Health unit mergers makes sense

I am an advocate for lean, cost-effective, transparent, honest and respectful governments. I believe this is lacking in all three levels of government today. In Ontario, health care is the single largest budget item in the province accounting for 38.1 per cent of expenses in 2017-2018. That is $53.8 billion dollars and projected to rise in upcoming years! There is an initiative to amalgamate the 36 public health units with the 14 Local Health Integration Networks (LHINs). I believe this is long overdue and welcome its implementation.

Value-for-money audits conducted by the Auditor General assess whether money was spent with due regard for economy and efficiency, and whether appropriate procedures were in place to measure and report on the effectiveness of government programs. In the December 6, 2017 audit report it found the provincial government has no comprehensive chronic disease prevention strategy and does not know whether its 36 public health units are making headway in the fight against preventable chronic disease.

I attended a Peterborough Public Health board meeting on Dec. 13 and believe the “effective measuring and reporting” aspect of their responsibilities is lacking. A presentation on the local aspect of the opioid crisis lacked data on program effectiveness. In addition the presenter referred to “free” naloxone kits being distributed. The word “free” was used several times. Free to the board of health means it doesn’t come out of their budget. This self-centred reference to costs is troubling as I believe they have lost sight of the funder of their budget, the taxpayer.

On average, over the last 10 years, the Ministry has spent about $1 billion annually on public health-related programs and services. This spending is allocated to many parties, including public health units, not-for-profit organizations and Public Health Ontario. The 36 public health units’ amalgamation with the LHIN makes sense when you examine these costs and lack of oversight. Neither the Ombudsman of Ontario nor the Patient Ombudsman have a mandate to oversee public health units.

While boards of health are municipally based, they are accountable both locally and to the ministry through the Health Protection and Promotion Act and funding/accountability agreements. Ministry funding for boards of health is currently governed by the Public Health Funding and Accountability Agreement, which sets out the obligations of boards of health and the ministry.

The LHIN will be more financially accountable, be subject to oversight, and eliminate the need for so many health boards.

Dave Schofield Cindy St.