HEALTH CARE CONSULTANTS WITH A PAST, PRESENCE AND FUTURE

What is now known as Agnew Peckham opened its doors in Canada as Neergaard, Agnew and Craig on Bloor Street in Toronto on January 1, 1950. As an extension of a New York based firm established in the early 1920's, this was the first office in Canada devoted solely to health care consulting.

Four individuals were instrumental in developing the original firm. They were pioneers in Canadian health care consulting and contributed to our long and rich history. Charles Neergaard, a graduate engineer from Yale University, began his career in health care in 1922. He was a consultant for many hospitals, served on the boards of a number of hospitals and was Chair of the Committee on Hospital Planning and Equipment for the American Hospital Association. At the peak of his career, he had a consulting record that was unchallenged and a reputation as "knowing as much about hospitals as any man living" (Medical Economics, Inc., Rutherford, N.S., December 1951). He is perhaps best known for his introduction of the double corridor patient unit to hospital planning. He retired in the late 1950's and died in 1961.

Dr. Alan Craig was a graduate of McGill University Medical School. He first practised in London, Ontario and then in Halifax, Nova Scotia. Later, he moved to the United States to become Associate Director of the American College of Surgery where he assisted with the development of standards for what is now known as the Hospital Accreditation Program.

Dr. G. Harvey Agnew was the third founding partner, who began working with Neergaard & Craig in the late 1940's. A graduate of University of Toronto's Medical School, he was an attending physician at Toronto Western Hospital and Associate Chief of the Hospital's Department of Medicine. Through his interest in hospital standards, he eventually became full time director of the Hospital Department of the Canadian Medical Association which later evolved into the Canadian Hospital Association (CHA).

Dr. Agnew was Executive Secretary for the Canadian Hospital Association for almost 20 years. In this role, he lobbied the federal government to support development of hospitals. This effort resulted in government funding (announced in 1949) and major development and growth in Canadian hospitals, just prior to the implementation of provincial and national hospital insurance programs. Dr. Agnew also initiated the CHA's journal and served as its editor for many years. In 1947, while a professor and head of the Department of Hospital Administration at the University of Toronto, he developed the postgraduate program in hospital administration. Dr. Agnew was one of the first individuals selected for Honorary Fellowship in the American College of Hospital Administrators. Dr. Agnew became known in Canada as "Mr. Hospital" because of his extensive involvement in every aspect of hospital planning. He became a partner of the firm in 1950, when the first Canadian office was opened.

" A Geriatric Clinic should be set up for residents and outpatients. A home care plan should be considered for those on the waiting list." - Report for the Baycrest Hospital and Jewish Home for the Aged, 1957

Arthur H. Peckham Jr. also helped establish the early firm in Canada. He was a graduate of the mechanical engineering and commercial art program from New London Junior College in Connecticut before receiving his degree in architecture from Yale University. Mr. Peckham was originally recruited to consult with the firm because of his interest in hospitals. He became a partner in 1955. Many hospital administrators in Canada recall the privilege of working with Arthur Peckham who became known as one of the best hospital planners in North America.

Other staff involved with the firm in its early days included Helge Westermann, a graduate of the School of Architecture from Copenhagen and a Master of Architecture from Harvard University. He worked on the planning of numerous hospitals in Europe and America.

"You and your colleagues are to be commended upon a fine history of health care consulting during the past half century, and you have provided so many of us with sound wisdom and advice as well as launched us on so many ventures. The enthusiasm of your company and the support of those providing the planning expertise are commendable, and I know that you will have further successes in the future." - valued client

YEARS OF GROWTH OF HEALTH CARE CONSULTING IN CANADA

Within its first two years the Canadian operation was thriving and a new office was established on St. Clair Avenue West, where it remained for over twenty years. With the retirement of Mr. Neergaard in 1956, the New York office was closed and the Toronto office was renamed Agnew, Peckham and Associates.

That year the firm engaged its first full time consultant, Ronald J. C. McQueen, who had been a student of Dr. Agnew's in the graduate program at the University of Toronto. Mr. McQueen had previously been the education director of the Canadian Hospital Association's well known program in hospital organization and management.

During the early years, the firm practised coast to coast, undertaking province-wide studies as well as studies for individual hospitals in Canada and some in the United States. In those days, consultants would be invited to present to a hospital Board and if the Board liked the presentation, the firm would often be hired on the spot, without even enquiring about the price!

The firm's practice evolved into three distinct practice areas: needs assessment, functional programming and detailed interpretation of them in functional architectural layouts. It was not until 1970 that the firm experienced competition, coming from the United States and former Canadians such as Gordon Friesen.

Dr. Agnew died in 1971 while still active in consulting and writing his well known book "Canadian Hospitals - 1920 to 1970, A Dramatic Half Century". The book was completed by his wife, Mary, and research assistant, Murray McKenzie. It was published in Dr. Agnew's honour in 1974 (University of Toronto Press).

Predictions for the Future Hospitals will not operate as individual entities; rather they will be components of regional systems. There will be far fewer admissions to hospitals & an increase in ambulatory care. There will be an increase in the level of technology & a change in skills required to support it. - G. Harvey Agnew, 1974 Canadian Hospitals 1920 to 1970

Following Dr. Agnew's death, Arthur Peckham was named President, Ron McQueen was appointed Executive Vice President and a relatively new member of the firm, Dr. Peter F. Hart, was named a Vice President and Director. Dr. Hart was a graduate of medicine and the program in health administration. He later briefly operated an extension of the firm in Philadelphia.

In the 1970's and beyond, Agnew Peckham and Associates continued to gain a strong reputation in health care consulting in Canada. Doris Lojahn was an architect who worked for the firm from its early years until 1983. In the later years, she worked with the Canadian office, usually based from her home in Maine.

During this time, the firm also employed a number of talented consultants with backgrounds in architecture, including Frank Hall, Martin Fiset, Ron Awde, Katy Ginn and Stephen Bagworth, who worked closely with Arthur Peckham.

On the programming side, the firm employed a number of students of the health administration program who then joined the firm as consultants. They included Garth Pierce, Dr. Hans Boerma, Wayne Sibole, Morton Gould, George Van, Richard Batty, Patricia Cawley, and Michael Loughlan.

In 1984, Arthur Peckham moved back to the United States but continued his involvement with the firm's work in the Canadian Maritimes until his death in 1990. After Mr. Peckham moved, Ron McQueen became President for a brief period. Subsequently, four consultants who had been working with Arthur Peckham and Ron McQueen took over as partners: Katy Ginn, Lucy Brun, Tom Butt and Dr. Peter Hawrylyshyn.

Over the years the firm has employed a number of consultants with clinical, diagnostic, support services and planning expertise, many of whom have continued to serve the firm and its extensive client base for significant periods of time. Some of these individuals have joined the partnership, helping to develop the business to its current status. The current partners at Agnew Peckham have all been successful with the firm for many years: Stephen Bagworth, Lucy Brun, Jeannine Gourlie and Debbie McDonald.

Today, the firm continues to benefit from the skills and expertise of a multi-disciplinary consulting team. Our current team includes senior consultants whose significant contribution has advanced health care planning. And their varied experience and detailed knowledge of the planning process has helped to strategically position our clients for success. In particular, senior consultants Patricia Cawley and Larry Rook bring their extensive expertise to our clients and are the key individuals that continue to provide leadership within the firm.

Agnew Peckham has been governed by a commitment to excellence in the client services, advice and analysis we provide. Hopefully, the quality of our work will prevail and we will continue to be of service to the long list of clients that we have worked with in our more than 50 years of service and to many others.