Is Hoskins’ health reform plan bold or a bust?
TheStar.com – Opinion/Commentary – Critics denounce Ontario home-care reform package as a bureaucratic nightmare
Dec. 1, 2016. By BOB HEPBURN, Politics
Ontario Health Minister Eric Hoskins earned widespread praise in June when he unveiled legislation to dramatically reform the way patients receive health care at home and in the community.
At the time, the bill, called the Patients First Act, was described as the biggest change in Ontario’s health system in 50 years.
As Hoskins envisaged the reforms, patients would have faster access to a family doctor, those leaving hospitals would receive prompt home care and millions of dollars would be saved by eliminating an entire level of health-care bureaucracy.
Many key players in the health-care field, including nurses and patient advocates, called Hoskins “courageous” and lauded the legislation as “bold.”
The bill will likely get final approval next week in the Ontario Legislature. But over the past six months the praise Hoskins received for tabling the reform plan has almost completely evaporated.
Today, both Hoskins and the bill are being widely denounced, some of it justified, much of it not. For example, Ontario doctors are so angry they are threatening an unspecified “job action” if Hoskins doesn’t kill the bill.
Even some of Hoskins’ most vocal initial supporters now fear the reforms will create a bureaucratic nightmare and won’t save any money.
However, senior health ministry officials counter that the criticisms are unwarranted, that the reforms will result in some $50 million a year in savings and patients will benefit greatly once all the changes are in place. They also say some critics are upset because they feel the reforms go too far while others are unhappy because the reforms don’t go far enough.
At the centre of the reforms is a massive reorganization of the home-care system. The plan is to dismantle the 14 bureaucratic-heavy Community Care Access Centres (CCAC) that oversee home care and move their 7,000 employees and functions to the 14 Local Health Integration Networks (LHIN) that currently are responsible for overall planning and financing of regional health services. The bill also creates about 70 new “sub-LHINs” that will act on a more regionally focused basis.
Doctors are unhappy because they claim the legislation gives the LHINs too much power over them. Specifically, they say it allows the LHINs to ask for such information as when their offices are open. Ministry officials say the data is needed to better inform patients of when and where they can get medical attention.
Meanwhile, nurses, led by the Registered Nurses Association of Ontario, are upset because 4,000 CCAC care coordinators who deal with home-care patients will simply be transferred to the LHINs, rather than to primary-care facilities. Ministry officials say most coordinators will eventually end up working in primary-care settings, but labour agreements prevent that from happening immediately.
And patient advocates are concerned the bill weakens the role of patients in health-care planning and concentrates too much control at Queen’s Park. They are right in demanding that patients have a real say in how our health-care system operates at local and provincial levels.
Other critics suggest Hoskins has bowed to power-hungry bureaucrats in his own ministry, many of whom love to micro-manage, by giving them too much authority over the beefed-up LHINs.
Still others cannot understand how the government will save any money when every CCAC staffer, including all the high-paid CEOs, some of whom are paid more than $250,000 a year, and their teams will be doing the same work on day one at the LHINs as they are now.
That’s hardly a massive restructuring and reform if everyone keeps their job and they all just move to a different building, says one skeptic.
The first CCAC will be disbanded on May 1. The second will shut down about a week later. All 14 CCACs will be out of business by summer’s end.
Clearly, it will take months — if not years — before Ontario residents see any real improvement in the individual care they receive at home, in a community clinic or a hospital that can be attributed to Hoskins’ reform package.
While this bill may not be perfect or go far enough to please all the critics, Ontario’s health-care system and the troubled home-care sector in particular are in desperate need of reform.
Hoskins must not lose his nerve now and bow to unreasonable demands to roll back most, if not all, of his reform package. That’s because we deserve a better system than we have now.
< https://www.thestar.com/opinion/commentary/2016/12/01/is-hoskins-health-reform-plan-bold-or-a-bust-hepburn.html >
Tags: budget, Health, ideology, jurisdiction, mental Health
This entry was posted on Thursday, December 1st, 2016 at 4:18 pm and is filed under Health Delivery System. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.
Leave a Reply
Recent Comments