By MPP Toby Barrett
The frequent and expensive reorganization of Ontario’s health care over the past 13 years has left the system in upheaval and patients forgotten.
The so-called Patients First Act – Bill 41 – is the latest experiment in rejigging our health care system. Like government attempts to tinker with ORNGE, E-health, and the original creation of LHINs, the latest stab at health care will continue to transfer money from patients to bureaucrats.
Before my election as MPP, I had a 20 year career with an Ontario Ministry of Health agency addressing addictions. During that time I always kept in touch with my uncle – a hospital administrator – with respect to the overall objective of our work. As he explained to me time and time again – our only priority in this business is the patient. Hospitals, doctors, budgets, programs… they all exist for one reason and one reason only – to serve the patient.
Bureaucratized health care does not serve patients well
As our Health Critic, MPP Jeff Yurek, has so aptly pointed out, Bill 41 could be renamed – the Putting Bureaucrats First Act.
The Patients First Act would see Local Health Integration Networks (LHINs) absorb Community Care Access Centres (CCACs) to deliver home care service through 80 sub-LHINs.
The Auditor General reported LHINs are failing to meet their mandate and are not integrated – and now we see them rewarded with additional power.
Home care patients, meanwhile, are falling through the cracks. According to Ontario’s Auditor General only 61 per cent of home care dollars go to frontline service — the rest goes to administration.
Bill 41 will expand the mandate of the LHINs to cover primary care planning, management and delivery of home care, create new health care entities, and manage placement of people in long-term care facilities.
The day the bill becomes law, CCAC employees, assets, liabilities, rights and obligations will be transferred to their corresponding LHIN. The CCAC will no longer be the primary health care provider. Directors and officers of the CCAC will be terminated.
The Minister of Health and Long-Term Care’s role will expand under Bill 41 to issue policy and operational directives to the LHIN and make suggestions for LHIN supervisors. The minister will also be able to issue directives to hospital boards when he or she deems it to be in the “public interest”.
The minister will also be empowered to appoint LHINs as an agent for payment of doctors and other health practitioners.
Physicians have not been impressed government policy of late. With this government already having a strained relationship, the bill could make things worse. Given the demand for doctors, they can move to other jurisdictions that are more doctor friendly. Again, patients will be the losers with fewer doctors.
Government does not do well reigning in bureaucracy and its expense. And bureaucracy does not do well in providing cost-effective service for patients.
The putting Patients First Act really boils down to government replacing one burdensome level of bureaucracy with another. Each move by this government on the file has removed much-needed money from patient services, and instead invested it in bureaucracies that ultimately failed.
In my opinion, Bill 41, even though it’s titled Putting Patients First, doesn’t do enough to improve things for the most important component of the heath care equation – the patient.