CE LHIN – It’s all in the game

Dr. Alex Hukowich was at his feisty best June 15 during his last day on the board of the Central East Local Health Integration Network (CE LHIN). Board members are limited to two terms, and for Hukowich and William Gleed, time was up.

Hukowich is frequently the conscience of the board, serving up his unembellished insights into the shortcomings of the health system and sometimes the LHIN itself. When others may have chosen their language carefully in a meeting open to the public, Hukowich often let his words fly.

When he’s not speaking, you can read his expressive body language across the room. Following the blow-up over the transfer of mental health beds out of the Ajax-Pickering Hospital, Hukowich spent much of the next meeting holding his head in his hands.

When residents from his home community of Northumberland County came to the LHIN this spring to complain of cuts to the local hospital, Hukowich lectured his colleagues on the board, suggesting there was a difference between access to care and availability of services.

Hukowich was fiercely independent. When we asked him if he would be interested in meeting with some of the workers impacted by the decision at Rouge Valley, he looked like a scalded cat, saying it would be inappropriate for him to do so.

June 15 Hukowich was very much engaged in the board proceedings. He was upset the board had no input into how hospital performance funding was weighted, suggesting it was inappropriate that quality indicators were rewarded less than financial accountability.  He questioned the trend towards larger long-term care homes in Canada while other countries were moving to smaller, more “homier” facilities.

When he was given the opportunity to offer some parting words, Hukowich stood up with a big grin on his face. At first he brought back the issue of accessibility versus availability, reminding the board that unless they could find a way of measuring accessibility by looking at the cost of time and travel for patients, any discussion of accessibility was “just talk.”

He presented a gift of a DVD on the Art of Critical Decision-making, claiming he had watched it too late in his board tenure for it to be much use to him.

Noting the recent passing of one of the creators behind Trivial Pursuit, Hukowich then brought out his own LHIN game to pass on to Board Chair Foster Loucks. The game consisted of a box and several coloured playing pieces. Green pieces represented funded parts of the health system that were valuable. Red pieces represented funded parts of the system of little to no value. He also introduced yellow and white pieces that would be thrown into the box by the opponents as the player engaged in the task of trying to remove the wasteful parts from the box. White pieces were new initiatives that would be good for the system, whereas the yellow pieces represented new projects from special interests that were of little use. Hukowich said there was one last component to the game – the player, representing the LHIN, had to pick out the pieces blindfolded.

Loucks, wearing the blindfold, picked out three green pieces and one red piece.

Hukowich’s metaphor for the LHIN was a telling one. Clearly the board members feel they are making decisions without all the information, not knowing if they are taking out valuable parts of the system or trimming waste. For a person of conscience, this would be troubling. For those of us who use and pay for the system, it speaks volumes on the caprice of decision-making under the LHINs.

Amid much nervous laughter, Hukowich was applauded one last time. The CE LHIN board meetings will simply not be the same without him.

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