Hospital plan doesn't satisfy

Children Hospital's purchase of the former Waltham Hospital will bring the city pediatric services and prestige, but falls short of filling vital needs, say health care analysts and officials.

''It certainly will not be like the old Waltham Hospital," said Jeanette Clough, a former head of that defunct hospital and now chief executive at Mount Auburn Hospital in Cambridge.

Clough and other health care specialists say it is likely that Children's will use Waltham's 11-acre campus for routine outpatient services, expanding its reach in the suburbs, where many of its paying customers reside, and freeing up premium space downtown.

Officials at Children's have talked about offering day surgery, radiology, neurology, and orthopedics in Waltham, but the hospital's chief executive officer, Sandra Fenwick, said no decisions would be made for at least three months.

For many in Waltham, including Mayor Jeannette McCarthy, having emergency room care in Waltham outweighs having a renowned specialty hospital.

''I don't know what Children's Hospital is going to have up there," McCarthy said. ''I was hoping for at least emergency services and that remains to be seen."

The changes in Waltham's health care scene are part of a trend that is seeing the demise of community hospitals and the expansion into the suburbs of well-known urban hospitals.

Alan Sager, a former Waltham Hospital trustee and professor at the Boston University School of Public Health, compares the strategy of urban hospitals to that of department stores 50 years ago. The motivations are the same, Sager said: more space, more customers, easier access, and ultimately, more money.

''Teaching hospitals know that they need to keep attracting suburban patients with [private insurers]," Sager said, because they pay at higher rates than Medicaid and Medicare patients. Those patients subsidize the academic hospitals' more esoteric and expensive care, which helps them to sustain their lofty reputations, Sager said.

Children's already has satellite facilities in Lexington and Peabody. Lexington, which is near full capacity, is building a fourth operating room. Massachusetts General Hospital set up shop off Route 128 in Waltham in 1998, where it offers primary and specialty care, including pediatric neurology and orthopedics.

Waltham Hospital, which became the private Sterling Medical Center when the hospital closed in July 2003, is in a prime location, with easy access to Route 128 and the Mass. Pike. Considering what Children's might have paid for real estate in Boston, Clough said, $53 million for a 400,000-square-foot building in Waltham ''was probably a bargain."

Sterling's tenants include Newton-Wellesley Hospital's urgent care center, Beth Israel Deaconess's cancer center, and Waltham Behavioral Care's eating disorders unit. They will remain under their current long leases.

Children's says it may lease to other medical entities some of the remaining space, which is about a third of the total.

But Waltham residents say that what they miss most about their hospital is an emergency room providing round-the-clock care and a measure of health security.

''When you need it, it's nice if its five minutes away instead of 15 minutes away," said Dan Taylor, who was shopping at the Waltham farmers' market on Saturday with his 3-year-old daughter, Rebecca.

Children's says an emergency room is not out of the question, but that offering such service would require partnering with an adult health care provider.

Newton-Wellesley Hospital, which has seen an increase of at least 250 patients a month at its emergency room in Newton since Waltham Hospital closed, has looked at opening an emergency room in Waltham, said Patrick Jordan, a senior vice president at Newton-Wellesley.

''We've done the numbers, and it's cost-prohibitive," he said.

Two years ago, Boulder Capital -- developer of the Sterling Medical Center -- paid $8.5 million to CareGroup Healthcare System for the hospital and 18 acres it sits on.

The City Council, hoping the cash infusion could save the hospital, gave its indirect support by rezoning the land to allow apartments to built adjacent to the medical facility.

Some officials, including McCarthy, criticized the plan, arguing that if the hospital closed, the site would go to private, for-profit interests, and Waltham's health care would be secondary.

Sager said that the state in 2002 found that Waltham Hospital's emergency room and other hospital services were deemed ''essential" to the community.

''Those services were not continued by the Sterling operation, and it seems unlikely that Children's will reinstate those services," Sager said. ''What we see is, among all these private transactions, the essential services of Waltham Hospital are lost," he said.

Joshua Myerov can be reached at myerovjosh@yahoo.com.