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Many will agree that Ontario's health care system is large and complex with more than 154 hospital corporations, 42 Community Care Access Centres, hundreds of private and public long-term care homes, labs, public health units and other providers. For some patients and their families, the system can be sometimes confusing and daunting to navigate in search of care.
Building an integrated, patient-centered health care system is at the "heart" of the government's Local Health Integration Networks (LHINs). By devolving powers for the planning and delivery of health care to the community level through 14 LHINs, the government believes it will lead to better coordination and integration of health services.
To give "life" to LHINs, Minister of Health and Long-Term Care George Smitherman today introduced Bill 36, Local Health System Integration Act in the Legislature. The bill outlines the LHINs' roles and powers, and the Ministry's new role.
A few highlights:
Health Service Providers: The bill applies to hospitals, divested psychiatric hospitals, Community Care Access Centres (CCACs), Community Support Service Agencies, Mental Health and Addictions Agencies, Community Health Centres and Long-Term Care Homes. The bill does not apply to physicians, ambulance services (emergency and non-emergency), labs, provincial drug programs and individualized care, and independent health facilities.
Funding: LHINs would be responsible for allocating $20 billion out of the Ministry's total budget of $32 billion. To put this figure into some context, Ontario hospitals received more than $12 billion for 05/06. The Ministry will be responsible for allocating $12 billion towards physicians and other provincial programs, and will continue to fund major capital projects. The proposed timetable to devolve this funding power is to be determined.
Governance: Compared to regional health models adopted in other provinces, LHINs would not have the legal power to consolidate or alter existing health organizations' governance structures. Therefore, the composition and structure of UHN's Board of Trustees will not be affected.
CCACs: The bill would reduce the number of CCACs from 42 to 14 to align with the number of LHINs. The number of CCAC "storefronts" in communities will not change.
Integration: The Ministry's release states that "LHINs and service providers would be required to develop strategies to integrate services." Further, it states that "legislation would specifically set out the types of integration LHINs could require such as moving a service from one provider to another."
Consolidation of Support Services: The government has stated its support for Hospital Business Services (HBS), a not-for-profit shared service organization providing business office functions to member hospitals, including UHN. The purpose is to generate non-clinical savings for member hospitals in order to reinvest in front-line patient care. As a hospital, our primary business is delivering patient care. Over the last three years, UHN has benefited from merging our materials management functions with Sunnybrook & Women's and Mount Sinai.
The legislation would generally apply the Public Sector Labour Relations Transition Act (PSLRTA), 1997 for labour matters. This Act was enacted during Health Services Restructuring Commission.
Final Thoughts: This is a complex and ambitious bill that will ultimately change Ontario's health care landscape by influencing the way we, as health care organizations, plan, evaluate and relate to government and other providers. Over the next few weeks, the Senior Management Team will be analyzing the bill in closer detail to better understand its implications. No doubt, there will be lots of discussions and analysis in the sector.
With the creation of LHINs, I continue to be excited by the opportunity to share our integration success stories and to learn from our health partners. UHN's integration record is something we should all be proud of! Initiatives such as SIMS' IT partnerships (CCACs and rehab and community hospitals), Total Joint Network, materials management consolidation with two hospitals, Electronic Patient Records connecting UHN to Mount Sinai and MDS Diagnostic Services, has resulted in better patient care, and increased organizational and system efficiency.
This draft legislation sets into motion the evolution of Ontario's health care system. You can learn more about LHINs by accessing http://www.health.gov.on.ca/english/media/news_releases/archives/nr_05/nr_112405.htm
As always, I welcome your feedback!