St. Vincent’s Hospital, a proud and historic facility which was integral to the community fabric of Greenwich Village and the Lower West Side, was forced to close as part of a bankruptcy procedure on April 30, 2010. This left large swaths of Manhattan without accessible primary care and without an adequate trauma facility. It was a comprehensive full-service hospital with 758 beds. Its services included a Level 1 trauma and critical care center; comprehensive cardiovascular care; excellent neonatal services including a neonatal ICU; a cancer center; an HIV center; a full service emergency department; and inpatient and outpatient psychiatric addiction services. The Emergency Department alone treated 65,000 patients in 2009; St Vincent’s surgeons performed 20,000 surgeries a year.
The hospital was crucial to what is, contrary to popular impression, a medically under-served community. 18% of Village and SoHo residents have no personal physician. In Chelsea, the figure is 23%. In particular, hospitals like St. Vincent’s have served as primary care facilities for low income residents. In this regard, St. Vincent’s had an important relationship with Chinatown and also served large low income public housing developments in Chelsea. 25% of the hospital’s service population had household income of $25,000 a year or less. Its homeless program treated 10,000 patients a year, with 55,000 patient visits.
The absence of the St. Vincent’s Level 1 trauma center threatens lives. There are only four such trauma centers in Manhattan; the closest one on the West Side is at St Luke’s, on West 114th Street. Let’s recall how close a possible tragedy was when, after Hurricane Sandy, there were no hospitals open south of 59th Street. It is not hard to imagine the tragedies which would have flowed from explosions, a major fire, or a building collapse, all of which can easily occur during circumstances which saw Lower Manhattan flooded out of all of its hospitals.
It is unconscionable that for the first time in 165 years we have no hospital and no emergency room on the West side of Manhattan below 57th St. There is no way around the truth that this has cost lives and will cost many more.
However, St. Vincent’s is gone, and it is not coming back. What can be done to fill the vacuum of medical need? What can a Borough President do to help fill this vacuum?
We won’t see another 750 bed hospital in the Village, but we can fill many of the holes detailed above with a more modest but still robust facility. Imagine a 100 bed hospital with a full service emergency department, a Level 1 trauma center, an ambulatory surgical center, and perhaps HIV, homeless, and substance abuse outpatient services. My investigation (and discussions reported in this newspaper) leads me to believe that the money is available for financing such a facility, and, with Obamacare, for the facility being break-even or even profitable. It would even make an attractive investment vehicle for a consortium of doctors. I know that other major medical centers would have pursued an annex on the St. Vincent’s site if they were given a bit of governmental support.
The prime issue is not capital availability but finding an affordable location. This is where the Borough President’s office can play a role. As Borough President, I will make the issue a priority; I will give it attention and engage in persuasion. I will convene a task force of experts to identify a location and pathway to bring a hospital – with a full emergency room and trauma center — back to the Lower West Side. Further, the Borough President has great power in land use and zoning issues.
We should identify health care as a Lower West Side “community need” and work within the established land use process to see that this need is met. Perhaps in the context of the air rights sale which Hudson River Park will engage in over the coming years? The West Side is likely to see lots of applications for zoning changes in the coming years, and the Borough President plays a key role in that process. I have a proven record in my Upper West Side district of linking zoning changes and land transfers to adequate community facilities.