Social Policy in Ontario

“This is not going to happen overnight,” Elliott said Tuesday at the Bridgepoint rehabilitation hospital, where she announced between 30 and 50 “Ontario Health Teams” will form across the province to better co-ordinate all levels of care.

Each will serve about 300,000 people in a geographic area or a specific group of patients across the province, such as children with fragile medical conditions.

Premier Doug Ford’s Progressive Conservative government is relying on health-care providers — from hospitals down the line to doctors, home-care agencies, mental health and addiction services, labs and more — to devise their own service models meeting provincial standards.

“It will be up to the local health-care providers in each community to come together to form a plan about how they can connect care for patients in their community,” Elliott told a news conference.

In one example to fix what she called a “disconnected” system, patients discharged from hospital needing home care should get it immediately to make sure they don’t end up back in emergency departments with costly and potentially dangerous complications.

During an hour-long technical briefing on the People’s Health Care Act, ministry officials said on background that the new system will likely start with a handful of small, local teams to test what works best before growing bigger, providing valuable lessons for others to follow. Targets for improvement in wait times and care levels will be set. Typically, government background briefings include slide decks and other materials to explain complex changes, but only the framework legislation was provided.

Elliott said reform is needed because 1,200 patients a day typically get treatment in hospital hallways because of overcrowding and 30,000 people are on the waiting list for nursing home beds.

Representing doctors across the province, the Ontario Medical Association agreed change is essential but is awaiting more information.

“The details matter,” said president Dr. Nadia Alam. “The biggest question the OMA has is the ‘how’ of it.”

New Democrat Leader Andrea Horwath, who raised alarm bells about the pending changes by releasing a leaked copy of draft government legislation last month pointing to the new Ontario Health “super agency,” said she remains skeptical.

“The minister has not clearly stated there will be no privatization … that’s our biggest worry,” she told reporters before the legislation was introduced.

“A lot of this has been done behind closed doors.”

Ontario Hospital Association president Anthony Dale applauded the new direction, saying different parts of the system don’t co-ordinate care well.

“What the minister’s doing today is basically lifting some of that inappropriate oversight and red tape and third-party intermediaries that get in the way of care providers actually working together,” he said.

“The health provider community knows what has to be done at the local level, especially. It’s just that, right now, they are in many instances actually prohibited from working together to deal with them.”

Dr. Joshua Tepper, chief executive of North York General Hospital, said he already holds meetings bi-weekly with family doctors, home-care agencies, a neighbouring nursing home and other providers in the area, with the new Ontario Health Teams looking like an extension of that.

“It’s about getting together and looking at our community and saying ‘what can we collectively do for our patients and being given the freedom and the opportunity to do that, removing those gaps that patients experience.”

The risk is that patients will “fall between the cracks” as the system is re-engineered, interim Liberal leader John Fraser warned.

Elliott said “tinkering around the edges” will no longer work in fixing the massive health-care system and stated publicly funded universal access to care remains a priority.

“That means paying for services with your OHIP card.”

As the Star first reported Jan. 17, the government has been planning a new health care “super agency” that will eventually swallow 20 health agencies to provide for streamlined accountability.

Under the legislation, those agencies include Cancer Care Ontario, eHealth Ontario, various Local Health Integration Networks created by a previous Liberal government, and Trillium Gift of Life Network.

It’s not known how many jobs will be lost when back-office administrative functions at the agencies are folded into Health Ontario, but Elliott said any savings will be put into “front-line care.”

Officials said the new Ontario Health Teams will not have headquarters and instead operate using people at various health facilities like hospitals or primary care offices to answer phones and emails to help patients navigate the system with access to their health-care records.

20 agencies to be absorbed into Ontario Health super agency:

• Cancer Care Ontario: Advises the province on how to improve the performance of health systems for cancer, chronic kidney disease and access to care.

• Health Quality Ontario: Acts as an independent watchdog on quality in health care with the aim of improving quality.

• eHealth Ontario: Oversees the province’s electronic health record system, allowing patient information to be safely shared among providers.

• Trillium Gift of Life Network: co-ordinates organ and tissue donation and transplantation.

• HealthForce Ontario Marketing and Recruitment Agency: Provides health human resource services and support.

• 14 Local Health Integration Networks: Co-ordinate health services in distinct geographic regions of the province.

• Health Shared Services Ontario: Provides business and IT support to LHINs.

With file from Theresa Boyle     Rob Ferguson is a Toronto-based reporter covering Ontario politics.

https://www.thestar.com/politics/provincial/2019/02/25/new-ontario-health-agency-would-overhaul-disconnected-medical-system-minister-says.html