There was no good news for the neighborhoods in last week's report on the status of the Caritas Christi health care system, as the future of Caritas Carney Hospital was called into question.

Attorney General Martha Coakley, herself a one-time Dorchester resident whose career in politics began when she lived here on Pope's Hill a decade ago, placed her imprimatur on a consultant's report that calls for diminishing the Carney's role as an acute care hospital.  Coakley's Philadelphia-based consultant wrote,  "Acute medical-surgical inpatient hospital care may not be the appropriate future for Carney."

Instead, the report suggests that Carney consider expanding its services to behavioral health, such as psychiatry and substance abuse treatment- that is, a psychiatric care facility. Currently, Carney operates such a secure, locked-down unit that represents about 25% of its in-patient beds. It is not likely that local political and civic leaders will support such a drastic change.

The report does serve to underscore an important point: the future of the Carney remains uncertain, and the people who know the Carney and our neighborhood best- Carney staff, managers and trustees- do not have the authority to decide the hospital's future. Once an independent hospital owned by an order of Catholic nuns, Caritas Carney is now a subsidiary of Caritas Christi, the local health care system owned by Boston's Roman Catholic archdiocese. And Caritas, itself struggling to redefine its own future, can be expected to make decisions based on its own viability. Since Carney is widely viewed as a drain on the Caritas system, the officials just may be tempted to place its fiscal needs ahead of the needs of the Dorchester and Mattapan communities.

One Caritas official told this newspaper: "One thing is for sure, Carney can't maintain the status quo. There has to be change. We have to find a balance of services at Carney to make it profitable." Ironically, if there is a status quo problem, it can be attributed largely to the problems surrounding Caritas itself.

To be sure, local Carney officials say the Caritas system has been largely supportive in recent years, even providing a significant infusion of funds to offset recent operating losses. Carney Hospital has shown recent growth in patients and in profitability, and it remains an important resource in the working class neighborhoods it serves here on the south side of the city. It can boast of a marvelous, dedicated staff- physicians, nurses, and support staff- who work as a coordinated team that has shown remarkable resilience over the years.

In his own comments, Carney president Dr. Dan O'Leary said,

"There is a gritty resilience to Caritas Carney.  There is a reason for this.  It is central to the lives of this community.  It is not going away.  And as long as I am President, Caritas Carney Hospital will continue to meet the needs of the community it serves, including providing inpatient acute care services.  Absent that, it will not long endure. 

"History has shown that this hospital meets vital community needs," O'Leary said."Whatever we do will be with the goal of maintaining Caritas Carney Hospital as a viable community hospital providing quality services - both inpatient and outpatient."

The Carney Hospital is vital to the needs of our community. It is our hope that Caritas will weigh the best interests of the people of Dorchester and Mattapan as it moves ahead in defining the Carney's future.

- Ed Forry