Ru­ral boards of health fu­ri­ous at re­port

New plan could strip ru­ral mu­nic­i­pal­i­ties of de­ci­sion-mak­ing

The Chatham Daily News - - NEWS - LOUIS PIN @STTJ_Pin lpin@post­

It was hot in south­west On­tario Wed­nes­day af­ter­noon, but it was the lo­cal board of health meet­ing rooms that were siz­zling as mem­bers went through the Min­istry of Health and Long-Term Care’s June re­port. It was worse than they thought. The re­port, Pub­lic Health within an In­te­grated Health Sys­tem, was qui­etly pub­lished June 9. It pro­poses stream­lin­ing pub­lic health by, in part, con­sol­i­dat­ing the 36 mu­nic­i­pal boards of health into 14 larger boards, a mea­sure in­tended to save costs and in­crease ef­fi­ciency.

It would also bet­ter sup­port ar­eas that cur­rently have smaller health boards, boards that lack re­sources to func­tion ad­e­quately.

A more stream­lined, ef­fi­cient sys­tem would be an up­grade to the prov­ince’s cur­rent sys­tem, says the re­port.

But mem­bers of the El­gin-St. Thomas Board of Health – among oth­ers – are skep­ti­cal, say­ing the pro­posed sys­tem would save vir­tu­ally no money while strip­ping ru­ral mu­nic­i­pal­i­ties of their lever­age.

“The ru­ral ar­eas just get left be­hind,” said David Marr, coun­cil­lor on El­gin County coun­cil. “The cities, the large cities, will say ‘this is what we’re do­ing ’ and the rest of us will fol­low suit. That’s not right.”

“This is the worst thing they could ever do to pub­lic health,” said Heather Jack­son, mayor of the City of St. Thomas. “This gov­ern­ment is go­ing to ruin the way that we de­liver pub­lic health.”

If the re­port sticks, El­gin-St. Thomas will be grouped with Mid­dle­sex-Lon­don, Ox­ford County, Perth District, Huron County, and Grey Bruce – ef­fec­tively putting Port Stan­ley and Tober­mory in the same ju­ris­dic­tion.

The min­istry hand-picked an ex­pert panel to cre­ate the re­port. It in­cluded four peo­ple from Toronto: the chief med­i­cal of­fi­cer of health for the prov­ince, the CEO of the Toronto Cen­tral LHIN; the chief nurs­ing of­fi­cer with Toronto Pub­lic Health; and a Univer­sity of Toronto as­sis­tant pro­fes­sor.

Other rep­re­sen­ta­tives were med­i­cal of­fi­cers of health from the Guelph and Ni­a­gara re­gions, a hos­pi­tal chief of staff in Ot­tawa, chair of the Wind­sor-Es­sex health unit, and a health ad­vi­sor from the Nish­nawbe Aski Na­tion near Thun­der Bay.

Ru­ral On­tario was con­spic­u­ously un­der­rep­re­sented, some­thing the El­gin-St. Thomas board picked up on im­me­di­ately.

“Peo­ple in Owen Sound are not go­ing to have the same is­sues that we have,” Jack­son said. “We’re not go­ing to have the over­sight. We’re not go­ing to have con­trol of our pro­grams … this to me reeks of the same sys­tem that they use for (ac­com­mo­da­tion review com­mit­tees), when they’re look­ing at clos­ing schools.”

Other mem­bers echoed her con­cerns.

“You’re go­ing to be sit­ting there by your­self,” Marr said. “One per­son from this unit … go­ing up against the needs of ev­ery­body else.”

Amal­ga­ma­tion is a sore topic for many south­west On­tario mu­nic­i­pal­i­ties, es­pe­cially in neigh­bour­ing Chatham-Kent. The pro­posed sys­tem would group them with Wind­sor-Es­sex and Sar­nia Lambton.

Six of the 14 pro­posed boards would be in the GTA.

“I lived through amal­ga­ma­tion,” said Marr. “What hap­pened back then was the prov­ince at that time stepped in and said ‘Chatham-Kent, you’re go­ing to be one (mu­nic­i­pal­ity).’ That was the shot across the bow … ev­ery other mu­nic­i­pal­ity across the prov­ince said ‘we’d bet­ter come up with some­thing. At least (it will be) our de­ci­sion and not their de­ci­sion.’”

Also on Wed­nes­day, med­i­cal of­fi­cers of health from across On­tario met in Toronto to dis­cuss the re­port.

Dr. David Colby, med­i­cal of­fi­cer of health for Chatham-Kent, was among them.

“The re­port hinges on some as­sump­tions,” Colby said the next day. “One, that pub­lic health should be in­te­grated into the health-care sys­tem … I think that’s some­thing that the min­istry (wants) but many of us do not see as de­sir­able at all.”

An­other of Colby’s con­cerns is the re­port, pre­scrib­ing broader ar­eas span­ning nu­mer­ous mu­nic­i­pal­i­ties, will ren­der the re­la­tion­ship be­tween mu­nic­i­pal­i­ties and boards of health null and void.

But the main worry, says Colby, was in the process. He spoke highly of the peo­ple in­volved in the ex­pert panel but said the lack of trans­parency, cou­pled with a pre­scribed man­date, clouds the fi­nal re­port.

“This is ba­si­cally an opin­ion piece,” Colby said. “This is not a pro­posal, this is not a leg­isla­tive frame­work … I would hope that there’s go­ing to be a very ad­e­quate and thor­ough con­sul­ta­tion pe­riod be­fore any of this is im­ple­mented.”

Other groups still to meet in­clude the South­west Board of Health CEOs, to meet at the be­gin­ning of Oc­to­ber, and the As­so­ci­a­tion of On­tario Pub­lic Health Busi­ness Ad­min­is­tra­tors.

The dead­line for re­sponses is Oct. 31.

The El­gin-St. Thomas Board of Health, among oth­ers, will pre­pare their fi­nal re­sponse af­ter fi­nal de­lib­er­a­tions. On the other hand, it’s un­likely that re­sponse will be much dif­fer­ent than it was Wed­nes­day.

“It’s go­ing to be a prob­lem,” Marr said. “That’s the bot­tom line.”


The pro­posed change would lump south­west On­tario into two districts: Wind­sor-Es­sex, Chatham-Kent, and Sar­nia-Lambton; and ev­ery­thing from Port Stan­ley to Tober­mory. The con­cern is spe­cific needs in ru­ral ar­eas like El­gin County will be for­got­ten as pub­lic health takes on a broader, more stream­lined ap­proach.

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