Timing is everything. In a medical emergency such as trauma cases and acute situations, Immediate care is essential. We are told that minutes or even seconds may be a matter of life or death. Immediate access to emergency treatment is essential. We are told by health care professionals that "A delay to a medical care facility could result in compromising the stabilization of the patient and could be catastrophic to the patient." This is a comment by experienced health care providers from both rural and urban settings. It is a fact, geographically, that our localized areas of southwestern New York State are essentially miles away from large city hospitals. The need for immediate health care treatment, for emergency cases, requires that high priority must be placed on the "ETA" to the nearest local hospital. The essentiality of critical "timing" is a must in a medical emergency. It is troubling, in a recent Report on Heath Care Facilities at the State level, this essentiality was not ...as a result of oversight or negligence... taken into consideration. Consider, with a critical medical emergency patient, for example from Cattaraugus, NY, trying to reach a far away Buffalo hospital during a blustering snow storm such as we recently experienced. In short, the critical emergency needs of a large geographical rural population of people in this part of the State were apparently not considered. That is shocking.

Without doubt, the Berger Commission's Report on Health Care Facilities is seriously marred with a lack of understanding of LOCAL geographical conditions, people needs and human trauma. As we see it, the Report is flawed with informational deprivation, outdated statistics, and a neglect of geographical reality. Further, it is devoid of sound judgment, prudent management and smart decision making. It is an example of long range strategic planning gone wrong. It presents a flagrant lack of cognizance of the desperate rural health care needs of an aging population and of a growing need for the expansion of continued up-to-date health care facilities "rightsized" for this area. We ask the question: Could our comparative short- fall of voters and "power brokers" at our end of the State actually be a factor in the skewed nature of the recommendations contained in the Berger Report?

The Report contains recommendations which clearly affect access to health care and the well being of every man, woman and child in this region. It is shocking to hear of its recommended changes. Specifically, we condemn the approval and implementation of those recommended changes which dramatically impact the TLC Health Network (Tri-County Hospital in Gowanda and the Lake Shore Hospital in Irving), Bertrand Chaffee Hospital in Springville, Westfield Memorial Hospital in Westfield, and Brooks Hospital in Dunkirk. All of these ARE strategic and outstanding health care facilities and they provide vital heath care for a sizable geographic population. The high quality medical services at these facilities must be sustained and any form of the diminution of these vital services would not only be a hardship but indeed a medical travesty for the people of this region

Recently, "rightsizing" has been a creative initiative pursed by our local facilities. Point in fact, Tri-County and Lake Shore Hospitals (now TLC) back in January 2002 had the foresight to "rightsize" health care in light of emerging needs. Westfield, Chaffee, and Brooks Hospitals also made appropriate changes. Many have spoken of the outstanding quality hospital services which have been available and provided by a most competent, dedicated and caring staff. One can document the lives which have been spared and the trauma which has been treated because of the availability of quality facilities and superior services. Your columnists can personally attest to this fact.

What we call for is a rejection of certain specific recommendations with reference to area local facilities. Our area residents and others need to be reassured that: the emergency rooms, the outpatient and in-patient services will continue to be provided; that the laboratory facilities and radiology centers will remain in tact and appropriate and essential therapeutics will be readily available; that long term care availability will continue to be provided. A dependent, vast, rural and semi-urban population of people is reliant on the continued viability of these professional services and units. To deplete much of this health care viability is totally unconscionable.

Interestingly, all of our local hospitals have been generating strategic plans to meet the needs of our current local health care facilities. We applaud their creative and innovative planning. For example, the TLC Health Network and Bertrand Chaffee Hospital were looking at cooperative services arrangements and Westfield Memorial and St. Vincent Health Care System were doing likewise. We ask if these plans developed locally were even considered in the development of the State approved Berger Commission Report. Or, just as the saying goes "so much for LOCAL planning and grassroots input."

We have not in this column even begun to identify the catastrophic impact on the economy of this total region if the recommendations of the Report were to be implemented. Hundreds upon hundreds of individuals would become unemployed. This, along with the discontinuance of the economic catalyst effect of these facilities, would be financially devastating to the entire area.

Through the years, we have had accessible health care facilities... not elaborate or extravagant but functional... and staffed by dedicated high quality personnel. And these hospitals were and are accessible facilities serving a broad semi-rural geographical spectrum of people. Their locations in Irving, Gowanda, Springville, Westfield and Dunkirk has made it possible for a countless number of men, women and children to reach critical medical help in a timely lifesaving manner. Early intervention, where every second counts, is critical to diagnosis and treatment. And these Hospitals are doing just that.

For any office holding official to not adhere to and advance these concerns is treasonous to the citizens whose interests they should hold dear. We hope all of our local elected officials and citizens will contact Governor Eliot Spitzer and his new Health Czar and unequivocally express their disdain for this misguided, hasty and completely devastating plan for Southern Tier health-care. Without our hospitals, emergency rooms and appropriate professional health care facilities, there would be seriously limited comprehensive treatment in our localized areas. We must shore up our efforts, for it is our duty to insist they keep what we desperately need. That is how we see it FROM OUR PERSPECTIVE.