There are moments in life for which one cannot be properly prepared. One is running down a hospital corridor to get in the door of ICU before the 10 minutes of visiting time for a two-hour block ends. I would know. A few years ago, my heart pounded through my ears, as the necessity to see and comfort my loved one propelled me beyond physical limits of my body and sprint the last 10 feet to the door. I made it. More so, I felt lucky to have a public hospital treat my loved one and trusted them to do what’s right in care and good faith.
Right now, we, as a community, are facing a discussion about fair and equal access to healthcare for everyone in our area. More so, that public trust in the powers that be deal openly and honestly with the people they have sworn to represent.
For the last several months the proposed sale of New Hanover Regional Medical Center (NHRMC) has had our area in a quiver of confusion. “The Hospital Sale” is about public trust—or lack thereof. The speed with which the initial announcement and subsequent timeline were presented to the public left me in shock. The obvious disregard of citizen concerns was painful, as was the vote to move the process forward, despite requests by hospital staff and citizens for more time and more answers.
NHRMC is the largest employer in our region with more than 7,000 employees, according to StarNews. New Hanover County Public Schools hold second at more than 3,500. Just pause for a moment to consider that 7,000 households derive their sustenance from our local hospital.
Since the New Hanover County Board of Commissioners voted on September 16 (three in favor, two opposed) to approve an “intent to sell” resolution for the county to begin formally exploring new ownership of the hospital, I have been in turmoil trying to figure out how we got here.
I am not alone in the confusion. The revelations in days before and after the vote bring into question the transparency of the process and honesty of the information the public has received. State Senator Harper Peterson filed a formal complaint with NC Attorney General Josh Stein, citing “fundamental fiduciary, legal and procedural responsibilities have been put in question and have damaged the public’s trust in fair and open government.” He later notes he attended four public meetings on the topic—”listened to hundreds of citizens’ comments and questions, and recognize there is great uneasiness throughout the community that this process has been rushed, and there is concern an impartial, fact-driven and inclusive process will not be followed in the future. Specifically, certain county commissioner(s) have publicly expressed a desire to sell NHRMC, have ridiculed public comment and concerns responsibly expressed at public meetings, and have suppressed and dismissed the public’s desire to extend the September 16 vote.”
In addition, upsetting revelations have eroded further trust, specifically the intentional effort to circumvent the Public Meeting Law when discussing the potential sale of NHRMC. If three county commissioners gather, the items discussed fall under “public meetings” and thus must meet public disclosure. If less than three commissioners meet, the meeting doesn’t have to be advertised 10 days in advance or have official minutes taken and published.
County Commissioner Rob Zapple has gone on the record to share his concerns regarding the way he and other commissioners were approached about the sale. They were intentionally approached singly or in groups of two to meet with hospital officials regarding the possible sale, which means the discussions with them would not fall under the purview of public meeting. If indeed NHRMC and county government are trying to ensure transparency and a sense of public trust in the process, evading public meeting laws—though not technically illegal—certainly is not the way to do it.
When County Manager Chris Coudriet first began to make his case publicly for the sale of the hospital, he focused on the financial loss created by medical care from people who cannot afford to pay. It begs the immediate question: Why would a for-profit model, located on the other side of the country, care at all about the welfare of the neediest people in our community? Before accusing me of overreacting or fear mongering, let’s consider the history of NHRMC.
Hospitals and medical care were part of segregated life in the 19th and 20th centuries in Wilmington. In 1904 William Sprunt donated $10,000 to James Walker Memorial Hospital (JWMH), located on Rankin Street, to build the “colored annex”; African-American doctors did not have the same staff privileges at JWMH until 1957. Local Civil Rights Activist and prominent physician Dr. Eaton led a lawsuit filed by African-American physicians that argued if JWMH received federal funding, all citizens were entitled to equal use of the facilities.
At the time, Community Hospital (est. 1921), on the other side of Market Street, was the African-American hospital. When the county first tried to raise a bond issue to build New Hanover Memorial, the African-American community did not support it. They were convinced, though they would be taxed equally for it, they would not receive the same services. Given the history, it seemed like a perfectly legitimate concern.
In 1962 surveyors on horseback assessed the future site of NHRMC—which was mostly pine forest. The first attempt to vote on a bond issue to build the new hospital did not pass. It took concerted effort and promises. Eventually, the African-American community was persuaded to vote in favor of the new hospital.
