February 23, 2015

The Peterborough Health Coalition

304-136 Ware St.
Peterborough, ON
K9J 2B8
Attention: Mr. Roy Brady
Thank you for your letter of Jan. 12 and for your presentation to our Jan. 28 meeting of the
Board of Directors. This letter is intended to respond to both your letter and verbal presentation.
We would first like to thank you for bringing forward to the Board a number of valuable insights
and ideas. We appreciate you taking the time to share these thoughts on behalf of the
Peterborough Health Coalition.
Our Board of Directors, senior executive team, physicians, professionals and the entire hospital
staff are here to serve the needs of our patients, in collaboration with our partners in the
communities we serve. This commitment is reflected in the Mission, Vision and Values outlined
in our 2014-2017 Strategic Plan:

Mission: We are a regional hospital building healthy communities with our partners and
patients
Vision: Exceeding your expectations, every day
Values: Guided by You Doing it Right Depend on Us

Patients are at the centre of everything we do at PRHC. Our hospital leaders, physicians and
staff members frequently involve patients and family members in care-focused events to share
their unique insights and experiences as we continuously work to improve patient care. The
hospital also has a Patient Relations department whose purpose is to assist in guiding people
through their hospital experience, as well as dealing with any concerns that patients and their
families may have regarding the care they receive.
PRHC physicians, staff and leadership have earned patient satisfaction results in the 99th
percentile, as first reported to media and the public in November 2014. As a result of this
accomplishment, patient satisfaction research institute National Research Corporation Canada
(NRC) Picker has identified PRHC as one of the top-performing hospitals in Canada and the
U.S. We will continue to focus our attention on providing excellent patient care moving forward.

We understand that you are interested in receiving more information. We are enclosing with this
letter a presentation provided to our local media representatives and posted on the hospitals
public website. This document outlines in more detail our actions taken to strengthen the
hospitals financial controls, as well as some of our key clinical achievements in recent months
and years. We trust you will find this additional information helpful.
You have used the following language in your letter: the $57 million accounting error. It is
important to clarify that the $57 million amount referred to by the hospital resulted from a
number of accounting errors, not one error. Please note that accounting error is a term used in
professional accounting guidelines, and is defined as follows:
An error in an accounting item that was not caused intentionally. An
accounting error can include discrepancies in dollar figures, or might
be an error in using accounting policy incorrectly (i.e. a compliance
error). Accounting error should not be confused with fraud, which is an
intentional error in an accounting item, usually to hide or alter data for
personal gain.
Your letter also referred to misappropriated funds. We assure you that following extensive
internal and external reviews in consultation with various partners, we are satisfied there is no
evidence of personal financial gain related to the accounting errors. We have kept the Central
East LHIN informed throughout the review process.
With respect to the hospitals financial restatements, we have been transparent in making this
information public and have taken accountability for the accounting errors and for strengthening
the hospitals accounting controls moving forward to ensure similar errors do not occur in the
future. The Board takes its fiduciary accountability seriously, and is providing oversight to
strengthen governance and processes.
Your letter suggests that changes in hospital staffing would not have occurred had these
accounting errors not been made. These errors would not have impacted decisions made in
2010. When staffing changes occurred in 2010 following the Peer Review and the
implementation of the Hospital Improvement Plan, the hospital was in a vastly different financial
state than it is today. The majority of the accounting errors identified occurred in the past three
years.
Changes in processes and staffing allocations in more recent years have resulted in part from
significant shifts in the provincial funding mechanism for hospitals. Changes have also been
made specifically to improve the quality of care we offer to our patients. These include, for
example, shortening of wait times in the Emergency Department, for certain elective surgeries
(e.g. hip & knee replacements) and reduction of length of stay.
These changes have significantly strengthened the hospitals position moving forward.
The hospitals Board of Directors is committed to collaboration with all of our partners, including
broad community consultation when developing the hospitals strategic plan. Our internal and
external consultations throughout the upcoming CEO search process will include the
Peterborough Health Coalition, among other community groups. We have also added two
community members (who are not members of the Board or Board Community Members at
Large) to the search committee.

We agree with you that trust and mutual respect are cornerstones to any successful partnership
or collaboration. We have a skills-based Board in place, whose members represent and
advocate for the community they serve, and not as representatives of particular stakeholder or
advocacy groups. We will be considering additional opportunities to enhance our community
engagement efforts, such as but not limited to community forums, advertising of meetings,
open houses, and online surveys. We agree that these additional opportunities would be
welcomed by our community, and we are committed to providing accessible alternatives that will
allow the public to participate meaningfully in the hospital governance process.
We are continually looking for ways to further engage with our leadership, staff and physicians.
The hospitals senior leadership team has recently launched an initiative to enhance internal
communications throughout the organization, including weekly attendance by senior leadership
team members at staff meetings to listen, learn and share information. The hospital is a
collaborative working environment, and we welcome constructive feedback and suggestions for
positive change.
We would like to conclude by stating that most of our board members have been patients
themselves, or have friends or family who have been patients at our hospital. Each and every
one of us at PRHC has a personal stake in the care this organization provides, and we take our
responsibility to our community and our patients very seriously.
Again, on behalf of the Board, we thank you for your input and ideas. We trust that we can go
forward together to continue providing high-quality of care for our patients.
Sincerely,
Alan Wotherspoon, Chair, PRHC Board of Directors
Dr. Peter McLaughlin, Interim CEO, PRHC