Editorial: Hospital chief fails to lead in birthing center closure

  • Holyoke Medical Center, Wednesday, June 3. gazette file photo

Published: 6/25/2020 3:45:16 PM

Holyoke Medical Center’s rationale behind the pending closure of its maternity services unit seems reasonable — annual losses of $3 million to $4 million “for years” and an inability to increase deliveries, hospital brass say — but CEO Spiros Hatiras’ unwillingness to be transparent about the decision and what it might mean for the community is a failure to lead.

There was finger-pointing this week when Hatiras, who has not returned multiple calls and emails from the Gazette about this topic, wrote an email to Holyoke City Council President Todd McGee asking him to “correct the record.” He wrote that he wanted to save everyone “embarrassment” following criticism from councilors over his poor communication about the decision to close the hospital’s Birthing Center.

The hospital’s boss went on to say that he followed appropriate state requirements by notifying relevant local stakeholders of the service closure, including the council president, 30 days before the hospital was set to file a formal 90-day closure notice to the state Department of Public Health. That notice is expected to be filed next week. He then said he sent two emails and multiple calls to McGee from May 29 to June 4.

“It is not my place to supersede that authority and proceed directly to the city council. The requirement was pretty clear as to what I needed to do,” he wrote.

This all may be true, but doing the bare minimum is not enough. Hatiras should have gone around McGee if necessary to inform the city’s political leaders of the hospital’s decision. He should have offered to hold a community meeting, met with the news media and gathered together stakeholders as many times as necessary. He needs to put this tough decision into context for the city, the hospital and its patients and for the larger community.

Hatiras should also address accusations made by former nurse midwives and nurses of Midwifery Care of Holyoke, who said they and other co-workers were subject to “bullying” and micromanagement by administrators. Some of these employees put the blame for the birthing services closure squarely on management.

HMC is not the only hospital that owes its residents a better explanation behind its decision to close a key department. Providence Behavioral Health Hospital, which said in March it planned to close 74 inpatient psychiatric beds, also needs to do a better job communicating.

We know it’s not easy to explain the closure of key units of a hospital system, and the regulatory hoops are rigorous, but we’d like these leaders do a better job for one of our more vulnerable communities.

Hatiras did shed some light on HMC’s decision to close its Birthing Center in an email to staffers. He said the hospital had been unable to increase the number of deliveries at the 13-bed obstetrics unit and 10-bassinet infant nursery. Without a “critical volume,” further investments in the service are not financially feasible, and the annual multimillion-dollar losses are not something the hospital can sustain without risking the “entire organization,” he said.

It’s hard to argue with those numbers, but eliminating the maternity service has rightfully raised concerns among many in a community with a history of poor maternal health outcomes. Midwifery Care of Holyoke was formed in 1985 as the direct result of a state task force looking to lower the city’s infant mortality rate, which at the time was the highest in the state, with Latina women suffering disproportionately.

Women will still be able to receive prenatal care at HMC, but patients will deliver at Mercy Medical Center in Springfield, where HMC obstetricians will have privileges. There are other options, too, including Baystate Medical Center in Springfield and Cooley Dickinson Hospital in Northampton.

None of these choices are ideal for many people in Holyoke who lack adequate transportation, a concern that has been raised by advocates, city officials and former HMC employees.

Given the importance of hospitals and birthing units to a community and the number of closures across the state in recent years, a new bill designed to strengthen DPH’s “essential service closure process” is a step in the right direction.

The bill, put forward by the Massachusetts Nurses Association and sponsored by state Sen. John Velis, D-Westfield, would require hospitals to notify DPH of a closure earlier in the process and to show proof that they collected community feedback before issuing that notice.

The first step Hatiras ought to take is to accept an invitation to testify before the Holyoke City Council, whose members last week condemned the closure after some voiced frustration with hospital leadership over the lack of notice given to the council.

There are many questions that need answers, and those questions are coming from Holyoke residents, not regulators in Boston. It’s time for answers.

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