9 re­gional health-care ex­ec­u­tives axed as prov­ince piv­ots to­ward ‘su­per agency’

The Peterborough Examiner - - CANADA & WORLD - ROB FER­GU­SON

Nine chief ex­ec­u­tives of On­tario’s re­gional health agen­cies are get­ting pink slips and shar­ing $3 mil­lion in sev­er­ance as the prov­ince re­vamps its healthcare sys­tem in a bid to save money and im­prove ef­fi­ciency.

The move to cut the num­ber of Lo­cal Health In­te­gra­tion Net­works (LHIN) to five from 14 comes as or­ga­ni­za­tions like Cancer Care On­tario and eHealth On­tario are trans­ferred into a new “su­per agency” called On­tario Health ef­fec­tive Dec. 2, Health Min­is­ter Chris­tine El­liott an­nounced Wed­nes­day.

El­liott said noth­ing will change for pa­tients as the health sys­tem is stream­lined to save $250 mil­lion this year, rising to $350 mil­lion next year, with the money be­ing poured back into front-line care as the prov­ince’s pop­u­la­tion grows and ages.

“Pa­tients con­tinue to re­ceive care in the same way they al­ways have. This is re­ally just back-of­fice changes to find sav­ings and to in­te­grate pa­tient care,” she said in an in­ter­view, not­ing func­tions like hu­man re­sources and pay­roll for the many dif­fer­ent agen­cies are be­ing com­bined un­der the new On­tario Health to end un­nec­es­sary du­pli­ca­tion.

A health min­istry of­fi­cial said no one other than the heads of the LHINs, which pro­vide lo­cal health care plan­ning, are be­ing laid off now and no of­fices are clos­ing, but in fu­ture there will be “sig­nif­i­cant” sav­ings as real es­tate as­sets are con­sol­i­dated.

The Toronto Star re­ported in June that 416 ad­min­is­tra­tive staff were cut at Cancer Care On­tario and other health or­ga­ni­za­tions as Premier Doug Ford’s Pro­gres­sive Con­ser­va­tive gov­ern­ment be­gan the stream­lin­ing. A to­tal of 825 po­si­tions were elim­i­nated, of which 409 were va­cant.

NDP Leader An­drea Hor­wath de­scribed her­self as “a skep­tic” when asked if she be­lieves the re­struc­tur­ing will im­prove health care for pa­tients.

“While the gov­ern­ment’s mak­ing all of th­ese changes build­ing their su­per-bu­reau­cracy, we see hall­way medicine get­ting worse and worse,” Hor­wath told re­porters in a ref­er­ence to over­crowded hos­pi­tals forced to treat pa­tients in cor­ri­dors be­cause not enough rooms are avail­able.

“This gov­ern­ment has shown time and time again that their in­ter­est is in cut­ting costs, and the im­pacts of that be damned.”

Each of the five LHINs will now cover an ex­panded area cov­er­ing west­ern, eastern, cen­tral and northern On­tario, with Toronto as a sep­a­rate re­gion.

El­liott an­nounced her vi­sion for the new health sys­tem in Fe­bru­ary, say­ing the goal is to pro­vide more “seam­less” care by eras­ing bu­reau­cratic bar­ri­ers be­tween hos­pi­tals, doc­tors, home care and dozens of other providers over the next three years.

Un­der the plan, be­tween 30 and 50 “On­tario

Health Teams” will form across the prov­ince to co-or­di­nate all lev­els of care, from doctor vis­its to hos­pi­tals stays and home care.

Each team is ex­pected to serve about 300,000 peo­ple in a geo­graphic area or a spe­cific group of pa­tients across the prov­ince, such as chil­dren with frag­ile med­i­cal con­di­tions. Premier Doug Ford’s Pro­gres­sive Con­ser­va­tive gov­ern­ment is re­ly­ing on health-care providers — from hos­pi­tals to doc­tors, home-care agen­cies, men­tal health and ad­dic­tion ser­vices, labs and more — to de­vise their own ser­vice mod­els meet­ing pro­vin­cial stan­dards.

So far, the gov­ern­ment has se­lected 31 of 150 agen­cies that have sig­nalled an in­ter­est to form On­tario Health Teams and is putting them through an ap­pli­ca­tion process ex­pected to be com­pleted by the end of the year, El­liott said Wed­nes­day.

Although Ford promised his ef­forts to bal­ance the pro­vin­cial bud­get would not cost any jobs — tweet­ing on May 27, 2018 that “Un­der our gov­ern­ment, not a sin­gle per­son will lose their job” — El­liott main­tained he meant “front-line jobs” only.

“That’s what we heard time and time again, that we need more peo­ple on the front line,” she said.

The health min­is­ter has spo­ken pre­vi­ously of prob­lems pa­tients can have nav­i­gat­ing a “dis­con­nected” health-care sys­tem, with changes needed to make sure that pa­tients dis­charged from hos­pi­tal need­ing home care get it im­me­di­ately to make sure they don’t end up back in emer­gency rooms with po­ten­tially dan­ger­ous and costly com­pli­ca­tions.

El­liott’s re­vamp is in part driven by the gov­ern­ment’s prom­ise to end “hall­way health care,” in which about 1,200 pa­tients a day re­ceive treat­ment in hos­pi­tal hall­ways be­cause of over­crowd­ing, and more than 30,000 peo­ple are on the wait­ing list for nurs­ing home beds.

There are about 5,400 pa­tients in hos­pi­tals who no longer need acute care but can­not get into long-term care. The gov­ern­ment has com­mit­ted to adding 15,000 nurs­ing home beds within five years, but the in­de­pen­dent Fi­nan­cial Ac­count­abil­ity Of­fice has warned more are needed to cut wait times.

“In gen­eral, most large com­mu­nity and aca­demic teach­ing hos­pi­tals are func­tion­ing at ex­tremely high oc­cu­pancy lev­els, es­sen­tially in a semi-per­ma­nent state of 100 per cent and higher. That’s been the trend the last three years,” said An­thony Dale, chief ex­ec­u­tive of the On­tario Hos­pi­tal As­so­ci­a­tion.

“It’s sim­ple math — a grow­ing pop­u­la­tion and an ag­ing pop­u­la­tion.”

RICHARD LAUTENS TORONTO STAR

On­tario Health Min­is­ter Chris­tine El­liott says money saved from stream­lined ser­vices will be re­turned to front-line care. “This is re­ally just back-of­fice changes to find sav­ings and to in­te­grate pa­tient care,” she said.

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