Elliott promises transparency in new health care system
Provincial health minister says new super agency will assume responsibility for all long-term care home contracts in Ontario
Ontario’s minister of health said the province’s new health care system — from its governing super agency to its regional health authorities — will be transparent and accountable to the public.
In an exclusive interview with The St. Catharines Standard and The Hamilton Spectator, health minister and deputy premier Christine Elliott said the Ontario Health super agency and its subordinate regional health bodies, called Ontario Health Teams, will operate under provincial freedom of information laws.
They will also be required to have public board meetings and post minutes of those meetings.
“There will be public accountability and transparency. That is what we as a government promised the people of Ontario,” said Elliott in the Thursday interview at her Bay Street office in Toronto.
“As Minister of Health, I intend to fulfil that with respect to the local Ontario Health Teams and their accessibility to the public, to the media, to answer the questions that everyone will have.”
Elliott’s commitment to maintaining transparency in Ontario’s evolving health care system was part of wide-ranging interview with The Spectator and The Standard in response to the papers’ joint investigative series on the changes to Ontario health care published last month.
The series, titled “Operation Health Care Reform,” was a comprehensive deep dive into the sweeping changes underway by the government of Premier Doug Ford.
The series looked at the dismantling of the current system and the creation of the new super agency to oversee all aspects of health care.
It also examined the creation of the Ontario Health Teams, the end of Cancer Care Ontario as an independent agency, hallway medicine, integrated comprehensive care and other issues.
Critics of the Ford government’s plan have argued the government is
There will be public accountability and transparency. That is what we as a government promised the people of Ontario.
making sweeping changes too quickly without a clear plan.
They also charge that there has been little consultation and raised questions about the extent of transparency the new health care system will have.
For instance, the super agency’s nascent board of directors, lead by interim board chair Bill Hatanaka, has held board meetings that have been closed to the public.
During the interview, Elliott said this is because Ontario Health is “still being organized and set up. They don’t have their full complement ready yet.”
“One thing is, they are getting organized right now to find a permanent chief executive officer. They are engaging in that process now. Once they are entirely set up and the board has been fully established then they will be [transparent],” said Elliott.
“Right now, it is a time of transition and there are still LHINs on the ground. Once that transition has been completed and Ontario Health is fully making the decisions on all aspects of those issues that were dealt with by the LHINs before, then they will be having public meetings. “
Elliott said she expects Ontario Health board meetings to be public by the spring.
She also said the Ontario Health Teams — alliances of local health providers that will oversee most aspects of health care within their jurisdictions — will be required to hold public meetings and publicly post minutes.
However, it is not clear how the Ontario health teams will be administrated or to what extent they will be publicly accessible.
The provincial government is not imposing a governance structure upon the Ontario Health Teams, preferring instead to allow them to decide how they will be run.
Home care and long-term care
Responsibility for home-care contracts will be turned over to the provincial super agency instead of determined locally.
Right now, contracts for nursing, personal support, therapy, equipment and other home-care services are awarded by each of the 14 Local Health Integration Networks.
A provincial listing of the service providers shows more than 280 contracts — including 20 in the Hamilton Niagara Haldimand Brant LHIN, which includes Burlington.
After the restructuring, the contracts will be the responsibility of Ontario Health, which critics say could lead to large forprofit private companies increasingly taking over the delivery of publicly-funded home care.
LHINs also currently are the point-of-contact for patients needing home care or long-term care and oversee its delivery. Under the new plan, the local Ontario Health Teams will eventually take over both of those roles.
Adding complication is that long-term care is no longer part of the Ministry of Health. It is now overseen by Minister of Long-Term Care Merrilee Fullerton.
Regardless, long-term care homes will be part of the local Ontario Health Teams.
“They will be funded through the Ministry of Long-Term Care,” said Elliott. “But the operation of them within the local Ontario Health Teams is still part of my responsibility as Minister of Health.”
Cancer Care Ontario and the rise of “provincial health teams”
As part of the project to centralize health-care administration into Ontario Health, the province’s much-lauded cancer agency — Cancer Care Ontario — will cease to exist as an independent agency.
The $1.9 billion agency oversees cancer care in Ontario.
It, along with five other standalone health bodies including Trillium Gift of Life Network, is being gobbled up by Ontario Health.
Elliott said CCO will “still exist as a provincial resource” and will advise Ontario Health “concerning innovative cancer care and making sure every region in Ontario has the appropriate basket of cancer care resources.”
CCO and the other agencies are being absorbed into Ontario Health, she said, to cut costs and apply best practices across the health system.
However, the current healthcare restructuring is creating a new group of effectively independent health care groups that will have their own administrations.
While most of the Ontario Health Team applications were made by health-care groups within a geographic region — both Niagara and Hamilton have OHT applications that are now moving to the next stage of development — there are some institutions that have applied to become what Elliott called “provincial teams.”
These teams would not be folded into Ontario Health, but would be provincewide teams that focus on a specific aspect of medicine, including children’s hospitals and specialized spinal treatments.
“They will be resources across the province so they will be dealing with situations where perhaps locally you can get to a hospital-level but you may need a specialized children’s hospital like CHEO or like SickKids where you need to make sure you have the resources available from that larger group,” Elliott said.
“The individual local Ontario Health Teams can then refer patients to or seek advice from them.”
She said the difference between these provincial teams and CCO is that the teams are focused on delivering service and are subordinate to Ontario Health.
Next steps in the transformation
The province is looking to combine some regional proposals as it works to keep the number of Ontario Health Teams below 100.
“What we are looking at now is … putting some of the smaller groups together that show promise,” said Elliott. “But it has to be a natural fit. It can’t be just us putting two groups together that don’t have those commonalities.”
Hamilton, Niagara and Burlington’s proposals are not with those being considered for merger. All three were among the 31 proposals invited in July to make a full application by Oct. 9.
Elliott says she’s looking for teams that will take into consideration the needs of francophones, Indigenous people and other area cultural and linguistic groups.
“Are these organizations that are coming together going to make sure that everyone in their geographic area receives the care that they need,” she said.
“We need to be able to reach everyone.” For more, see the online story