The ad included the following promise: "This new concept in care brings together physicians, nurse practitioners, social workers, community care access providers, physiotherapists, etc." This sounds very much like the program that Centre de Sante Communitaire du Niagara offers as a community health centre in Welland, and which is coming to fruition in Port Colborne and Fort Erie's CHC.

Is the NHS promising to supply Port Colborne and Fort Erie with a parallel plan for the general population in these two cities or is the NHS not-so-subtly signalling a proposed takeover of these community health centres? CHCs were approved and mandated to attend to specifically named and rostered demographic areas of Port Colborne and Fort Erie. To which of these possibilities does this vague and rosy promise of the NHS refer?

Just one case in point. On Dec. 12, 2007, the Ministry of Health issued a news release that reported a $400,000 renovation grant for the emergency department at Niagara Health System's Port Colborne General Hospital. CEO Debbie Sevenpifer is quoted as saying, "We're excited to be moving forward with this important upgrade of our emergency department at the Port Colborne General. A modernized ER will be a better functioning ER to serve the needs of our patients."

Almost exactly six months later, the NHS has served notice to close the emergency room in Port Colborne. In the face of this, how can anyone believe in the reliability of promises by the Niagara Health System?

Whatever else respondents will have to say to Dr. Kitts and his team, the lack of openness and perhaps inability or even unwillingness to engender trust in what the NHS refers to as "community" should be very high on the list of our experiences with the NHS.

Dr. Garnet McDiarmid

Port Colborne