Gloucester officials and advocates pressing for more answers regarding the future of Addison Gilbert Hospital reiterated last week they'd like a written commitment that the hospital will remain a full-service hospital, especially when it comes to emergency care.
But they won't be getting it — at least not now. And that's no fault of Northeast Health System CEO Ken Hanover or anyone else.
The fact is, Hanover, whose company serves as Addison Gilbert's parent corporation, can't make that kind of promise, and must know he would be dishonest if he did. And it seems downright unrealistic — even a bit unfair — for elected officials and others to even keep making such a demand.
Here are the cold facts: As Northeast continues to explore options aimed at a merger or "affiliation" with one or more other major health-care providers, AGH's parent company may not be able to call every shot. And neither Hanover nor anyone else at Northeast could, in good faith, sign off on guarantees regarding specific facilities or services at this point.
Indeed, coming out of Hanover's latest visit to the Gloucester City Council last week, local officials should be encouraged that he is listening to them and has made a promise he can keep — that he will keep them informed as Northeast explores partnership options with other, larger health care organizations.
Hanover indeed offered proof he has been listening since he arrived to lead the Beverly-based hospital corporation 18 months ago.
Besides the often-expressed wish for Addison Gilbert to remain a full-service hospital, "you would like us to add more primary care doctors ... and more general surgeons and surgical subspecialties as well," he said, adding, "In short, I understand the wants, and will be discussing those with our potential partners."
But "discussing" is a key word here. Northeast can certainly discuss and negotiate, but it will not be dictating anything. It is not bargaining from a position of strength, and appears to need a partner more than at least some of its potential partners needs it.
Given the way the health care landscape is changing, both through the new federal health care law and the efforts by the Patrick administration to curb the growth of its costs in Massachusetts, Northeast must join a bigger organization if it is to thrive, or even survive.
Hanover said as much when he told councilors that Northeast trustees are seeking a partnership "to ensure our future vitality and to maintain our ongoing ability to serve the health care needs of our community ..."
To that end, he reiterated that Northeast sent out a request for proposals to four bigger players — Lahey Clinic, Beth Israel Deaconess Medical Center, Vanguard Health Systems and Steward Health Care System, which just purchased the Caritas Christi chain of hospitals and is a potential buyer for the Merrimack Valley Hospital in Haverhill as well.
This is a necessary move — big players will be able to compete more effectively than smaller ones, especially as the giant Partners Health Care — with Mass. General Hospital and Brigham and Women's in its arsenal — reaches deeper and deeper into the North Shore market.
Hanover said that, once a partner is chosen and a "preliminary term sheet" spelling out the key components of the partnership is developed, he will meet with local and state officials and conduct two community forums, possibly by June. That is the best he can do, and city officials and AGH advocates should realize that.
Yes, in a previous generation, Addison Gilbert prospered as an independent hospital. It is beloved by many members of the community, who feel a sense of ownership. And we'd like to think that, if an "affiliation" partner came in with a proposal that would close Addison Gilbert, or cut into its core services, Northeast's affiliation panel would reject such a deal out of hand.
But is that a certainty? Of course not.
Once again, it's best that AGH advocates work with Northeast officials, not against them, in their joint mission of keeping Addison Gilbert open, alive and well. But that fight must be waged with realism, not in a fantasy world of unrealistic guarantees.