February 29th is the magic date for getting your proposals for restructuring Ontario’s health care (and home and community care) services in to Minister Hoskins
The discussion paper – “Patients First – A Proposal to Strengthen Patient-Centred Health Care in Ontario” – was released on December 17th, 2015. The Ministry of Health and Long-Term Care (MOHLTC) held a “Roundtable” discussion about aspects of the restructuring proposals in Toronto on February 17th, and is hosting other roundtables in Ottawa, Sudbury and Thunder Bay – all by the 29th.
The Province’s restructuring proposals are primarily about reorganizing provider relationships. Providers are coming first; “patients” are coming second. Entry, or eligibility criteria, to the restructured health continuum still seem to be acute illness or debilitating chronic disease. Doctors remainthe gatekeepers. Seniors or kids living in the community who may need assistance with daily living are not currently acknowledged. Home and community support services are not seen as critical components of primary care.
The Ministry’s “Roadmap to Better Home and Community Care” (released in 2015), should intersect with the health care restructuring process. This is not obvious to Care Watchers. It seems to be on a side track running a number of pilot projects. Meanwhile discussions about provincial service standards or a basket of services for home and community care are completely absent from the debate! Care Watchers would be justified in concluding that the current dysfunctional service packages will simply be uploaded to the LHINs and it will be business as usual. Well documented inequities and gaps will continue to exist.
Where are we at now? The Ministry is dissolving the CCAC Boards and transferring HCC funding, management and service delivery to the LHINs. Many CCAC field staff will also be transferred to the LHINs (because the LHINs currently lack the capacity to take on a broader mandate), but their apparently overpaid CEOs are likely to be jettisoned. This will allow the Province to say that it has addressed the Auditor General’s criticisms of the CCACs and the associated public outcry. LHINs will have (as yet undefined) sub-regions for service delivery and an as yet undefined entity will provide clinical leadership and coordination to “ensure service integration”. Also, the Province is considering “bundling” funding for primary care, hospital and home/community services to foster integration and cost efficiency. Want to bet which providers will consume the lion’s share?
Will the Ministry’s proposals actually provide better services to Ontarians?
The Ministry advised that it plans to introduce restructuring legislation by late April/early May – within current legislative session – this means that most decisions have already been made, if not actually finalized! Submissions re health care restructuring are requested byFebruary 29th via the Ministry’s consultation portal: firstname.lastname@example.org. Or visit the MOHLTC website http://bit.ly/1IbYjsF.
Speak up or forever hold your peace!