TORONTO — Ontario is consolidating its local and provincial health networks to create a central agency as part of a system overhaul, the health minister announced Tuesday, though she wouldn't say if the move will save money or lead to job losses.
Legislation introduced Tuesday would create a new agency, called Ontario Health, to consolidate the 14 local health integration networks, Cancer Care Ontario, eHealth Ontario and several other agencies. The system transformation, including establishing local health teams to co-ordinate care, will take years, Health Minister Christine Elliott said.
"Too much time and attention is spent on maintaining a siloed and fragmented system, and far too many people believe it is the patient's or the family's job to navigate this complicated system during what is already one of the most traumatic and stress-filled periods in their lives,'' Elliott said. "That is just wrong.''
Background materials from the government say that each of the agencies being rolled into Ontario Health has a full senior management team and administrative support, "and over time some of this work has become duplicative.''
The "duplicative'' work refers to some of the administrative functions, Elliott stressed, but she said those services will be required in the new local health teams, too.
"I think we have to look at this as a rearrangement, but rearranged around the patient,'' she said. "This is not a financial exercise.''
When asked how many staff would lose their jobs as a result of the reorganization, the minister said that is something she can't answer right now.
"We promised that we would put more people on the front line in health-care services, and that's what we intend to do so that there are people who are working in the LHINs, for example, right now who provide wonderful home care,'' Elliott said. "We will still need them. Nothing's going to change that way. People will still need home care. We want to make sure that we can amplify those home care numbers. So, in the end, it will work out.''
Elliott didn't say if the government expects to save money through the agency consolidation, but noted Ontario spends 42 cents of every dollar on health care, and studies show the province isn't getting good value for it.
The other agencies being rolled into Ontario Health are Health Quality Ontario, Trillium Gift of Life Network, Health Shared Services Ontario, and HealthForce Ontario Marketing and Recruitment Agency.
As well, Ontario Health Teams will be established to provide what Elliott called seamless access to health services, including primary care, hospitals, home and community care, palliative care, residential long-term care, and mental health and addictions services.
The teams would be responsible for delivering all of the care for their patients and connecting them to services. Elliott said the goal is to have 30 to 50 health teams set up, each responsible for up to 300,000 people. It won't change how patients go to the doctor, Elliott said.
A group of providers will come together — for example a hospital, a local nurse practitioner clinic and a mental health team — and will be responsible fiscally and for the delivery of care to everyone within the geographic area, Elliott said. The health teams will be given a lot of flexibility in how they operate to allow for local variation, officials said.
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People will still be able to choose who provides their care, and more choices will be available through technology, Elliot said, such as giving patients an option to securely access their electronic health records and virtual care options.
"Imagine, we can book appointments online,'' Elliott said. "We have access to our own health-care record.''
NDP Leader Andrea Horwath said she fears the changes will open the door to greater privatization of services.
"This morning's press conference did not allay our concerns about opening up our public health care system to private, for profit, motivated corporations,'' she said.
The Ontario Health Coalition said it would fight any attempt to privatize the public non-profit health services, while the Canadian Union of Public Employees said it will begin escalating actions across the province to push the government to reconsider the changes.
"This dangerous Ford government reboot of our public health system must be stopped before patient care and safety fall victim to the gaps, holes and pitfalls this massive overhaul will create,'' said CUPE Ontario President Fred Hahn.
But the changes had some supporters in the health care sector, including the associations representing the province's doctors, registered nurses and hospitals.
Dr. Nadia Alam, president of the Ontario Medical Association, welcomed the proposed changes, saying patients are currently struggling to get the care that they need.
"If we can do anything to make that easier it's a good day,'' she said.
System is 'wildly out of balance'
Anthony Dale, the CEO of the Ontario Hospital Association, said a broader view of the health-care system will help address overcrowding and help break down barriers that exist between care providers in the health-care system.
"One in six hospital beds are occupied by someone who needs to be in long-term care or at home or assisted living,'' he said. "It's a system wildly out of balance.''
The Registered Nurses' Association of Ontario said they're optimistic that the government plan will divert money from middle management in the health bureaucracy to front line care.
"I think some of those organizations, quite frankly, have ballooned in terms of staffing,'' said CEO Doris Grinspun. "I think what they need is a very clear mandate.''
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