Will the Tories continue to play nice on the LHIN review?

The role of the Ontario Tories on the review of the Local Health Integration Networks is an interesting one to observe.

Mandated by the legislation that created the Local Health Integration Networks in 2006, the review has been handed over to the legislature’s Standing Committee on Social Policy. The NDP had argued to no avail that this standing committee was already stretched and that a special select committee should be struck given the central role the LHINs play within the health system.

The Tories are trying to play nice despite the fact that they have already issued a white paper than advocates simply doing away with the Local Health Integration Networks. To some that may sound promising, but the reality is the LHINs replaced 16-18 district health councils and seven regional offices of the Ministry of Health. The creation of the LHINs also led to the reduction of the Community Care Access Centres from 42 to 14. To simply cut them would create a substantial void.

The Tory plan is to replace the LHINs by giving the work to “hub hospitals,” which would effectively commission or contract local health care. The Tories would also completely do away with the Community Care Access Centres.

The Tories never calculated the cost of transferring these roles to the hospitals, instead insisting that shuttering the LHINs and CCACs would be all gravy. Clearly they think planning, contracting and accountability all come for free.

Yet the similar commissioning model the Harris Tories implemented on the CCACs was both costly and created many levels of administration before money arrived in the form of a front-line worker appearing on a patient’s doorstep. So why would the Tories want to repeat that mistake on a grander scale?

The Tories also ignore the fact that it was their government that created the CCACs after rejecting the NDP concept of the multi-service agency.

When the committee began its work in November long-time Tory health critic Christine Elliott was initially absent, instead leaving the hapless Lisa Thompson to pitch embarrassingly questions to departing deputy minister Saäd Rafi.

While both the Liberals and NDP were using the initial technical briefing to understand the framework and raise specific questions on how the LHINs worked – or didn’t – the Tories were asking questions that appeared to be at the level of a grade school kid.

For example, while Liberal MPP Helena Jaczek raised the challenges of having her constituents receive hospital care in one LHIN and home care in another, Thompson’s showed her total lack of depth on the issue by asking Rafi to rate the LHINs overall on a scale of one to ten.

Rafi was taken aback by Thompson’s question, later pointing out his role was to provide advice, not opinion.

Thompson, the MPP for Huron Bruce, then went on to screw up the name of the hospital in her constituency, initially getting it right before correcting herself and calling it Bruce South Grey (instead of South Grey Bruce Health Centre).

If there is one thing the Tories like it’s contracting out. Thompson asked Rafi why laboratories were not included in the government’s plans to contract out hospital services to independent health facilities. His response was professional and polite. He could have instead pointed out that just about all community-based lab work is already contracted out. We might have added at a much higher cost than equivalent testing done at the hospitals.

Instead of contributing ideas on how to improve the LHINs, the early line of questioning for the Tories was around trying to establish an a-ha moment that would justify their poorly thought-out white paper.

Thompson looked for validation directly from Rafi asking him what he thought of the Tory concept of hub hospitals which she called “health hubs.” Again he deferred to offering advice not opinion.

Jane McKenna, the Tory MPP for Burlington, repeatedly asked why the LHINs had not met all their targets after seven years – no doubt the mantra they intend to take into the next election.

Of course there is a simple answer to McKenna’s seven year complaint – would the Tories prefer the LHINs to have targets that are easier to attain?

That, of course, was not the official response, which instead dealt with an uneven allocation of resources that the LHINs inherited.

In December, with the arrival of the Tory’s Christine Elliott, the official opposition appeared to take a greater interest in the discussion and began asking decent questions on the committee.

Hitting the road later this month and into February, it will be interesting to watch whether the Tories become motivated to fix the LHINs, or whether they will play to local communities upset about issues that have less to do with the structure of the LHINs and more to do with the austerity the Wynne government has imposed on health care.

Committee Road Dates: Fort Erie(January 27), Hamilton (January 28), Kitchener-Waterloo (January 29)Windsor (January 30), Sudbury (February 4), Thunder Bay (February 5),Champlain (near Ottawa)(February 10) and Kingston (February 11). Toronto dates may be added later. All dates are subject to change.

If you would like to present at one of the committee hearings, please contact Valerie Quioc Lim at valerie_quioc@ontla.ola.org or call 416-325-7352. Deadline to request an oral presentation at these road hearings in this Friday — January 10 at 4 pm.

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