Pro­posed changes con­cern health unit

The Enterprise-Bulletin (Collingwood) - - OPINION - PA­TRICK BALES pbales@ post­media. com twit­ter. com/ patrick­bales

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.

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