Photo by Eric Sumberg
State Senator Tom Duane posed a question to the health experts on the panel last Friday. Audience members submitted questions as they entered, many of which were along the same lines as those that Duane and the other politicians had been planning to ask, a Duane spokesperson said.
Giving birth to a new hospital wouldn’t be easy, experts say
By Lincoln Anderson
About 200 people turned out last Friday for what was billed as an “educational panel” on how to get back a hospital for the Lower West Side. They learned a lot — but it wasn’t all encouraging news.
The panel of 10 health experts — assembled by state Senator Tom Duane and his staff — didn’t speak with a unified voice by any means. Some of them said that, in the wake of St. Vincent’s Hospital’s closing, people should give up hope of getting a new hospital, and instead focus on securing targeted health services for the community. Others, citing healthcare trends, stated bluntly that it would be hard to make a case for how a new hospital could survive financially.
However, prompting cheers from the audience, a former St. Vincent’s nurse said that a smaller, more streamlined hospital could quickly be reconstituted at the old St. Vincent’s site — and that St. Vincent’s former doctors and nurses would come running. In a similar vein, the idea of a minimal hospital, only large enough to support an emergency room, was also discussed.
At the outset of the forum, held in Our Lady of Pompei Church’s basement hall at Bleecker and Carmine Sts., Duane, the event’s lead sponsor, stressed that the purpose was to listen to and learn from the health experts — not to vent anger over St. Vincent’s closing.
Duane no doubt wanted to avoid a repeat of April 24 when he was heckled as he was speaking after a march to save the Greenwich Village hospital. “Watta ya gonna do? Watta ya gonna do?” frustrated nurses had chanted at the state senator, demanding specifics on how to save the hospital, which closed down for good a week later.
“I know — we know — there is a lot of anger in this room, and in this community, and in our neighborhoods,” Duane told the senior-heavy Pompei audience. “We all have that anger.” He acknowledged there remained “enormous questions about how St. Vincent’s closing could happen so suddenly.”
However, he said, the goal is now to figure out how “we can turn that anger into action” to get a new hospital.
“We have to know what they know,” Duane said of the health experts. “Together, we’re going to get back a full-service hospital and the best care that anyone has seen in New York.”
Also on the stage with Duane — at least at the beginning — were the event’s co-sponsors, including City Council Speaker Christine Quinn, Borough President Scott Stringer, Congressmember Jerrold Nadler, state Senator Daniel Squadron and Assemblymembers Deborah Glick and Richard Gottfried, and representing Community Boards 2 and 4, Jo Hamilton and John Weis, the boards’ respective chairpersons.
Duane also gave credit to activist Yetta Kurland, saying she “helped get the word out” about Friday’s event.
Duane and Gottfried — the respective chairpersons of the state Senate’s and Assembly’s Health committees — were the only elected officials who stayed for the whole two-hour event. Glick stayed for most of the time. Quinn, Stringer and Nadler left fairly early on.
‘Why did it close?’
The first question was posed to James Tallon, president of the United Hospital Fund of New York — “What factors led to St. Vincent’s closure?”
Tallon said it was basically trends that are affecting the entire healthcare industry: Technology is improving, leading to shorter hospital stays.
“The heart attack that would have kept you there two weeks, today they have you out in a couple of days,” he said. “The hospital bed is a declining product. The hospital service — that is going to be done on an ambulatory basis increasingly.”
Also, Tallon added, the competition in Manhattan healthcare is fierce, or as he put it, “the most intensive medical environment in the world.” For many people, there were always other healthcare options than St. Vincent’s, and that hurt the hospital, he said.
Judy Wessler, director of the Commission on the Public’s Health System and a Charles St. resident, however, chalked up St. Vincent’s failure to “a lot of incompetence, a lot of mismanagement, a lot of money wasted, just a lot of bad decisions — paying for high-priced executives instead of care.”
Eileen Dunn, a former St. Vincent’s nurse who is on the board of the New York State Nurses Association, said the “beginning of the end” for the hospital came six years ago, shortly before St. Vincent’s filed for its first bankruptcy.
“I can say we had the best doctors and nurses at that hospital,” Dunn said. But she added, “We didn’t even have blood-pressure machines that worked. ... We questioned why there were so many vice presidents.”
Nadler said, “It’s imperative that we all have a full-service hospital. The question is now — what can we do? We will do everything we can to restore what we had and to, God willing, make it better.”
Stringer also pledged his support, before exiting with Nadler.
