Proposed changes concern health unit
Potential changes to 36 health units in the province has the local board concerned.
The Minister’s Expert Panel on Public Health released its report on Public Heath within an Integrated Health System in June and, over the summer, health units across Ontario have been going over the document, exploring its recommendations regarding organizational structures for public health in Ontario.
The report calls for creating 14 health units out of the current 36, seeking to link the health units with the Local Health Integration Networks (LHIN) by aligning with LHIN boundaries, and respecting municipal boundaries and relationships when possible.
If the report recommended just that, the Simcoe Muskoka District Health Unit would be on board.
But the health unit doesn’t seem to think that has happened here, so its board is less than impressed with what’s been presented.
“On the whole, the board was supportive of those intentions,” said Dr. Charles Gardner, medical officer of health with the local health unit. “But when they looked at the details, they felt, in a number of ways, the details did not conform with or support the intention.”
In particular, Gardner said, the new health unit jurisdictions do not align with municipal boundaries in a way that will allow the health units to continue to foster what he feels has been a successful relationship between boards of health and municipalities.
He pointed to the anti-tobacco ordinances that were passed by lower- and upper-tier municipalities in Ontario near the turn of the century. Those bylaws, which paved the way for the Smoke-Free Ontario Act, would not have been possible without strong working relationships between local governments and their community health units.
“Public health is all about protecting and promoting health and preventing disease for the entire community,” Gardner said. “One of our best ways of doing that is through promotion of health public policy; changes in the law, essentially.
“If we lose our alignment with municipal boundaries, it will greatly weaken our relationship with municipalities and greatly weaken our ability to do that kind of work.”
Gardner said it almost appears as if the panel is trading off a closer relationship between health boards and municipalities for closer ties between the boards and the greater health-care system. However, the boundaries recommended don’t align with the current LHIN structure, and changes to those boundaries are not discussed in the report.
Under the panel’s recommendations, the Simcoe Muskoka District Health Unit would merge with the western portion of the North Bay Parry Sound District Health Unit in what the panel refers to as North Simcoe Muskoka. The local health unit board feels the size proposed under some of these mergers is excessive but realizes it is not in the situation some of the other boards across the province are in.
He pointed to the new South West region, which would encompass a swath of land stretching from Lake Erie to the west side of Georgian Bay, including cities such as London and Owen Sound, combining six health units.
“We would be actually lightly affected compared with most of the other proposed mergers across the province,” Gardner said. “The board actually didn’t take a perspective of focusing exclusively locally. They gave feedback about the whole.”
Following its meeting Sept. 20, the board sent a letter to the province regarding the recommendations in the report.
The province is taking feedback from boards of health until the end of October.