6/16/11

So what might a post-LHIN health care system look like?

The Ontario Progressive Conservatives have announced that they plan to kill off the Local Health Integration Networks (LHINs), but beyond some vague mumbles, have not identified how they might implement such a change. 


So, if the LHINs meet their demise, how will the PCs oversee health care?  


They could turn the responsibility back to the Ministry of Health & Long Term Care.   But that would saddle the PCs with the responsibility for the bad news that will certainly come with the modest funding they plan to provide to health care.  So further restructuring may be in the cards.


One, radical proposal came out recently from Telus health care consultant John Ronson.  In a nutshell he recommends the following:


  • Kill the Community Care Access Centres (CCACs which oversee home care, among other things) as well as the LHINs;
  • Create 30-40 “Integrated Health Organizations” (IHOs) with full responsibility for hospitals, home care and primary care (with more services added later on like ambulances and drugs);
  • Create an Executive Committee with 6 regional super bosses who will coordinate the health care system with the Ministry of Health & Long Term Care
  • Cut the staff of the Ministry of Health & Long Term  Care by 50%. 


Apparently, the IHOs would employ hospital employees and some home care workers (with other services contracted out).    This would be a huge reduction in the number of employers and lead to representation votes at every hospital and CCAC.  

Notably, Ronson believes that the LHINs have failed because they have not brought about major change, despite all the powers that were turned over to them on paper.  The suggestion is that a powerful Ministry of Health & LTC has throttled their ability to drive change -- hence Ronson's suggestion to cut Ministry staff by 50%. (Although, one might also note that such a change could well drive up work for health care consultants). 

Ronson's evidence that the Ministry of Health & LTC throttled the LHINs is weak (he sites a single comment from a LHIN official, who, apparently, was making a slightly different point).  


Perhaps a more likely factor was the doubt that labour and community groups created about LHINs and yet another round of health care restructuring.  The last round, under the previous Progressive Conservative government, was disastrous, with hospital closures, hospital mergers, the introduction of compulsory contracting for home care services, and sharply higher health care costs.  


Another round may prove no better.  




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