06/02/2016 14:01 EDT | Updated 06/03/2017 01:12 EDT

Ontario bill would overhaul $50 billion health-care system, close CCACs

TORONTO — Ontario's Liberal government introduced legislation Thursday to improve patient care through better integration of the many service providers in the province's $50-billion health-care system.

The 14 Local Health Integration Networks (LHINs) set up by the Liberals will be given an expanded role, while the Community Care Access Centres (CCACs) created by the previous Progressive Conservative government will be shut down.

The LHINs will be responsible for oversight and delivery of primary care as well as home and community care, and will hand out $25 billion in funding every year, half of the province's health-care budget.

"It's about integrating the different parts of our health care system, and turning it around so we...look at it from the perspective of the patient and caregiver, the family and community," said Health Minister Eric Hoskins.

The LHINs will get additional responsibility for "planning and performance" of primary care providers, including doctors, who have been locked in a lengthy battle with the Liberals over a new fee schedule.

"This will allow us to work with primary care providers to identify what services are available, to look at the needs of communities and do that based on population, and then to plan exactly how services can be improved," said Hoskins.

The Ontario Medical Associaton said the Liberals' legislation "violates the government's Constitutional obligation to negotiate" the provision of medical services.

"The province must work with Ontario's doctors in partnership to make any changes going forward," OMA president Dr. Virginia Walley said in a statement.

The legislation formalizes the relationship between public health units, boards of health and the LHINs, and will help eliminate "silos" in the system, added Hoskins.

"Across the health care spectrum, we can benefit from the expertise the public health officials have on social determinants of health and health equity and population health," he said.

Hoskins wasn't prepared to put a number on it, but said he believes there will be "significant savings" from getting rid of the CCACs, and expects most of their front-line staff will be "moved over" to the LHINS.

The province spends $90 million a year to run the LHINs, and the Progressive Conservatives are worried the legislation will just create more bureaucracy and take money away from front-line health care services.

"It seems to me there's quite an emphasis on growing different layers of bureaucracy, and our concern is what the impact on patients will be," said health PC critic Jeff Yurek.

"I hope this isn't just an experiment the government is trying out because patients are going to suffer."

In her 2015 report, auditor general Bonnie Lysyk said no LHIN had ever met all of its performance targets, and she found the Liberals responded by relaxing the targets.

NDP Leader Andrea Horwath said the Liberals have "thrown our health-care system into a complete state of crisis" and she has no confidence in their legislation.

"After 13 years they've done nothing but destroy our health-care system," said Horwath.

"Why would anybody think they're going to be able to fix it with the piece of legislation they tabled this afternoon?"

The Registered Nurses Association of Ontario praised the "healthy dose of change" that Hoskins is prescribing for the system.

"Having one body accountable for whole system planning, funding allocation and monitoring will result in stronger and healthier communities," said RNAO CEO Doris Grinspun.

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