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Health care overhaul: Providers unsure what Tories plan will mean in reality

We spoke with Health Sciences North and the Ontario Nurses Association for their reaction to Conservatives’ plan to reform health care
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Health reporter Carol Mulligan spoke with Health Sciences North and the Ontario Nurses’ Association about their reaction to Ontario’s health care reform plan. (Stock)

As Health Minister Christine Elliott was rolling out her government’s plan to reform health care Monday, a team at Health Sciences North was on a conference call with officials from her ministry, discussing the hospital’s urgent need for more beds.

Premier Doug Ford’s Progressive Conservative government is undertaking the biggest overhaul of Ontario health care since medicare, but it is reassuring there are “separate conversations happening with government about people’s needs right here in Sudbury,” said HSN president and CEO Dominic Giroux.

Many of Ontario’s 1,800 health service providers and 14.8 million patients are poring over the 72-page health reform document, trying to determine what it means for them. Under the act, the Tories will disband the province’s 14 Local Health Integration Networks and six other agencies including Cancer Care Ontario and the Trillium Gift of Life Network.

Health services in the province will be overseen by one super-agency with health teams formed in several locations to ease the transition among health care providers and ensure patients receive better health care — according to the Ford government.

The North East LHIN is among those that will be disbanded although it is not known how and when that will be done. A spokeswoman for the NE LHIN, Cynthia Stables, said the agency was not commenting on the reform plan.

Hundreds of people work for the NE LHIN and their futures are uncertain under the plan that will take years to implement. The NE LHIN plans and funds services for 565,000 people across 400,000 square kilometres in five sub-regions.

Critics of the act say it opens the way to a system in which more services can and will be provided by business and private agencies. That was not the subject of conversation Monday, said Giroux, as he and thousands of health care planners engaged in webinars and conference calls to determine the impact of the reforms on their organizations.

It is too soon to tell what the consolidation of health agencies will mean. The MHLTC is “essentially trying ... to break down the silos” among health services such as acute care, home care, palliative care, mental health programs, long-term care homes and other organizations.
Giroux said HSN saw some of the changes coming and aligned the priorities of its recently launched five-year strategic plan with the direction the PC government indicated it was going. 

For instance, one of the five goals of the HSN plan is to digitally enable HSN so patients and health care providers have better access to patient information, a goal articulated in the Tories’ plan.

It will take years to implement the changes and while that occurs HSN will continue to grapple with bed shortages that have been so dire in recent weeks that elective surgeries have been cancelled and dozens of patients every day are admitted in the emergency department and waiting for a medical bed or being accommodated in “unconventional” spaces such as television rooms and linen closets.

A face was put on the bed crisis this week when the family of a terminally ill man who arrived at HSN’s emergency department Feb. 15 died in the department because there were no beds available for Danny Komarechka. Sister Kimberly Komarechka stressed that her family did not blame hospital staff for the undignified way her brother spent his last hours. But she expressed her family’s frustration that the shortage of beds resulted in a situation such as theirs.

Giroux expressed his condolences to the Komarechka family on the loss of its beloved brother, father and son. Situations such as this sharpen HSN’s focus — which can be diverted to organizational and cost-cutting measures — and bring it back to the patient.

HSN is committed to “learning from the mistakes of the past and making sure we have the right capacity to meet the needs of patients and families,” including those in the palliative phase, said the hospital CEO.

HSN is developing a capital master plan to create more conventional bed spaces. Giroux said the risk is always that as hospitals engage in provincial structural changes, they lose touch with “what really matters 24/7 for our patients.”

That is why Giroux said he was encouraged issues such as bed shortages are still being discussed despite the province’s health reform plans.

Vicki McKenna, provincial president of the Ontario Nurses’ Association, said Monday afternoon that she and her team were analysing the plan and determining what it means for their members.

“It is always about the details,” said McKenna. “We have nurses everywhere” — in hospitals, long-term care homes and working for agencies. “Right now it’s our (nurses) in the LHINS who are feeling the most destablilized because it’s so uncertain, there’s so many questions, so many things we’re looking for answers to.”

The bottom line for nurses is “what about the people I care for?” said McKenna. “How is this going to work and how about all of these pieces?”

She called the act “philosophical” but said the reality and implementation of it remain to be seen.
McKenna said she and other nurses have been through many kinds of health care restructuring over the years. “We know what change management looks like. What it looks like when it works and what it looks like when it doesn’t.”

ONA will have more to say about the PCs’ reform agenda after it has had time to analyse it, she said.

Carol Mulligan is an award-winning reporter and one of Greater Sudbury’s most experienced journalists. Got a question or story idea for Carol? Email [email protected].


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