Tallon said, the economics of a new hospital would have to work. First, he explained, there’s the cost of starting the hospital, including building a new one were it to be somewhere other than the old St. Vincent’s site; then, there’s the cost of attracting a hospital staff and providing services — all which must be projected to break even financially over a 10- or 15-year period.
Retool hospital site?
Glick asked about St. Vincent’s physical plant, specifically its main buildings on the east side of Seventh Ave. between 11th and 12th Sts.
“Should that facility become available after bankruptcy, what should be done?” Glick asked.
Dunn answered first by saying that the failed plan by St. Vincent’s to build a new hospital on its O’Toole site, on the west side of Seventh Ave. at 12th St., while selling its east campus for private development to the Rudin Organization, was unrealistic.
“The nurses never backed ‘Henry’s Folly,’” she scoffed, “because there was no money there. That was never going to happen.” She was referring to Henry Amorso, the hospital’s former C.E.O.
Dunn said representatives of Mt. Sinai Medical Center, who were inspecting the hospital for a possible takeover, found it to be in surprisingly good condition, and saw no need for a new hospital on the O’Toole site. But Mt. Sinai suddenly pulled out of talks, soon after which St. Vincent’s decided to close.
However, LaRay Brown, a senior vice president of the city’s Health and Hospitals Corporation, said the city has been rebuilding its old hospitals during the last 10 years, and that “it’s a huge amount of money.”
H.H.C. — which operates Bellevue Medical Center and also Gouverneur Hospital on the Lower East Side — has a $1 billion debt from serving a huge amount of low-income Medicare and Medicaid patients, she noted.
Both Brown and Wessler felt strongly that a new hospital would never open in the Village. They said that instead of focusing on hospital services, the community should work on increasing local healthcare services.
Wessler later drew jeers when she said that heart attacks can be prevented by primary care — then more catcalls when she added, “One heart attack doesn’t mean you’re going to have another one.”
‘Clinics don’t do crises’
But Dunn protested: “As far as having health clinics all over the West Side — I’m sorry, my patients don’t deserve that.” She later noted, “On 9/11, or in Times Square if that bomb had gone off, I don’t think these little places would have taken people. The federal government needs to get involved here and keep us safe,” she said, as the audience applauded her remarks.
Hamilton, C.B. 2’s chairperson, asked if any funding from the Department of Homeland Security or Department of Defense might be available to help finance a new hospital project. David Rich, executive vice president of the Greater New York Hospital Association, said he wasn’t aware of any.
Weis, C.B. 4’s chairperson, asked what the staff considerations at a new hospital would be.
Dunn said it wouldn’t be a problem: “If you were going to tell me tonight that we were going to have a new hospital at 12th St. and Seventh Ave., I would make a few phone calls and we would have enough doctors and nurses to fill that hospital within a week; 1199 would come back, S.E.I.U. would come back; a lot of doctors have offices right around St. Vincent’s,” Dunn said. Again, the audience cheered its approval.
Rich said everything is basically on hold right now with St. Vincent’s campus, however, noting, “I can’t even imagine anyone looking at this until the bankruptcy court is done with its work.”
E.R. is the key
Assemblymember Gottfried said it was clear that an E.R. is what the community wants most, as the audience clapped. He admitted, though, that no one has ever heard of “a free-standing E.R.”
“I think the question is — how much hospital does an emergency room have to be attached to to enable it to function?” he said.
“It does not make sense to have an emergency room without a hospital,” Brown said. “And it costs millions of dollars to operate an emergency room.”
Dunn said a Level 1 trauma center with a 300-bed hospital would probably be enough. A hospital with an intensive-care unit and surgeons is needed so that E.R. patients can be admitted as inpatients to recover, as opposed to being transported from the E.R. to a nearby hospital.
Dunn said when she first started working at St. Vincent’s, there were 800 beds, which had dropped to 500 beds about 10 years ago. At the end, St. Vincent’s had 250 to 300 beds, she said.
After the meeting, Dunn said that just St. Vincent’s Coleman building — which is only about 20 years old — at 11th St. and Seventh Ave., would be enough for a hospital, and that its upper floors were where the acute-care beds used to be.
But, speaking on Sunday, Arthur Schwartz — the attorney who has filed a lawsuit to block the state’s plan for an urgent-care clinic at St. Vincent’s — said St. Vincent’s former east campus is far too valuable to developers and won’t see another hospital; he thought the O’Toole site, though, might potentially be usable as a hospital, saying it wasn’t as attractive as a development site.
“Urgent-care center” were words last Friday’s audience didn’t want to hear. At one point, after a panelist uttered them, frustration swept the crowd and they started chanting, “Hospital! Hospital!”
