Campaign Continues to Keep Hospital Open
The fight to keep North Central Bronx Hospital (NCB) open picked up steam earlier this month with another rally in front of the Norwood institution and heightened criticism from Bronx politicians and community leaders. While officials of the city's Health and Hospitals Corporation (HHC), the agency that oversees public hospitals, firmly stated that there are no plans to close the facility, employees insist the city is heading resolutely in that direction by slowly dismantling it department by department.
Rumors have flourished since April when news articles reported the city's intentions to close the facility. Subsequent denials by HHC officials have done little to quiet the controversy.
It is no secret that the Giuliani administration would prefer to privatize the city's public hospitals. But state law prohibits the sale and privatization of public hospitals and the state's Court of Appeals blocked the city's plan to privatize Coney Island Hospital in Brooklyn. The city had attempted to circumvent the law by turning over that hospital to private management.
This time, the city is trying to close a hospital by manipulating patient population, allege representatives of the Commission on the Public Health System (CPHS), a nonprofit advocacy group. NCB, a 457-bed facility, now averages 200 patients daily. If its patient census falls between 50 and 80 patients per day, the hospital may be able to legitimately close.
'looks like a ghost town'
Hospital employees say they are progressively seeing many less patients and many more empty beds. Kevin Cruz, an NCB maintenance worker for 20 years, said some parts of NCB "look like a ghost town." Officials said NCB is consolidating its services with Jacobi, the other hospital in the North Bronx Healthcare Network, but it appears to be a one-way movement with only NCB patients being transferred to Jacobi on Pelham Parkway in the east Bronx.
Although well known for its pediatric care and women's services, the pediatric inpatient ward and asthma unit at NCB, which provided 40 beds, was shut down in March and obstetric and gynecological services have been cut. NCB lost 25 more beds when inpatient rehabilitation service was eliminated. Patients that need these services are referred to Jacobi, but Bronx residents complain there is poor public transportation access. Grace Colon worries about what her mother, a Norwood resident, will do if NCB closes. "NCB is a hop, skip and jump away for her," she said. "Jacobi is so far. She'd have to take a few buses."
Layoffs at NCB have also taken a tremendous toll. Just three years ago, NCB employed 2,700 people; now, its employees number 1,200. And because medical attending physicians were laid off, the medicine wards were limited to admit only 60 patients, down from 90 a few months ago.
"Basically, we're cut to the core. We're being designed to fail," said Alice Sutter, an NCB nurse practitioner in the Special Care Clinic for AIDS patients. Sutter said that in her three and a half years at the clinic, she has seen 20 staffers laid off without replacements, including doctors, nurses and housekeepers.
HHC officials have repeatedly said that there are no plans to close the hospital and that cuts in services are the result of lack of demand.
"We are consolidating underutilized services, but we are strengthening other areas of the hospital," said Nancy McPartlin, a spokeswoman for NCB. She pointed to recent investments at NCB, including new clinics for the ear and throat, ophthalmology, urology and neurosurgery. And $13 million is presently being spent to upgrade the hospital's physical plant, according to a press release issued by Joseph Orlando, who heads the North Bronx Healthcare Network.
HHC also attributes the cost-cutting consolidation at NCB to heavy competition in the
health care industry, due to Medicaid expansion and increased managed care.
One department that hasn't downsized is the emergency room (ER) according to ER doctor Kevin Brown, who said there has been a large increase in ambulance patients for critical care in the ER. Brown said the ER used to be staffed by doctors-in-training, but now attending physicians are on the full-time staff and Emergency Medical Service ambulances are increasingly relying on NCB because of the ER's heightened reputation.
Serving the poor
The main argument for maintaining private hospitals is that they serve everyone regardless of ability to pay, while private hospitals are only required by law to service emergency cases. NCB provides the insured and uninsured with emergency care, primary care, follow-up visits and prescriptions. And in the northwest Bronx area that NCB serves, at least 25 percent of people are uninsured, according to a report issued by Public Advocate Mark Green. Area residents also suffer a high rate of tuberculosis, asthma and AIDS, according to CPHS.
"If we are committed to helping the poor, we cannot shrink this hospital," said Assemblyman Jeffrey Dinowitz at the July 15 rally.
Brown doubts that closing the hospital would be cost effective. Patients may opt to call an ambulance rather than make the long trip on public transportation to Jacobi, he said. Brown also noted that providing services to the uninsured can prevent future costly treatments through the detection of sexually transmitted diseases or cancer or by identifying patients at risk of heart attack or stroke.
Staffers and patients alike praised NCB as a community hospital that provides personal, warm and committed care. "I love the care they give my son," said Denise, who brings her toddler to NCB for regular checkups, and did not give her last name. "I wish and pray that they will stay open."
Rallies, meetings, hearings, media outreach, legal investigation and petition distribution are some of the initiatives activists are undertaking to ensure that NCB stays open. Bronx politicians have pledged their support. In a July 14 letter to HHC president Luis Marcos, Bronx Borough President Fernando Ferrer, Congressman Eliot Engel, State Senator Eric Schneiderman, Assemblymen Jeffrey Dinowitz and Jeffrey Klein, Councilman Adolfo Carrion, and Councilwoman June Eisland wrote, "By failing to provide adequate health care for these individuals, the city is effectively rejecting its commitment to serve the poor and the uninsured."
Meanwhile, in the face of official denials, frustration with the city is growing among NCB staffers like Kevin Cruz. "It's like you're being mugged in broad daylight and nobody believes they're seeing it," he said.
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