The departing CEO of the Central Toronto Local Health Integration Network says he is not one hundred per cent sure if the LHIN model is going to work, but defended the work the crown agency was doing.
Matt Anderson addressed a Longwood’s “Breakfast with the Chiefs” forum February 11th at Mt. Sinai Hospital in Toronto prior to being appointed the new CEO of William Osler Healthcare in Brampton.
In his hour-long session, Anderson said the priorities of the government were the priorities of the Central Toronto LHIN – a frank admission that contradicts the government’s insistence that the LHINs meant local people would determine their health service needs and priorities.
“If they (elected officials) say these are the priorities that the people of Ontario wish for, these are the priorities,” he said.
Anderson said the lack of a functioning e-Health system was a major obstacle to integration.
If it was at all unclear who was calling the shots, Anderson even prefaced his data slides by saying he “was allowed by the province to bring the data to you.” In fact, Anderson touted the transparency the LHINs brought to health service planning as one of the major levers at his disposal.
Despite having $4.2 billion to allocate to the 180 health service providers within his LHIN, Anderson admitted the discretionary funding the LHIN could decide upon was very small – about $10-$12 million.
Clearly most of the LHIN’s work appears to be around finding ways to measure health care performance and collecting data.
However, Anderson warned that the frequency of integration orders were likely to accelerate – this being the LHIN’s major leverage.
He did caution that integrations were misperceived as mergers, that in fact the description of integrations was so broad that it could represent any number of actions to make the system work as one.
Anderson called the accountability agreements with the health service providers to be “blunt instruments” and that the LHIN was beginning to refine what was in these agreements.
Although the LHINs have had CEOs and Chairs since June 2005, Anderson admits that they are still finding their way. One of the major projects for 2010/11 is for the Toronto Central LHIN to define what health equity actually means – this despite his statement that they were applying an equity filter to “everything we do.”
The LHIN CEO admits that they have much work to do on their own scorecard with the province – there’s “too much red.”
The Central Toronto LHIN is making modest progress on ER wait times, although he admits this is mostly the internal work of the hospitals, not the planning of the LHIN.
He said that progress was more limited on moving alternate level of care patients out of hospital beds – that in fact the situation was flatlined.
Afterwards a participant asked him whether the separation of the two major London Hospitals meant the attempt to integrate the health system was facing difficulties. Anderson admitted that in his own LHIN Sunnybrook and Women’s College Hospitals were going through a de-merger. “It’s not the end of the world,” he said, although the demergers meant there would be another agency with another agenda to negotiate.
He said de-mergers should have some clinical benefit before they take place.
————————————-
February 25th Globe columnist Adam Radwanski reflected on the departure of Anderson as being symbolic of the lack of real power the LHINs have. “The fact remains that he is leaving a job where he was theoretically overseeing health care a the centre of the biggest city in the country to run three suburban hospitals,” Radwanski writes. “Mr. Anderson will probably be able to do more good for patients in his new job.”
OPSEU Diablogue 