September 3, 2024
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Signage on the doors of the Carney's emergency department as seen on Sun., Sept.1. Bill Walczak photo
I walked the grounds of the now-closed Carney Hospital on Sunday, just hours after they locked the doors. I heard the stone-cold silence of state leaders who violated their own regulations in their rush to shutter the Carney after its service to our community dating back to the Civil War.
What was left there was an ambulance from a Gloucester company parked next to the Emergency Room door. The EMT told me that people were driving up, seeing the closed sign, and driving on. People en route to an ER don’t have time to ask questions.
I had thought that the purpose of the state’s Department of Public Health (DPH) and Executive Office of Health and Human Services (EOHHS) was to protect the health of Massachusetts residents. I was wrong. In the case of our Dorchester community, DPH, led by Commissioner Robbie Goldstein, and EOHHS, led by Secretary Kate Walsh, protected the interests of the very flawed marketplace, which includes equity firms that purchase hospitals. The health of the public didn’t rate.
How else to explain the decision to allow Steward to close two hospitals, one in a rural area many miles away from other hospitals, and the other in a low-income area with large numbers of people of color that records some of the poorest health outcomes in the state.
That these state officials also allowed Steward to close the hospitals in just 30 days, in violation of their own state regulations requiring 120 days, indicates that they were not interested in addressing the health consequences of the hospital closures. Thirty days is not enough time to determine how emergency care will happen, where primary care and specialty patients will be seen, and how medical records will be transmitted to other sites. Just the basics of communicating with a community of more than 200,000 people in the Carney service area is not possible in such a truncated timeline.
Our local health care system does not have the primary care and urgent care capacity to replace the now-lost Carney services. Community health centers have long waiting lists for primary care services, and do not have the urgent care capacity to service any part of the 31,000 annual visits by patients to the Carney ER who will now need to go elsewhere.
Several of the health centers do not have urgent care at all, and, for those that do, weekend hours are extremely limited. Health center requests to the state for funding for expansion of urgent care hours have not been supported as yet. Even if they were granted at the level of financial support necessary to staff these services, it would take months to ramp them up. Beyond that, community health centers have no capacity to replace lost geriatric, adolescent, and adult inpatient psychiatry services.
When Steward closed Quincy Hospital in 2014, the state required the company to continue emergency services there for several years. When Quincy’s ER closed in 2020, patients were referred to the Carney ER. In contrast, Carney’s ER was closed with just 30 days’ notice. Boston’s Public Health Commission put up a sign that says: “Hospital Closed, for info/resources call 617-534-5050.”
When you dial that number, you hear: “If this is a medical emergency, please hang up and dial 911. Hello, you have reached the Mayor’s Health Line at the Public Health Commission. Our regular business hours are Monday through Friday 9 a.m. to 5 p.m.”
This is a disaster. Secretary Walsh and Commissioner Goldstein should never have allowed the hospitals to close. When they did, they hid behind the judgment of a federal bankruptcy judge from a court in Houston known to do the bidding of corporations in bankruptcy.
At the very least, they should never have allowed a closing in 30 days without a plan for dealing with the health care needs of those 31,000 ER visits, the residency training of 45 physicians, 70 psychiatry beds, and 60,000 ambulatory and specialty care visits seen last year at the Carney.
What makes our pain even worse is the coldness and prevarication of Kate’s and Robbie’s leadership.
We were told that “the market has spoken,” that they could do nothing to save the hospitals, that the bankruptcy judge had all power, that the state couldn’t use eminent domain, and that it couldn’t declare a health emergency. Then we found out that they indeed could do these things, but maybe only to assist Boston Medical Center in improving its insurance mix.
We were told that Carney and Nashoba couldn’t be saved because there were no “qualified bidders,” yet government leaders in Pennsylvania acted to find a qualified bidder to save their Steward hospital when faced with the same challenge. We were told there was no money to maintain services at the Carney, despite $8 billion in the state’s “rainy day fund,” and a recent $600+ million settlement with the tobacco industry. We were told that the state didn’t want to get into the business of running a hospital, when, in fact, it currently runs four hospitals.
Kate and Robbie have gotten their way, and the Carney is now closed, leaving many residents and patients without health care recourse. They didn’t even try to save the emergency room and the psychiatry beds; they essentially redlined these essential services and made this care more difficult to procure for the Dorchester/Mattapan/Hyde Park/Quincy communities.
A rebuilding of community health capacity is now essential to create a health care system for this large part of metro Boston. The community’s residents and health care experts – not those who turned their backs on our community – should lead this effort.
Bill Walczak is a resident of Dorchester and the former CEO of Codman Square Health Center, which he co-founded. He also served as president of Carney Hospital under Steward Healthcare for 14 months in 2011-2012.
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