Local Health Integration Networks | OPSEU Diablogue

Category Archives: Local Health Integration Networks

LHIN consultation guidelines can’t come soon enough

Posted on September 23, 2010 | 1 comment

The province has promised to provide community engagement guidelines to the Local Health Integration Networks following this summer’s Ombudsman’s Report.

In that report, the Ombudsman noted a board member of the Hamilton Niagara Haldimand Brant LHIN considered conversations on golf courses and grocery store line-ups as public consultation.

The guidelines, expected in October, can’t arrive soon enough.

At Wednesday’s board meeting of the South West LHIN, Dr. Murray Bryant said an integration proposal from St. Joseph’s Health Care and London Health Sciences “failed the most cursory test” when it came to public engagement.

Further, the $1.018 million project to consolidate breast cancer services comes to the LHIN for approval despite the fact that the plan is already being implemented.

Michael Barret, CEO of the SW LHIN did suggest the joint leadership of the two hospitals may have led them to believe an integration decision was unnecessary.

However, board members found it hard to believe that the largest hospitals in the region would be unaware of their obligations.

Board members did discuss holding up their approval for the project to “educate” the hospitals on the need for public involvement in the decision-making process, but opted instead to rubber stamp the proposal.

The same outrage could have been expressed for the integration to follow – the movement of 50 specialized mental health beds from Regional Mental Health – London to Grand River Hospital in Kitchener.

Among evidence of public engagement, CEO Cliff Nordal includes public hearings held by the Health Services Restructuring Commission – which issued its report in 1997. He also refers to meetings where staff was given their options with regards to transfers to Grand River – hardly a stunning moment of meaningful community engagement.

Staff at the mental health centre tells us that there has been no recent opportunity for the general public to provide input into the decision to move these beds to other communities. When the two Regional Mental Health sites are redeveloped in 2014, it is expected the London area will have about half its present number of mental health beds.

It is clear from the integration proposal that the four LHINs involved in the master plan have no intention on consulting on the master plan. Instead the transfers appear to be dealt with piecemeal. This is the antithesis of what the LHINs were supposed to be doing –looking at the broader planning needs of the region.

Looking at the community engagement descriptions in the various integration proposal documents, there is clearly one major input missing: what the community had to say.

Whoever designed the template forms for these proposals left this out. It suggests the LHINs are interested that consultation took place, not the substance of what was heard.

This makes a total farce out of the public engagement process, and leaves the false impression that there may have been consensus in these engagements. Nothing could be further from the truth.

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Posted in Health System, Local Health Integration Networks

Ombudsman’s report shows LHIN uninterested in results of hospital’s public consultation

Posted on August 19, 2010 | 1 comment

One of the key issues raised in the Ombudsman’s recent report, “The LHIN Spin” is how public consultation is dealt with.

With voluntary integrations (for example a hospital initiated change to service), there is no requirement for the LHIN to consult the public if it agrees with the integration proposal. However, there is a requirement on the part of the health service provider to do so.

The Ombudsman reports that “while LHIN officials acknowledged that they do have a role in ensuring that a health service provider conducts stakeholder outreach, they stated that they relied on and trusted the information provided by Hamilton Health Sciences concerning its efforts to obtain public input.”

However, in the case of Hamilton Health Sciences, the LHIN did not even request any of the results of that consultation.

In theory, the community could be uniformly opposed to a decision, offer good alternate proposals, and none of this would ever inform the LHIN when they made their final decision. Such disregard for the content of these consultations suggest the LHIN was not interested in what the community had to say, only in the fact that it was consulted and legal obligations were met.

In the case of Hamilton Health Sciences, when the Hamilton Spectator contacted the hospital to ask about results from their consultation, HHS said the results were recorded in the form of “personal and mental notes” and been the subject of “debriefing conversations.” In other words, consultations were held, but nothing was really recorded for review by the LHIN or others.

Further, in the case of the Hamilton Niagara Haldimand Brant LHIN, the board was told not to attend health service provider consultations sessions to hear for themselves what the public had to say.

A hospital has every incentive to filter what they have heard in order to support the proposal they are bringing to the LHIN. If neither staff nor board from the LHIN is attending these sessions, and if no real documentation is made of concerns raised at these meetings, the LHIN will have no idea if the hospital’s representation of those comments was fair

In the case of Hamilton Health Sciences, it was clear they didn’t even care.

The Ombudsman makes a recommendation that “adequate records of community outreach should also be kept and made available to ensure that stakeholder views are accurately represented.”

LHINs do not permit deputations to its board meetings. Given the community cannot rely on the self-interest of health care providers to accurately reflect their view back to the LHIN, they should have the opportunity to do it themselves.