Hospital helps everyone
Glick added that, beyond community residents who want a hospital, Manhattan sees a daily influx of 2 million or 3 million people, including commuters from the suburbs and tourists from around the world — plus, of course, large numbers of nightlife visitors.
“If we have an accident — a bus flips over — half of those people aren’t from here, but will go to the nearest hospital, wherever that is,” Glick pointed out.
“Maybe St. Vincent’s wouldn’t be as big if it came back,” the assemblymember reflected, “but I also can’t imagine this community without a full-service hospital.”
As for the planned urgent-care center, Wessler said she didn’t like Lenox Hill Hospital being awarded the contract to run it since, she said, Lenox Hill, unlike St. Vincent’s, isn’t known for helping the needy.
“There was something smelly about that deal,” she said.
Similarly, a panelist who requested anonymity later said some suspect Lenox Hill will try to “pick off” the more affluent of St. Vincent’s former patients, and ignore serving the indigent.
In response to a question by C.B. 4’s Weis on what the community can do to help push for a hospital, Dunn said people in the Village/Chelsea area should feel lucky to be represented by Duane and Gottfried, the Legislature’s two Health Committee chairpersons, and should work with them.
Added Kevin Finnegan, political director of 1199 S.E.I.U., the healthcare workers’ union, “I think the political resistance is nonexistent. What we don’t have is money.”
Clinics are gearing up
Elizabeth Benjamin, a board of directors member at Callen-Lorde Community Health Center, on W. 18th St. in Chelsea, said they’ve been readying to help fill the vacuum from St. Vincent’s closing. The state has provided a $4.6 million grant to four local health clinics, including Callen-Lorde, along with $9.4 million for the Village-based urgent-care center. The other three clinics are the Ryan-NENA center on E. Third St., the Charles B. Wang center in Chinatown and the Ryan/Chelsea-Clinton center on W. 46th St.
The four clinics, Benjamin said, together will be able to take an additional 75,000 patient visits per year, noting that most of St. Vincent’s E.R. visits were “treat and release.”
“We will be open night and day,” she said. “We’re all hiring more doctors, more nurses.”
Regarding whether the Village-area urgent-care center would be on the St. Vincent’s site, Finnegan said although that agreement was made before the hospital declared bankruptcy, it’s now in the bankruptcy court’s hands, and that he didn’t have an answer.
Work vs. rally — or both?
At the end of the two-hour panel, Duane gave his assessment, and vowed to keep fighting for a hospital.
“We got a lot of tough news. We got a lot of help,” he said.
“I will be at every demonstration. I will be at every rally,” he pledged, though adding, “We’re going to work, work — not just rally.
“We can march around, but we have to work together,” Duane said. “I’m in anger — but I’m putting it into action.”
Yetta Kurland, in fact, will be “marching around,” more specifically, leading “Hands Around St. Vincent’s” on Sat., May 29, from 2 p.m. to 4 p.m., at 12th St. and Seventh Ave.
It was an open secret that Kurland’s activism — and holding two town hall meetings on St. Vincent’s — helped bring about last Friday’s educational panel. To her chagrin, though, she wasn’t invited to join the elected officials up onstage.
Kurland ran a strong race against Quinn last year in the Democratic primary and is expected to run again in 2013 — but she remains somewhat of a political outsider.
Afterward, asked her thoughts on the educational panel, Kurland said, “I was very disappointed. I came here with an open mind. ... We’re not going to be dissuaded by the pessimism of the presentation. We’re going to rally, show up on May 29 — to show our elected officials that there is a way, there is a location to have public health and safety on the Lower West Side.”
‘A reality check’
Brad Hoylman, chairperson of C.B. 2’s St. Vincent’s Omnibus Committee and a former chairperson of C.B. 2, is also expected to make a run in 2013 for the District 3 Council seat.
“I think the forum was in some respects an important reality check,” he said. “It’s true that some of the panel experts were more skeptical than others about the chances of us getting a full-service hospital back in the neighborhood. But we need to know what we’re up against — especially when those skeptics seem to include the State Department of Health, which is the main decision-maker in what will replace St. Vincent’s.
“We absolutely need to fight for a full-service hospital, but it’s important to be responsible and realistic about what’s possible, too,” he said. “Not only is New York State out of money, but St. Vincent’s left behind about a billion dollars of debt and a long line of creditors. Both of these factors, unfortunately, will have an impact on what we can expect in a new facility. I wish we could, but we can’t just wave these issues away.”