Ontario’s health reforms loaded with risk and reward

This week The St. Catharines Standard and The Hamilton Spectator did something uncommon. The sister news organizations published a joint investigative feature on health-care reform in Ontario.

We did it together because the issues and challenges involved are shared by citizens of Hamilton and Niagara. The Local Health Integration Network, to be replaced by a new oversight body, covered both regions. It made sense to share our joint expertise, personified by Joanna Frketich of The Spectator and Grant LaFleche of The Standard.

We’re proud of the series, which is the most comprehensive reporting on the most significant reform to Ontario’s health system in recent history. We explained what we could, and were forthright about what we don’t know — which is a lot given the vagueness and lack of detail in the strategy.

That’s the worry. There is great potential in the reform plan. While we are not among those who describe the current system as broken, there’s no doubt it is underperforming, and too often failing health-care consumers. So you cannot fault the Ford government for wanting to improve the system, especially at a time when an aging population will increase use of and stress on health care.

There is also great risk, as there would be with any attempt to change something as vast, complex and critical as health care. If it’s not done right, the costs could be very high. Unfortunately, this government’s track record at getting things right is not stellar. The autism debacle. Public health cuts that had to be temporarily reversed. Breaking a beer company contract that will probably cost millions. Killing cap and trade for ideological reasons, forcing Ottawa to implement a carbon tax, and depriving towns and cities in millions from cap-and-trade revenue.

Can we trust the Ford government to get health reform right?

The government’s reform blueprint is called the Connecting Care Act. Read it and you’ll be surprised by the lack of detail. We know that an uncertain number of Ontario Health Teams (OHT) will be put in place. They will be made up of health-care stakeholders — hospitals, primary care (family docs and family health teams), community-based and long-term care providers. They will provide the local input on health care across the spectrum. They will report to a new super agency, called Ontario Health.

In and of itself, this structure is puzzling. Part of the province’s rationale is to reduce bureaucracy. But in the future, instead of having LHINs, we’ll have OHTs, reporting to the new super agency, which presumably reports to the ministry of health. This isn’t a smaller bureaucracy, it’s the opposite. The new system also collapses previously independent health agencies, such as Cancer Care Ontario, under one umbrella. But CCO is recognized as a world leader. Does it really make sense to break what isn’t broken in cancer care?

It’s also the same model Alberta has had in place for years. And health-care costs in that province have not gone down under the super agency system, they’ve gone up to a point where Alberta has higher per patient costs than any other province.

It’s not all bad news. Innovative initiatives, liked Bundled Care, which was developed at St. Joseph’s Healthcare in Hamilton, will be rolled out across the province, promising shorter hospital stays with remote support provided to patients at home.

Once the government comes back from its extended summer holiday, health reform will be prominent in the news, and we’ll continue to cover and try to explain it. For Ontarians who care, and we all should, this wave of reform demands close scrutiny and robust public discussion.