The NDP's health critic, and Nickel Belt's MPP, France Gélinas is concerned over a leaked provincial document suggesting the province is looking into making major changes to the local health integration network system in Ontario, and flirting with privatizing more of the health care system.
The document obtained by the NDP is a piece of draft legislation that includes provisions to cut the number of LHINs from 14 down to five. The LHINs oversee nearly $30 billion in annual operating funding that is funneled from the health ministry to hospitals, long-term care homes and community health centres.
The LHIN system was born in 2007 under the previous Liberal government. The idea was to regionalize (rather than centralize) decisions about how to spend provincial health care dollars, carving up into 14 regional spending bodies. The rationale being a bureaucrat in Northern Ontario, for example, better understands the needs of Northerners than a bureaucrat in Toronto.
LHINs are also the first point of contact for patients who want to get publicly funded home care or a spot in a provincial nursing home.
In a news release sent out by the NDP on Jan. 31, the party says it got its hands on a health care privatization bill the NDP argues indicates Doug Ford is revving up for serious cuts and privatization in Ontario's health care system.
You can read the 81-page draft legislation here.
The draft legislation, as written, would create a new "super agency" to oversee the health care system alongside the minister. Gélinas said if the Northeast LHIN were dissolved, Sudbury would then fall under one large regional body known as the North, encompassing everything north of the French River to the James Bay coast, west to the Manitoba border and east to the Quebec boarder — and it would be a disaster, she said.
"It would be devastating," Gélinas said. "If you live in Dryden and the office looking after you is based out of Sudbury, it might as well be in Calgary, the distance is the same.
"They want to move forward with integrated care, but for that to work you have to give local people a voice. The way we deliver care, whether it be Sudbury, or Gogama, or Iroquois Falls, it's very different from the way you deliver care in Toronto. It's the same thing, the way we deliver care in Sudbury is very different than in Dryden."
Gélinas, Horwath and the NDP all say 'reading between the lines' shows the Doug Ford government is taking a close look at expanded privatization of health care.
"I think they're looking at this as a huge favour to for-profit health care," said Gélinas. "You have to realize that health care is $62 billion a year and there are a lot of people interested in health care, not because they want to help people, but because they're interested in a piece of the $62 billion pie that comes up every year."
But speaking with CBC's Mike Crawley and Nick Boisvert on Thursday, Health Minister Christine Elliott said the NDP "got pretty much everything wrong" in its interpretation of the draft legislation — entitled the Health System Efficiency Act — and what it means.
The bill does appear to refer to more centralized control of health spending, but Elliott said the NDP has been talking about increased health care privatization in Ontario for years, telling CBC the party is "crying wolf." However, she wouldn't say if the draft bill would allow for more privatization in the system.
Ending hallway medicine
While the NDP and the Tories can argue over the intention and interpretation of the draft legislation, Gélinas told Sudbury.com the latest government report on the health care system seems to indicate the province is poised to make some major changes.
Dr. Rueben Devlin, Premier Doug Ford's special advisor and chair of the premier's council on improving health care and ending hallway medicine, released his first interim report Thursday morning, entitled "Hallway Health Care: A System Under Strain," outlining the patient experience in Ontario's hospitals, stress on caregivers and providers, and outlining the next steps to be taken.
Among those next steps is "a pressing need to integrate care around the patient and across providers in a way that makes sense in each of our communities in the province, and improves health outcomes for Ontarians."
While the report doesn't provide many specifics as to what an integrated care system would look like, Gélinas says that those who have been around the health care system long enough can form a pretty educated guess on what it means.
"He's not very specific as to what the transformations will be, but for people who follow health care we're able to read between the lines and see the direction that he is taking," said Gélinas.
The Nickel Belt MPP does lend credit to the validity of a number of statements made in the report and the picture it paints about the province's health care system.
Devlin wrote that, on any given day in the province, there are at least 1,000 patients receiving health care in the hallways of hospitals. At the same time, the wait time to access a bed in a long-term care home is 146 days, and this can vary significantly depending on where a person happens to reside in Ontario.
Gélinas doesn't dispute the facts and figures laid out in Devlin's report with respect to the ongoing issue of hallway medicine, alternate level care (ALC) patient numbers (always a hot button issue at Health Sciences North), the province's aging population, hospital wait times, or quality care.
Devlin's report states, "the final factor contributing to hallway health care is the lack of integration throughout the provision of health care services in Ontario," and goes on to explain that this is in part due to the size of the health care system.
"There are currently 21 health-related government agencies supporting the design and delivery of health care in Ontario. Many of these agencies were created to tackle specific problems, support research, or to establish quality standards and metrics to help the system as it matured. However, these agencies are not always well-aligned and there is limited strategic oversight to ensure the efficient and co-ordinated use of resources."
Among these 21 health-related government agencies are the Local Health Integration Networks, which are in the crosshairs to be cut down, the NDP maintains.
"He's talking about these agencies that he's looking at to transform the system," said Gélinas. "These include the LHINs, Cancer Care Ontario, e-health, Trillium Gift of Life, Health Quality Ontario ... a whole transformation."
