Merging health units raises major concerns

What does the delivery of public health services in Scarborough and Apsley have in common? The obvious answer would be, not much. One is among Ontario’s most dense, urban and multicultural communities. The other is among Ontario’s most sparsely populated, rural and homogeneous communities.

Yet under a proposed new management system for public health in Ontario, those two communities would have delivery of public health overseen by the same regional board.

The marriage of massive Scarborough and tiny Apsley is an extreme example of what would happen if the provincial government shrinks 34 current public health units into 16 regional boards, but it does nicely highlight the concerns of the majority of public health professionals.

The broad outlines of that remake are covered in a 29-page report of the Minister’s Expert Panel on Public Health, which had a mandate to push public health into a more “integrated system.”

Not surprisingly, the panel recommended that 16 existing Local Health Integration Networks (LHINs) be used as the framework.

The report is deliberately short on exactly how the much larger regional boards would work and how they would be funded.

But specifics aside, the basic notion that bigger regional networks tied to LHINs will provide more efficient public health service is questionable.

That point has been made by almost every public health unit in the province, including Peterborough’s, and by local politicians who have representatives on health unit boards and believe they and other local appointees know what their communities need.

They are right and the province and Health Minister Eric Hoskins should be listening.

The panel might be right when it says some small health units are unable to do a professional job and the result is uneven levels of service across the province, although no facts are cited to back the statement up.

But it is certainly not true of Peterborough Public Health. It and its medical officer of health, Dr. Rosana Salvaterra, have repeatedly been recognized for the quality of programs provided here. The City of Peterborough has also been a generous funder of the municipal share of public health costs.

If the province wants to insist on some form of amalgamation to reduce administrative costs –one goal cited in the panel’s report – it should consider a less drastic alternative.

The three health units that cover Peterborough, the City of Kawartha Lakes and the Cobourg-Port Hope area discussed amalgamation in the past but couldn’t come to agreement.

There is some logic in an administrative marriage of those three health units that preserves local control of public health delivery.

Trying to tie a knot between Scarborough and Apsley would be folly on a grand scale.