OPSEU recently submitted a number of freedom of information (FOI) requests to the Ministry of Health, one of which is still making its way through the system.
The early responses we have would suggest that “officially” little information is finding its way from the Local Health Integration Networks to the Ministry of Health. The Ministry of Health’s access and privacy office has told us that the only way to gather this information is to apply separately to all 14 provincial LHINs. It would be up to us to collate this information to get a provincial snapshot of what’s going on.
One has to wonder how the Ministry is making policy decisions if it doesn’t really collect such information from the LHINs?
The information the Ministry claims not to have includes detailed budgets for each of the 14 LHINs. It is true that you can find, with considerable effort in some cases, a very basic level budget on their web sites. However, we were told we would have to ask the LHINs directly for a more comprehensive view. The Ministry claims it does not possess this level of budget information, yet it was concerned enough a few months ago to insist the LHINs tighten up their spending procedures.
After hearing a discussion of staff-management ratios as part of their scorecard system, we asked to see this information from the Central East LHIN. We were told we couldn’t have it because this information belonged to the hospitals, not to the LHIN. Ontario is the only province in Canada not to subject its hospitals to FOI legislation, although the Minister of Health has been promising to change this since last fall. Once the LHIN collects it, one would normally believe it to belong to the LHIN. When we requested this same information from the Ministry, they claimed they do not receive these detailed scorecards from the LHINs. They claim to have no idea how many managers occupy positions in Ontario hospitals relative to front-line staff.
When we initially submitted a form to the Ministry asking for information about what the Central East LHIN was describing as $55 million in hospital “efficiencies,” we were sent a letter with our original request form telling us to resubmit it to the LHIN directly. The Ministry does not, apparently, provide direct access to LHIN information. Nor do they forward these requests on.
When we asked about the use of private consultants by the Ministry, they said we could have the information post 2004-05, but it would have to exclude e-Health and the LHINs, for which we would have to make separate applications.
When we asked for any review or evaluation of the pilot projects that utilized retirement homes for hospital “alternate level of care” (ALC) patients, we were shocked to receive a letter from the access and privacy office that said no such evaluation existed. Yet the Ministry has established new rules and is pushing hospitals to proceed in finding more retirement homes to house their ALC patients. How did they decide this without ever evaluating the pilots?
Similarly, when we asked for any correspondence between the LHIN, the Ministry and the Northumberland Hills Hospital around the closure of that hospital’s diabetes clinic, we were told none existed. Yet the LHIN claims the clinic was directly funded by the Ministry. Nobody formally expressed any concerns around the fact that 2,300 patients would be orphaned by the closure, or where alternate services might be provided? It’s absolutely breathtaking.
While there has been much discussion of problems with the LHINs, nobody yet has pointed out that finding province-wide information has become 14 times more difficult as a result of their creation in 2006.
The Minister and the OHA speak frequently about openness and transparency, but the reality on the ground is somewhat different.
Where is the information?