A tale of two LHINs – Champlain could learn from Central East when it comes to community involvement

In the past few weeks we have been challenging the Champlain Local Health Integration Network (LHIN) to step up to the plate around cuts and transfers of services from The Ottawa Hospital.

Champlain LHIN CEO Chantale LeClerc has dug herself in for the fight, insisting that considerable changes to health service delivery in her region do not warrant an integration decision nor any additional public consultation.

Curiously, in her most recent letters to both OPSEU and the Ontario Health Coalition, she has suggested that regional volumes of endoscopies have not yet been decided and that the LHIN has no mechanism to transfer them outside of a hospital environment (LHINs have no jurisdiction over private clinics performing public OHIP work).

The Ottawa Hospital CEO Jack Kitts is publicly stating the hospital will perform 4,000 fewer endoscopies per year (initially it was 5,000 fewer) and that it was his expectation that these volumes would be picked up by independent community-based clinics and other regional hospitals.

Clearly the hospital CEO and the LHIN CEO are not on the same page even though the LHIN is telling us the hospital is merely following its accountability agreement.

Endoscopies will be coming under what are called “Quality Based Procedures” for the coming year. These QBP get funded separately from hospital global budgets. That means if The Ottawa Hospital decides to stop doing 4,000 endoscopies, it also stops getting funding for them. Unless TOH is losing money on these procedures, it doesn’t suggest that such cuts will do anything to aid their bottom line – the whole point of this “restructuring.” Until we know where these procedures are migrating to (if anywhere), we have no idea whether the region will be saving any money or whether the public will be maintaining access.

How this can be a done deal when the LHIN itself doesn’t even know what its regional volumes will be is completely beyond us.

The hospital also stated that it will be doing 15 per cent fewer cataract surgeries, the LHIN maintaining that it has been successful in reducing wait times. Yet the most recent provincial wait times average is 141 days for cataract surgery. The posted wait at The Ottawa Hospital is 209 days. At nearby Montfort, the wait is 124 days.

The LHIN states the hospital has met its public consultation obligations by running its proposals through the hospital’s self-selected Community Advisory Council. Given the controversial nature of these cuts, this is fairly thin gruel.

Despite a large and noisy public demonstration in March, the LHIN has not wavered.

This is not the case in the Central East LHIN, which stretches from the Eastern end of Toronto to the Haliburton Highlands.

There the LHIN has listened to public concerns around The Scarborough Hospital’s proposed solutions to its deficit problem.

Central East LHIN CEO Debbie Hammons told the Scarborough Mirror that she has been inundated with calls, emails and petitions opposing the changes at the hospital.

The Scarborough hospital had proposed consolidating its maternal and newborn programs at the smaller Birchmount site, converting Birchmount into day surgery only, and sending all in-patient surgeries to the larger Lawrence Road site.

The LHIN overturned this decision and instead recommended that The Scarborough Hospital review service changes with a panel of physicians and community leaders addressing concerns and risks. They have also called on TSH to work on greater coordination between themselves and Rouge Valley Health System on vascular surgery, maternal health and pediatrics.

The same LHIN had overturned a merger proposal last year between the cash-strapped Scarborough Hospital and the much healthier Toronto East General hospital.

Clearly one of these LHINs is concerned about involving the community in major health service changes. They are trying to look at the big picture. One of them is just making excuses about what is self-evident — The Ottawa Hospital is making deep cuts to public health care to balance its budget.

It’s time the Champlain LHIN learned a lesson from its Central East counterpart in community involvement and revisit cuts at The Ottawa Hospital. LeClerc, still relatively new to the position, might want to give the more experienced Deb Hammons a call and figure out how to get out of this mess.

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