Skip to main content

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.  


Popular posts from this blog

Health care funding falls, again

Real provincial government health care funding per-person has fallen again this year in Ontario, the third year in a row.  Since 2009 real funding per-person has fallen 2.6% -- $63 per person. 

Across Canada real per person funding is in its fourth consecutive year of increase. Since 2009, real provincial funding across Canada is up $89 -- 3.6%.
In fact the funding gap between Ontario and Canada as a whole has gown consistently for years (as set out below in current dollars).

Ontario funds health care less than any other province -- indeed, the province that funds health care the second least (B.C.) provides $185 more per person per year, 4.7% more.  
Provincial health care spending in the rest of Canada (excluding Ontario) is now  $574 higher per person annually than in Ontario. 

 Ontario has not always provided lower than average health care funding increases-- but that has been the general pattern since 2005.
Private expenditures on health care have exceeded Ontario government increases …

Ontario long-term care staffing falls far short of other provinces

CUPE and others are campaigning for a legislated minimum average of four worked hours of nursing and personal care per resident per day in long-term care (LTC) facilities.  New research indicates that not only is LTC underfunded in Ontario, it is also understaffed compared to the other provinces. 
LTC staffing falls short:  The latest data published by the Canadian Institute for Health Information (and based on a mandatory survey undertaken by Statistics Canada) indicates that staffing at long-term care (LTC) facilities falls far short of other provinces. 
Part of this is driven by a low level of provincial funding for LTC.

Ontario has 0.575 health care full-time equivalent employees (FTEs) per bed staffed and in operation.[1]  The rest of Canada reports 0.665 health care FTEs.[2] The rest of Canada has 15.7% more health care staff per bed staffed and in operation than Ontario.[3] 

No other province reports fewer LTC health care staff per resident (or per bed) than Ontario.[4]

Occupancy r…

Six more problems with Public Private Partnerships (P3s)

The Auditor General (AG) has again identified issues in her annual reportwhich reflect problems with Ontario health care capacity and privatization.   First, here are six key problems with the maintenance of the 16 privatized P3 ("public private partnership") hospitals in Ontario:
There are long-term ongoing disputes with privatized P3 contractors over the P3 agreements, including about what is covered by the P3  (or “AFP” as the government likes to call them) contract.The hospitals are required to pay higher than reasonable rates tothe P3 contractor for  maintenance work the contractor has deemed to be outside of the P3 contract. Hospitals are almost forced to use P3 contractors to do maintenance work the contractors deem outside of the P3 contract or face the prospect of transferring the risk associated with maintaining the related hospital assets from the private-sector company back to the hospitalP3 companies with poor perf…