Need for community services called an ‘urgency’ in April
It has been a year since the Massachusetts Department of Public Health (DPH) allowed the closure of the Carney Hospital, which had served Boston and nearby suburbs since 1863. The state allowed it to close despite issuing a statement twelve days earlier saying that “The Department has made a finding that the Hospital is in fact an essential service necessary for preserving access and health status within the Hospital’s service area.” The DPH accelerated the closure – against its regulation requiring 120 days’ notice before closing a hospital – presumably to help Steward Health Care financially.
Ten months ago, the Boston Public Health Commission and DPH formed a “Dorchester Health Planning Working Group” to come up with recommendations on what to do with the twelve-acre Carney campus. Mayor Wu and DPH Commissioner Robbie Goldstein praised the report they released on April 23, with Goldstein commenting that “the recommendations in this report reflect both the urgency [my emphasis] of the moment and innovative care models that can serve as a blueprint for the work ahead. We are committed to continuing the dialogue with residents, community health centers, and our partners across government to advance solutions that are rooted in equity and responsive to the voices of the people most affected.”
Since then, the price tag for saving the other Steward hospitals has continued to climb and is now at $835 million and counting. But regarding the urgency of dealing with the health care needs of the Dorchester/Mattapan community and how the Carney factors into that? Resounding silence.
When the Carney was closed, Health and Human Services Secretary Kate Walsh expressed her opinion that the reason was because “the market has spoken.” I found that comment outrageous. The market cares about money – unless the government intervenes to ensure equity in areas determined to be important to society. In this case, the market certainly did not care about health or about people who were more likely to have lower-paying public health insurance like Medicaid.
And overall, it doesn’t care about whether the health care system makes sense, and so our laissez-faire, market-based economy has created a fragmented, unequal, and hugely costly system, one that put out of business a hospital serving a section of the city with a large low- income population, despite the greater need for health services and positive outcomes for poorer- health residents.
The state government isn’t the marketplace, and at least for essential services, it isn’t supposed to be making decisions based solely on market forces. In fact, the purpose of the DPH, as stated in its website, is: “DPH promotes and protects health and wellness and prevents injury and illness for all people. We prioritize racial equity in health by improving equitable access to quality public health and health care services and partnering with communities most impacted by health inequities and structural racism.”
Commissioner Goldstein has noted the urgency of this issue, so it’s past time for action. But DPH will not be able to take action regarding the goals of the Working Group without getting control of the Carney property, which still owned by Apollo Global Management, an Australian company with offices in New York.
Money should not be the issue here. The property is designated for health care, and when Apollo couldn’t get a legitimate bid for the property as a hospital, we learned that it has little value for that purpose. St. Elizabeth’s Hospital wound up being worth $66 million, and so the Carney property should go for less, probably a lot less. Essential health services, such as emergency and urgent and psychiatric care, could be contained in a segment of the 12-acre site, leaving space for other critical services and programs.
Making that happen would require a small amount of money, especially considering that the state has allowed billions of dollars to be spent on largely unnecessary new hospitals and wings for expensive downtown hospitals that will increase the cost of medical care. Recreating emergency care at the Carney in a renovated ER wouldn’t even be considered a “rounding error” compared to that.
Beyond that, Goldstein’s statement that DPH “has not heard from any hospital operator who is interested in operating the facility at Carney,” i.e., that a system would have to volunteer to take on important services at the Carney, is absurd on its face. The state makes deals all the time allowing hospital systems to create new wings, buildings, services, and mergers.
Having part of one of those deals involve operating an emergency room on Carney property should be an easy decision to make. Either Beth Israel, which operates Milton Hospital, or Boston Medical Center, which recently received both St. Elizabeth’s and Good Samaritan Medical Center as part of a state deal, would be the likeliest systems to take on services on the Carney campus.
The time to restore services at the Carney is now. Our Public Health commissioner says it’s an “urgency.”
Bill Walczak is a columnist for the Reporter and the former CEO of Codman Square Health Center who also served as president of Carney Hospital.