According to the Healing Through Time exhibit in NHRMC’s lobby, “When New Hanover opened in 1967, Community Hospital and JWMH both closed, and New Hanover Memorial merged the black and white hospitals without incident, a civil rights milestone for the region.” When considering the political climate in 1967, that is pretty remarkable.
Fast forward to 2019: equal access to healthcare still should be regarded as we look at the proposed sale of NHRMC. What assurances do we, the public, have that all patients will be treated with the same standards of care, without dramatically increasing costs to consumers? Especially when oversight to ensure equality and care would be left to a corporation not located here, with no sense of our community or our history?
This isn’t the first time the sale of the hospital has been explored. On September 2, 1986, the New Hanover County Board of Commissioners voted against the proposal to privatize the hospital. In 1991 the hospital was renamed New Hanover Regional Medical Center and the NHRMC Foundation was created to fund and support the hospital. By 1997 there had been three attempts to reorganize the structure of the hospital, and one included creating a Hospital Authority, not dissimilar from the Tourism Development Authority that operates our Convention and Visitor’s Bureau. The Emergency Services for New Hanover County (EMS) were acquired by NHRMC in 1998. Its operating cost is estimated at $2 million per year when funded by county revenue. That is another piece that hasn’t been adequately addressed: Who will own and operate EMS and at what cost to the consumers?
On May 19, 1998 NHRMC purchased Cape Fear Memorial Hospital for $98 million from Columbia/HCA, during a sell-off of 22 hospitals in one fell swoop. Cape Fear became part of our public hospital and Cape Fear Health Network was created. Perhaps that is a warning in itself about the potential for the hospital to be resold to an entity that the public has no say in choosing.
There are numerous economic pieces that have not been adequately addressed for New Hanover County residents. NHRMC’s assets are roughly estimated at $1 billion—which is the starting number for the discussion of the sale. As Sen. Peterson noted in his letter, there is no clear schedule of what is owned by NHRMC and what is owned by the county. That should be part of the public discussion for the beginning.
In addition to healthcare and employment provided directly by NHRMC, there is the education piece that fits into this economic picture, too. In 1964 Cape Fear Tech (now CFCC) began offering a licensed nursing program; in 1967 Wilmington College (now UNCW) graduated its first class of nursing students. Both programs developed from nursing training programs built by JWMH and Community Hospital.
In December 1972, Bruce and Dan Cameron funded what became the Coastal Area Health Education Center (Coastal AHEC), thus turning New Hanover into a teaching hospital where pharmacists, nurses and physicians are trained. It is a significant part of the legacy of medicine and healthcare in ILM.
Selling the hospital could bring with it the shuttering of AHEC and elimination of the teaching component—which has been the model with the private sale of other hospitals. Not only would it be a loss to staff, physicians, nurses and patients, it would greatly impact nursing programs offered at UNCW and CFCC.
Just think of the people who move here for the nursing programs: money they spend on housing, transportation, food, entertainment, taxes, etc. That piece alone would be a huge blow to the local economy.
I am baffled that we did not learn this lesson in 1960 when the Atlantic Coastline Railroad left (the then largest employer in the area). Even more recently, we suffered economic stimulus when our film industry left after the incentive program sunset. We are making steps forward with the film industry returning, but if we lose the education piece of the hospital, it will be a loss we feel immediately—one that will hit our pocketbooks long term on a day-to-day basis.
At present we, the people of New Hanover County, have a say in the continued development and investment in an asset that has accrued in value both financially and in the most fundamental of ways: in the quality of life and safety of the people live here.
Throughout all the coverage of the potential sale of NHRMC, County Commissioner Jonathan Barfield has asked a pertinent question that has been largely ignored. On September 17 The Port City Daily reported Barfield noting a program had been devised to allow NHRMC to borrow outside the county to fund construction, which they are currently prohibited from doing. Somehow the idea of selling NHRMC has become pressing, rather than allowing NHRMC to secure capital from new sources. He said a document outlining the process to give the hospital the ability to borrow is on his desk, yet it isn’t part of the conversation.
I have to agree with Commissioner Barfield. Why are we rushing to sell one of our most valuable assets, rather than investing in it? To say it could come under the heading of “penny wise and pound foolish” might be an understatement.