WAIMEA — Although North Hawaii Community Hospital is a blessing for patients, and one of the top employers in North Hawaii, the number of residents who work there has dropped over the last six months, with at least eight employees given notice or terminated since late March alone.
Of the most recent North Hawaii employees now out of work — with contracts not renewed or laid off — some have more than 10 years of experience. Several were given notice at the end of the same day, one after another, in short meetings late last month, according to several sources who spoke to North Hawaii News.
One 20-year veteran, just months away from retirement, was home on sick leave when she learned she’d lost her job.
In a May 29 interview, NHCH President Cindy Kamikawa, brought in by Queen’s nearly a year ago, described the cuts as, “Impacted individuals, less than five. And some will be able to look at other positions. But we expect less than five.”
It’s well known that the hospital has had a troubled financial history. In 2013, Queens offered to pony up nearly $1 million to save the hospital from insolvency.
CEO Art Ushijima, Queen’s president at the time, said, “If given the opportunity, we would dedicate ourselves to serving the people of North Hawaii with the same standard of excellence that has been the foundation of our founders’ values and vision.”
Queen’s took that opportunity, and if Ken Graham — NHCH’s president in 2014 — was correct in his report to Pacific Business News in Nov. 2014, the new effort turned a $1 million profit in its first year — the first black ink in 15 years according to Graham.
But the next year he told West Hawaii Today in March 2015 that they were trying to improve.
“We’re trying to get past the turnover, bring permanence and work to provide the services everyone cares about,” he said.
Two years on, those who have lost their jobs the last few months might be wondering what kind of permanence Graham had envisioned.
When asked to compare this past year’s profits to Graham’s 2014 figures, Kamikawa declined, explaining there have been so many changes over this period that no meaningful contrasts can be made. To the question, “Will there be black ink this year?” Kamikawa said, “No.”
She insisted that recent cuts were not a consequence of budgetary pressure, but performance, reflecting Queen’s continuing insistence on quality care.
Several sources, however, said Kamikawa’s explanation seemed like a stretch. Former patients, hospital employees and especially those watching their friends and colleagues let go, expressed dismay and even incredulity when given the president’s declaration.
Kamikawa told one professional with superb evaluations for more than 10 years of service that if it were not for the red ink, and Queens’s determination that nothing would do but a 15 percent cut, “this action wouldn’t be happening,” the source told North Hawaii News. The sources agreed to speak with the paper on grounds that their identity not be revealed due to the sensitive subject matter.
Others losing their jobs said they were not given this reassurance. A senior member of the hospital staff said that for these loyal employees to be found wanting in performance was unfair. Workers let go might wonder how this explanation could affect their careers.
Seven of the eight cuts were non-union positions.
According to Kamikawa, Queen’s program for NHCH is supported by three overriding concerns: first, the highest quality of care; second, an agenda not driven by finances, and third, access — “providing physicians and programs that serve our community.”
The unsupported assertion that the people cut were providing anything other than the best care, and the comments about red ink to former employees leads those let go to believe that the hospital’s agenda was, in fact, driven by the budget.
Asked why Queen’s will not say something like “We had to cut some good people, and we’re sorry about that, but will continue to provide the best care we can under these circumstances,” the senior staffer said, “That would be the honest thing to do.”
Kamikawa had positive news about hospital improvements in place and forthcoming, including major emergency room modifications and a streamlined electronic connection between Queen’s and primary doctors, ensuring an accurate transmission of records — particularly matters of medication and images, such as X-rays.
Three new permanent general surgeons have been added, as well as enhanced orthopedic service and additions to the Women’s Center programs. Ongoing is Queens’s recruitment of first-class doctors and caregivers who will, hopefully, choose the Big Island as their home.
Dr. John Dawson has served the hospital since its opening, and has been a doctor for hundreds of North Hawaii patients during his nearly 40 years of practice.
Of Queen’s, he said, “I think they’re doing pretty well,” during an interview at his Waimea home. While he admitted that bringing in people from Oahu was probably uncomfortable for everyone, he continued, “There are more good stories than bad ones.”
In West Hawaii Today’s Opinion section Wednesday, local resident Virginia James referenced an exemplary NHCH doctor saying, “Dr. Elliot Epner saved my life.” But this good story was simultaneously bad, because Dr. Epner was one of the employees let go.
In the Women’s Center, the midwife/obstetrician program was in some measure a victim of its own success, becoming so popular that they attracted pregnant women from all over the county. But it was an expensive program and soon had to be cut back dramatically.
Presently, however, NHCH is experiencing a strain that some have put voice to. The cuts have taken a toll on some. Other experienced doctors have left voluntarily, as well.
“Everybody’s overworked, and afraid,” said an anonymous source still on staff at NHCH.
It is certain that since the hospital opened its doors, many North Hawaii lives have been saved. But the current round of terminations are concerning for some, especially since they were unexpected and seemed unfair to some residents who have devoted their lives to the enterprise.
“No further cuts are anticipated at this time,” Kamikawa said. “When I do things, I do them thoughtfully and with a comprehensive review. I will continue to look at ways to streamline operations.”
But future financial imperatives could demand further belt-tightening.
“If it becomes financially unbearable — this must be understood by the community — we’re here to preserve continuity,” she said.
Dr. Dawson summarized the problem.
“Queen’s expectations were high and somewhat unrealistic — the money has to come from somewhere,” he said, citing problems in other Queen’s ventures. Health care, he said, “is not an easy business to expand. The hospital is experiencing growing pains.”
No one wants the hospital to go away, but with the recent volley of staff cuts and reports of discord inside, it appears that Queen’s and NHCH have not yet found the sweet spot of balance between solvency and harmony.
A NHCH community meeting led by hospital leaders is being planned for mid-July.