an organization model on the Island of Montreal, especially since there is not one, but two university networks present. 

Although the RUIS are not yet legal entities, the McGill University RUIS started meeting in September 2003 and is chaired by Dr. A. Fuks, Dean of the Faculty of Medicine. St. Mary’s was integrated to the RUIS from the beginning. It plays a key role in the McGill University Faculty of Medicine with the teaching it offers at various levels, as well as its involvement in research and other scientific activities.

The teaching role of St. Mary’s and the complementarity of services within the McGill University RUIS was reiterated in the report of the Commission d’analyse des projets d’implantation du Centre hospitalier de l’Université de Montréal et du Centre universitaire de santé McGill (Mulroney-Johnson Commission).

In April 2003, the former Montreal Regional Health and Social Services Board released its three-year plan entitled Action for health: Montreal improvement plan for health and well-being 2003-2006. The general focus of the plan was the improvement of access to care in the Montreal region. Some of the major points addressed in the document are:

•     The reduction of waiting lists for hip and knee replacements, and cataract surgery;

•     The coordination of specialized services; and

•     The availability of physicians. 

As part of this plan, St. Mary’s was appointed one of the three designated sites for cataract surgeries. The designation was fitting, considering St. Mary’s long-standing reputation as a specialist in cataract operations. This year, St. Mary’s performed 2,674 cataract operations and this number is expected to reach 7,500 by 2005-2006. Of course, this could not have been accomplished without everyone’s collaboration, especially the Surgery Program that co-ordinated the various aspects with all the clinical departments and the support services involved.

As cataracts are common among the elderly and the country is facing an ever-aging population, hospitals need to be prepared to deal with the growing caseload. St. Mary’s is happy to be part of the plan as it falls in line with its vision to continually provide the best possible quality of care to its patients. 

On September 26, 2003, the new principal of McGill visited our hospital. A few months following her appointment, Principal Heather Munroe-Blum toured the hospital and met with several groups of St. Mary’s clinical and governance community. The exchange was fruitful and will enhance the long-standing collaboration between McGill University and St. Mary’s Hospital Center towards patient care, teaching and research. 

On October 20, 21 and 22, the Canadian Council on Health Services Accreditation visited St. Mary’s. This organization promotes excellence in the provision of quality health care. When an institution participates in the accreditation process, it clearly shows to clients, communities, stakeholders and partners its commitment to quality. The overall comments at the end of the visit were excellent and we were granted a full, three-year accreditation. The excellence of this award is due to the involvement and volunteer leadership of our various boards and the work of clinical, support and management teams who share in the responsibility of ensuring that our mission of care and service to our patients is fulfilled.

The survey report acknowledged and commended St. Mary’s for numerous achievements since the previous visit. The main recommendation concerns the physical facilities and St. Mary’s has already started the process to come to terms with its aging building plant. Major renovations are currently underway or have been completed during the fiscal year. 

•     The renovation and air-conditioning projects on 7 and 8-Main have been successfully completed. These important projects would not have been possible without the generous gift of an anonymous donor. Patience, understanding and collaboration were key to the successful completion of the project. 

•     Thanks to the generosity of the Auxiliary of St. Mary’s Hospital Center, renovations were completed in the Mental Health Program, more specifically in the inpatient psychiatry unit. 

•     The Family Medicine Centre project is underway and is progressing well. The first step was to relocate the main entrance of the building on Jean-Brillant Street.  In order to begin the refurbishing, many services were temporarily moved either to the main building, to the building located at 5300 Côte-des-Neiges, or to the modular units installed in the parking lot next to the annex building. The target date for the completion of the project is December 2004. 

•     Two operating rooms have been equipped with new state-of-the art laparoscopy equipment for non-invasive surgeries. This will undoubtedly help in attracting and retaining surgeons. 

•     As reported last year, St. Mary’s was designated as one of the recipients of a Magnetic Resonance Imaging (MRI) system. The MRI has been ordered and is expected to be installed in the coming fall. This project is funded by the Agency and the Ministry of Health and Social Services.  

•     Through the continuous efforts of St. Mary’s Hospital Foundation, money has been secured for the birthing centre project. The project was approved by the Agency at its meeting of the Board of Directors in March 2004. The renovations will enable us to offer family-centered care, to improve efficiency and to enhance staff recruitment and retention. We are very happy that delivering mothers and their families will soon be able to benefit from a state-of-the-art labor and delivery suite. This project is the continuation of the renovations undertaken in the post-partum area in 1996-1997.

All these projects will no doubt add greatly to patient care and staff satisfaction. 

Once again, St. Mary’s was recognized as efficient and underfunded. Therefore, the Agency authorized us to end the fiscal year with a deficit of $5.4 million, provided that we would offer the same volume of services.  As the final statement of operations shows, we closed the year with a slightly higher deficit of $5,684,214 due to an uncontrollable increase in certain expenses, such as: drugs, medical and surgical supplies, parental leaves of absence and salary insurance.

The strength of St. Mary’s is bedside care given by caring employees and physicians who strive to sustain our high standards of quality patient care. Of course, this would not be possible without the continued support and commitment of our benefactors, volunteers and our boards (Hospital Center, Foundation, Governors and Auxiliary).  We are grateful to them, but most of all we are grateful to our patients and their families who put their confidence and trust in St. Mary’s Hospital Center.

In the coming years, St. Mary’s Hospital Center looks forward to playing a key role, not only in serving its community, but also in fulfilling its role as a member of the McGill University RUIS, which will no doubt impact favourably on patient care. 

Respectfully submitted, 

Richard J. Renaud
President