Labour has long remained skeptical about the value of the Local Health Integration Networks. From the start the perception was the LHINs would be used to distance government from unpopular decision-making and destabilize the health sector through continual integrations.
With the government now into full-fledged austerity mode, this may be an opportunity for the LHINs to gain currency with labour.
At stake is the government’s claim that cuts to hospitals are no more than a process of restructuring. With a freeze in base hospital funding and no obvious sector to pick up the slack, there appears to be a credibility gap between the rhetoric and the reality on the ground. When home care is the big funding winner with a four per cent increase this year – about 0.8 per cent when you exclude the impact of population growth, aging and inflation – it does leave us scratching our heads.
However, when the government introduced the Local Health System Integration Act, labour fought hard for protections and disclosure so that restructuring wouldn’t simply become an exercise in beating down worker’s wages.
As the regional health planning entities, the LHINs should be active in insisting that hospitals are not furtively closing or transferring services without first going through the integration process. That includes an insistence that the transferring provider, such as a public hospital, puts forward a plan that identifies where these services are going, what the cost will be and an assessment of the impact on access to care. As part of an integration process, the health care provider must also submit a human resources plan and demonstrate that they have undergone stakeholder consultations. Under LHSIA, when the work is transferred, so are the rights of workers presently attached to that work.
If we look at recent hospital announcements in Ottawa as well as in Perth and Smiths Falls, the hospitals are talking transfer but all we see are cuts.
The LHINs should be opening up this process to ensure that services are not just shuffled off into the void.
If the LHINs want to gain credibility with both labour and their regional communities, they need to do more than approve hospital restructuring plans, they need to ensure that the Act is followed and transfers occur in a planned, open and transparent manner.
This could very well be their moment. The question is, will they seize that moment?