Friends of the Annapolis County Health Centre

Access To 24/7 Emergency Services Denied by
District Health Authority Despite Doctors’ Wishes

Earlier this summer, news circulated that the Annapolis Community Health Centre would return to 24/7 emergency care beginning sometime in September. Though unconfirmed, it made perfect sense. The hiring of Dr. Simon Bonnington and the return in September of Dr. Ken Buchholz would give ACHC four full-time doctors all willing to work emergency room shifts. After validating the news, one doctor in an email to the Friends of the Annapolis Community Health Centre added, “Perhaps a small party outside the health centre would be in order to celebrate everyone's efforts — might make a nice photo for the papers!”

Sadly, the celebratory mood was short lived.

On Wednesday August 25, Karen Smith, the site manager at ACHC, delivered an announcement from the Annapolis Valley District Health Authority Executive Committee to doctors and staff stating that the emergency room will remain closed on Tuesdays and Thursdays and will not be reinstated September 21 as planned. The reason given by AVH executives: returning the ERĀ  to 24/7 before the release of the Ross report was premature and might confuse the community.

How ironic that AVH is concerned about confusing the community. In meetings and correspondence with the Friends of the ACHC and in public forums this past spring, AVH stated that our ER was jeopardized by a lack of doctors needed to maintain a 24/7 ER operation. But in the past few months the availability of additional doctors has created a new context. In May, Dr. Robert Barkwell notified AVH that the collaborative practice could now operate the ER 24/7 and was moving to do so. From his perspective, AVH executives met the announcement with what seemed like approval. This coincided with public statements made by CEO Janet Knox around the same time: “We continue to work with our team at ACHC to enhance delivery of service and to create best access...We do need to work together to serve our citizens well.”

Given the distinct impression that the “team at ACHC” and executives at AVH were on the same page, Dr. Barkwell recently drew up the doctors’ on-call schedule through October filling in the Tuesday and Thursday ER shifts. Soon after, without consulting with or giving the doctors any forewarning, members of the AVH executive pulled the plug. They assigned Karen Smith, who was on vacation at the time, to go to the meeting and convey the decision.

Despite all the rhetoric about open dialogue with doctors and citizens, AVH executives appear mired in the old school of provincial health care communications as observed by Dr. John Ross in his preliminary report released in June. “I found a common theme voiced by both the public and by health care workers,” he wrote, “...a lack of trust in DHA [District Health Authority] leaders, Department of Health, and government in general. I found a recurring sense that a lack of true provincial leadership for many years has resulted in communities feeling a need to fend for themselves.  This is exacerbated by a lack of accessible and transparent information."

After meeting with ACHC doctors, who feel betrayed by the cowardly and discourteous delivery of AVH’s directive, and after experiencing first-hand this “lack of accessible and transparent information” in our own communications with AVH over the past six months, the Friends of the ACHC believe that the community’s efforts to maintain and expand access to equal health care services are being thwarted. To be sure, while the district continues to amply support and finance other health facilities in the Valley, including its own administrative building, it increasingly marginalizes ACHC.

In February a group of citizens formed the Friends of the ACHC in hopes of saving our emergency room services. In that time we have learned more than we perhaps wanted to about how the district health authority operates, particularly with respect to rural health care delivery. We have met with and poured out our concerns to AVH executives and board members, helped AVH organize a public forum and corresponded with top officials regularly. We conclude that AVH has lost sight of its mission: “Working together to promote and improve the health of individuals, families and communities.”

The closure of the 24/7 Emergency Services at the Annapolis Community Health Centre threatens the economic health of our community and, more importantly, the health of its residents. The medical staff required to maintain a full-service 24/7 ER is available at the ACHC. There is no apparent or legitimate reason for AVH not to permit the ACHC from reopening at this capacity on September 21.

It is time for the executives of AVH, and the Board itself, to stop playing the Great Oz and come out from behind the curtain. The citizens of the ACHC catchment area deserve straightforward answers and have a right to equitable and accessible full-service 24/7 emergency health care.


Date: September 2, 2010


Read Position Statement 04-12-2010


This site has been created by the Friends of ACHC who are a concerned group of citizens working with the Annapolis West Health Foundation (AWHF), Annapolis Community Health Centre Auxiliary (ACHC Aux) and the Town of Annapolis Royal.

Volunteer participation and public comments are welcome, please contact us at: