Sentiment Stirred by Vote on Hospital : Health Care: Staff and patients say they would miss the aging County-USC facility, which will be closed if voters approve bonds.

Dr. Craig Smith knows the place has to go. The too-crowded waiting areas outside the emergency room, the too-narrow hallways, the too-few automatic doors--all are daily reminders for the trauma surgery resident at County-USC Medical Center.

But after seven years at the huge general hospital, reality sometimes gives way to sentiment.

“Yeah, I know things change--they even tear down baseball stadiums,” Smith said. “But it’s not easy to see it go. For as old as it is, I think it’s doing pretty well for itself.”

Such are the clashing emotions facing patients and employees at the medical center east of downtown after a decision Tuesday by county supervisors to replace the venerable complex.

Contingent on passage of what would amount to the largest bond issue in county history, the supervisors approved a $2.3-billion plan to replace the aging facility with two new, smaller hospitals--one on the current site and the other in the San Gabriel Valley.

The plan calls for putting a series of general obligation bond measures on the ballot in 1992. If approved, they would boost property taxes to pay for the new facilities and improvements throughout the county’s huge network of hospitals and neighborhood clinics. Estimated cost to the average homeowner over the 33-year life of the bonds would be $705, officials said.

Replacing the four-hospital complex--whose central facility, General Hospital, opened in 1932 and was made famous as the establishing shot for the soap opera of the same name--has been talked about for years. But the issue gained urgency when federal officials cited the facility for numerous fire code violations.

County health officials contend that the medical center could operate more efficiently if replaced by a 946-bed, state-of-the art hospital proposed for property east of General Hospital, and a 350-bed facility proposed for a site in Irwindale. County-USC has 2,045 licensed beds but only 1,398 are in use.

Under the proposal, General Hospital would remain in place for research use. The other three hospitals at the center would very likely be demolished.

The plan also calls for improvements at other county health facilities, including adding 100 beds each to Harbor-UCLA Medical Center in Torrance and Olive View Medical Center in Sylmar, replacing High Desert Hospital with a 274-bed hospital to meet the population growth in the Antelope Valley, and building a five-story trauma center at Martin Luther King Jr./Drew Medical Center in South-Central Los Angeles.

Also approved was replacement or renovation of aging clinics in Alhambra, Canoga Park, Compton, San Fernando, Torrance, Van Nuys and Venice.

If all goes according to plan, the new facility near General Hospital would open in 1999.

Medical Center Executive Director Jerry Buckingham acknowledged that he and county officials have a “serious challenge” in selling the bond measure. But he said: “We either pass that bond measure, or we go out of business--it’s that simple. . . . The infrastructure (of General Hospital) is just falling apart. Almost weekly some problem occurs with the plumbing, the electricity, the air conditioning, whatever. And they’re unexpected so you can’t plan for it.”

In recent weeks, talk of the possible move has prompted debate among medical center staff. While many seem to believe that something needs to be done about the antiquated facilities, there appear to be divisions over the solution.

“This place passed its prime a long time ago,” said Dr. Kim Kenfield, an anesthesiologist, “but I don’t know that splitting it up would be an answer. . . . That could just complicate the system.”

Patients and veteran hospital employees point to everyday signs of structural problems and decay.

Many rooms lack air conditioning, leaving patients sweating on a hot day like Tuesday. Some lab tests have to be checked by phone in the absence of a central computer system for the task, now common at many hospitals. Some rooms with five beds have just one bath. Fire extinguishers have to be checked around the clock on each of the 20 floors, in part because of fire-safety reprimands by federal officials.

Nonetheless, the hospital remains renowned and respected as both a national teaching center and a unique facility in providing immediate medical care for thousands of needy people each week who probably could not afford it otherwise.

Some hospital personnel grumble that the indigent take advantage of the hospital, using it for shelter, stealing food from hospital trays and seeking treatment for non-existent illnesses. But few dispute the fact that without it, many of the dozens who packed the emergency room Tuesday--seeking treatment for everything from pregnancies to gunshot wounds and hangnails--would simply go unattended.

Indeed, the most emotion-charged fear is that a relocation of some hospital operations might--at least in the minds of the needy--cut off access to medical care.

“By moving the place,” said a security officer who asked not to be identified, “all you’d be doing is taking it away from the people who really need it. It’s a shame.” After 22 years at the site, he added, “I’d really miss this place.”

One emergency room patient, who would not give his name, said, “Being black, I feel very strongly that this place has to be kept open for the people who really need it. Moving it, even a little ways away, you destroy that access. People don’t know where to turn.”