But they say much of the angst and anger residents have expressed is the result of misconceptions and the false belief that secret meetings, hidden agendas and bloated bureaucratic salaries are behind the plan.

NHS president and chief executive officer Debbie Sevenpifer gave an overview of public feedback to the plan to the NHS board at its regular monthly meeting Tuesday night in Welland.

The NHS continued to solicit comments on the plan after it was submitted to the Local Health Integration Network (LHIN) Niagara is part of, because there simply wasn't time to gather all the input before the plan was submitted, said Sevenpifer.

Betty-Lou Souter, chair of the NHS board, said the public made it clear the status quo is no longer acceptable at the NHS.

"Tough and unpopular decisions will have to be made," she said.

The public input, which included about 400 submissions from local groups, letters, e-mails and responses to an online questionnaire, will all be handed over to Dr. Jack Kitts, the man appointed by the LHIN to make recommendations on the NHS plan, and to the LHIN. Kitts is scheduled to submit his recommendations to the LHIN on Tuesday.

Sevenpifer said many people were critical of plans by the NHS to consolidate obstetrics at the planned new health care complex in west St. Catharines. Residents were also critical of plans to replace the emergency departments at the Port Colborne hospital and Douglas Memorial hospital in Fort Erie with prompt care centres and plans to move general surgery out of those south end hospitals.

People also cited a lack of available transportation in Niagara, a lack of trust and lack of consultation, she said.

The NHS report did not cite specific numbers of respondents who were for or against any part of the plan.

But residents also support the idea of so-called 'centres of excellence' at specific hospitals and agree the plan is a chance to improve health care and attract health-care professionals. Residents also agree that things such as more home care and long-term care beds in the community are needed to take the pressure off the NHS, said Sevenpifer.

NHS board member Mary Turner said it's likely many people who support the NHS plan kept quiet during the consultation process.

"I do think there are lots of people in Niagara who are in favour of the plan," she said.

Board member Paul Leon lamented what he saw as unfair personal attacks on NHS representatives, saying the NHS' prime goal is to bring the services and quality of care Niagara residents deserve to them.

"(People) are going to say mean things" when they're afraid and upset, he said. "We've seen evidence of that."

Board member Mark Sherk said he wanted to make it perfectly clear the NHS has no advance knowledge of what Kitts will recommend.

"The NHS doesn't have one iota" of inside information, he said.

Sevenpifer acknowledged the NHS needs to do a better job of communicating with the public. For instance, she said residents in Port Colborne and Fort Erie falsely believe they have two fully functioning hospitals at present, when in fact those patients receive two-thirds of inpatient care at hospitals in other cities.

It's also untrue that NHS bureaucrats are overpaid, Sevenpifer said, with those salaries about midway among similar hospital systems.

"We can always do a better job with communicating with stakeholders and communities," Sevenpifer said.

The consultation report can be viewed at www.niagarahealth.on.ca.