What is the most common health care issue facing children in Northeastern Ontario? It’s not obesity, diabetes, allergies, asthma, autism, Attention Deficit Hyperactive Disorder, or Fetal Alcohol Spectrum Disorder, although rates for all of these chronic conditions are greater in Northeastern Ontario than the national average.

The most prolific health care ailment affecting children is sexual assault, according to paediatric expert Dr. Nicolas Steinmetz, Associate Professor of #Paediatrics at McGill University, and the Chair Emeritus of the Montreal Children’s Hospital Foundation. Dr. Steinmetz shared that startling fact at this year’s Annual General Meeting of Health Sciences North (HSN) in Greater Sudbury, and he challenged health care planners in Northeastern Ontario to do more for children’s health care in all areas, but particularly sexual assault.

It’s a message HSN is taking to heart. Ironically, enhancing services for children who have been sexually and physically abused is a key component of HSN’s proposal before the North East Local Health Integration Network (NE LHIN) to expand the North Eastern Ontario Health Centre for Children (NEO Kids), which is HSN’s centre for paediatric outpatient care.

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The proposal to expand NEO Kids includes the creation of a Child Advocacy Centre, which will enable HSN to provide more acute care and counselling to children who have been physically or sexually harmed.

Currently, HSN provides acute care services (including forensic examinations) and follow-up counselling to children where cases of sexual and physical abuse have been verified by police or child protection services. Last year, HSN’s Violence Intervention and Prevention Program (VIPP) deal with 100 cases of child and youth sexual and physical abuse.

“We know there’s many more cases of sexual and physical abuse of children because it is one of the most under-reported crimes,” says Nancy Horan, Manager of VIPP. “Children often don’t know where to turn or who to turn to for help, especially if the abuser is in a position of power over them, so incidents are vastly under-reported. Also, at this point we don’t have the resources to help any more children than we already do. We aren’t providing ongoing support for children where abuse is only suspected, not confirmed. And we’re not capturing cases of neglect. We could help more kids with more resources, and that’s the proposal we have on the table.”

The proposed Child Advocacy Centre at an expanded NEO Kids would change that, according to Horan. The Child Advocacy Centre would bring together, in one central location, more resources and expertise for children who have been sexually or physically harmed. The proposed Child Advocacy Centre could include onsite partners such as the Children’s Aid Society, Greater Sudbury Police, and victim protection and children’s mental health agencies.

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“Children and families are often faced with having to visit more than 10 different professionals in different agencies from the time that child maltreatment is disclosed or discovered until the time that it reaches the court system,” adds Horan. “ Professionals from various agencies in the community, all of whom share the same goal of helping and supporting children and families, often work in isolation from one another. But the Child Advocacy Centre we’re proposing would serve as a ‘one-stop’ location for collaborative care in a safe, child friendly environment that deals exclusively with children.”

It is this approach to the care of children who’ve suffered sexual or physical abuse that underpins the entire NEO Kids philosophy of children’s healthcare, according to Dr. Sean Murray, the Medical Director of HSN’s Family and Child Program and the Lead Paediatrician for NEO Kids.

“We believe that children are not small adults, and the health care system can’t view or treat them that way,” says Dr. Murray. “Kids view the world differently. They have different needs. When they come for health care, they need to be in a setting that reflects who they are. What happens now is we provide children with care in places that were designed by and for adults, and often side-by-side with adults. That’s not optimal care for children and their families.

The other pillar of NEO Kids is that children should be treated as close to home as possible.

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We can and should keep medically-necessary travel to a minimum for kids, because travelling to another part of the province for care is emotionally, physically and financially straining for children and their families. So by expanding NEO Kids, we hope to dramatically reduce the number of children who have to leave northeastern Ontario to get outpatient care.”

HSN has put before the NE LHIN a proposal to build a 40,000 square foot expansion to the current NEO Kids facility, at a cost of approximately $55 million dollars. The proposal has received letters of support from hospitals across northeastern Ontario as well as Sick Kids Hospital and the Children’s Hospital of Eastern Ontario. The Board of Directors at the NE LHIN wants to see a strengthened business case for the project. HSN has been invited back to the LHIN Board in the fall of 2015 to pitch an updated proposal and the LHIN has offered to work with HSN to make the proposal successful.

“We’ll work with the LHIN to provide whatever further information it requires so that we can move this proposal along to the Ministry of Health,” adds Dr. Murray. “We do feel the time is right to expand children’s outpatient care in northeastern Ontario because we’re already bursting at the seams and demand for our services is expected to increase anywhere from 20 to 40 per cent in the next decade, and most of that is for children’s chronic diseases where we have some of the highest rates in Ontario, if not Canada. I became a paediatrician because as a child, I had to travel frequently out of Sudbury to get the care I needed, and I’m doing everything I can to ensure as many children as possible can avoid what I had to go through as a kid.