Too many needless government agencies in Ontario

TheStar.com – opinion/editorialopnion
Published On Thu Mar 08 2012.   By Carol Goar, Editorial Board

Ontario has 82 taxpayer-funded health agencies. A handful, such as Cancer Care Ontario and the Trillium Gift of Life Network, are widely known. A couple — ehealth Ontario and ORNGE — broke into the public consciousness because of scandal. But most operate in obscurity.

These agencies are often where trouble breeds.

Even when they’re benign, they diffuse health decisions over so many different bodies that it’s impossible for Ontarians to keep track.

And they’re expensive. Many are headed by well-paid executives and provide jobs for hundreds of government appointees.

Is this a smart way to use public funds? Is it a good way to deliver health care? Is it a responsible way to spend taxpayers’ money?

Surprisingly, banker Don Drummond, who just conducted a year-long review of Ontario’s public spending, said very little about this issue. As chair of the province’s Commission on Reform of Ontario’s Public Services, he talked about the need to streamline health-care services. But his only suggestion on the profusion of government satellites was: Consolidation of health service agencies and/or their boards should occur where appropriate while establishing any new consolidated agencies as separate legal entities to limit major labour harmonization and adjustment costs.”

There was nothing about scrapping any of them, reducing their allocation or folding them into the health ministry.

It would be reckless, of course, to take an axe to these agencies without a thorough investigation of what they do and how effectively they do it. But at a time of austerity, Ontarians need to know why the government needs so many stand-alone health agencies. Do patients benefit? Do taxpayers get value for their money?

To weigh this question, some basic information is needed.

All health agencies are not equal. Some, such as Cancer Care Ontario, organize services and deliver treatment. Some, such as the Health Professions Appeal and Review Board, adjudicate disputes between health-care providers and patients. And some are purely advisory. They conduct studies and surveys designed to influence government policy.

Nor are the members of all agencies compensated equally. Some get up to $188,950 a year. Others are merely reimbursed for their out-of-pocket expenses.

Each type of agency needs to be considered separately:

• Those that bring together health specialists in a sprawling field such as cancer research and treatment make sense. A separate agency gives the government a way to allocate a specific amount and let those best qualified decide how to distribute it.

• Similarly, agencies that adjudicate disputes within the health-care sector clearly need to be independent of government.

• For advisory agencies, the rationale is less clear. Does the government really need 20 councils representing every health-care profession from dental hygienists to respiratory therapists? Does it need 25 district health unit boards as well as 14 Local Health Integration Networks (LHINs)? Does it need arms-length expert committees to guide its choices on autistic spectrum disorders, HIV/AIDS and rabies? Does it need an external recruiting agency to hire health-care workers?

There isn’t likely to be a better time than now to cull these agencies (plus the 526 that report to other ministers). The premier is determined to cut provincial expenditures. Health Minister Deb Matthews has just embarked on a comprehensive overhaul of the health-care system. And the public is primed for belt-tightening.

Surely some of these agencies have outlived their purpose; some are maintained for reasons of political expediency and some exist chiefly to lobby the government.

By winnowing down the list, ministers could differentiate between agencies that do valuable work and those that make government more opaque, less accountable and more costly. They could simplify the maze that has developed at and around Queen’s Park.

It’s not just a matter of efficiency, it’s a question of fairness. At a time when Ontarians are being asked to sacrifice, it would unconscionable to deprive kids living in poverty, families warehoused in homeless shelters and struggling legal aid clinics of provincial support to perpetuate unnecessary government agencies.

(A complete list of provincial government agencies is on the website of Ontario’s Public Appointments Secretariat.)

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