A fresh start for South L.A. healthcare

Recent votes by the University of California Board of Regents and the Los Angeles County Board of Supervisors make it likely that a new public hospital will open in 2013 on the site of Martin Luther King Jr.-Charles R. Drew Medical Center. It’s fairly certain, as well, that the facility will bear the name of slain civil rights leader Martin Luther King Jr.

But one issue remains unresolved. Are we reopening an old hospital, or are we opening a whole new one?

The question may seem irrelevant; the important thing, after all, is that there is going to be a hospital in a community that needs one. But terminology matters, especially at an institution with such a complex and troubled history.

On the one hand, King-Drew was a source of great pride to the community it served for its highly regarded trauma unit and for being a medical center run by and for African Americans. But it was also a source of horror and shame, a place known for deadly medical mistakes, slipshod care and administrative incompetence. Long before a 2004 series in The Times detailed the problems at King-Drew, county workers and even some hospital staff were calling the place “Killer King.”

In the last few years before the facility was closed in 2007, the Board of Supervisors split the hospital from Drew University and put it under the management of another county facility, Harbor-UCLA Medical Center. Its new name -- Martin Luther King Jr.-Harbor Hospital -- was meant to underscore the final severing of the old hospital from the supposed sources of its troubles: the relationship with the university and the supposedly poisonous administration. But changing managers and the name did little good. The problems persisted, and the hospital was finally closed.

Six years will have passed by the time a hospital is again operating on the site, under entirely new management and oversight and, it is hoped, with an entirely new vision for delivery of health services. But it will be in the same building, with almost the same name. Many community advocates who insisted that it was wrong to close the hospital in the first place insist now that the old King will be reopened. In that reopening they see vindication and redemption, as well as an important sense of continuity.

Proponents of the reopening position can point to the fact that the main building of King-Drew will be the main building of the new or reopened hospital. They can also point out that the medical center never fully closed; that it has continued to operate as a county-run outpatient medical center, and that the 24/7 hospital will simply bring back the part that has been missing for a couple of years. Times news stories and headlines have referred consistently to reopening the hospital. A recent headline, for example, said “Troubled facility could reopen by 2013” -- making clear the continuity between the bad hospital that was and the hospital that will be.

But there is also an argument for breaking with the past. The medical center was poisoned to death by county politics and by a culture of the institution’s own making -- one that ostensibly promoted black empowerment and employment but in practice used those principles to enrich and protect bad doctors and to put the interests of the staff ahead of those of the patients. A series of “new starts” for the hospital failed. There were changes in management, employee retraining and an attempt to make the hospital an extension of Harbor-UCLA.

If this is the same “troubled” hospital and it’s merely going to be “reopened,” we haven’t really driven the stake through the heart of the hospital that failed miserably. Yes, the doctors will be hired and overseen by the University of California; the rest of the staff will be hired and overseen by a new public entity; and civil service rules will no longer apply. But if the community and local medical establishment insist that they are simply picking up where they left off two years ago, and will bring back their demands and expectations about this being a black-run institution with a special mission to respond to the employment, social, political and other needs of the community rather than the medical needs of everyone who comes through the door, we may have revived a monster.

The idea, according to some, was to extinguish the old county-run hospital and replace it with one that by its structure cannot have any of the qualities of the old King. Yes, it will use the same building, but only after extensive modifications and updates. The mission will be different -- a medium-sized community hospital rather than a large trauma center. The center of a new network of outpatient clinics distributed around the region rather than a one-stop, all-encompassing medical center.

The county has a clear duty to provide first-rate medical care to people left in the lurch by King-Drew’s closure, whether that be through a new hospital, a collection of smaller facilities, a more modern technology-based approach to medical care or anything else that would best serve the community. The county-UC plan for a new hospital seems to meet that need, and Martin Luther King is a fine name for a hospital that serves the underserved.

But let’s get past the idea that this is a reopening of the troubled hospital, or any notion that the new hospital represents continuity or vindication. The promise of the new arrangement is that the troubled hospital will be gone forever and the community will finally be served by something new, and something different -- something that will finally treat patients with the first-rate care they deserve.

Robert Greene is a Times editorial writer.

robert.greene@latimes.com