The first report of Ontario Premier Doug Ford’s health improvement council was clearly intended to convince the public that the often-brash premier is unlikely to do anything bold or scary with the province’s health-care system. That lasted about five hours.
People had barely finished digesting the thin gruel of health adviser Dr. Rueben Devlin’s report when up jumped NDP Leader Andrea Horwath waving a draft bill that seems to outline broad, some might say draconian, powers for the new provincial health super agency that Devlin alluded to in his report.
Horwath claimed the PC bill was a path to privatization, her favourite health-care complaint. While that conclusion didn’t seem to be well supported, the new agency is a cause for concern without a privatization component. As outlined, the agency will have the power to merge or close just about anything in health care. Top of that list is likely to be the province’s 21 health-care agencies, including 14 local health integration networks.
The PCs, in a hastily called news conference, said they don’t plan to privatize, but the day certainly didn’t go the way they had hoped.
There are a lot of things wrong with health care in Ontario, many of them outlined by Devlin in his report. The province’s emergency rooms are backed up with an average of 1,000 emergency patients a day being treated in the hallways or other overflow areas. Too many people who don’t require hospital care are taking up hospital beds because of a lack of long-term care and mental-health care. An inadequate volume of home care contributes to the hospital jam as well.
All of these problems are well-known. The fixes for them are well-known, too. None of them involves merging all the province’s health-care agencies into one.
The plan will be appealing to all those who believe that big government agencies are the best way to solve problems. One would not have thought that group would include conservatives.
If we want a super-agency to oversee all of health care, wouldn’t that be the health ministry? If the ministry doesn’t do that, what does it do? If we want accountability for results, and we should, that accountability lies with our elected politicians. Creating a new agency is just another dodge.
Rather than waste time, money and energy on reshaping the health bureaucracy, the Ford government should move directly to specific solutions to well-identified problems.
Ford has already promised to build 15,000 long-term care beds over five years. Let’s get moving. The volume of home care needs to be increased to meet demand. It’s the cheapest way to support people with health issues. What’s needed is a strategy to attract and retain personal support workers, who are in short supply. Ford has also promised more mental-health spending. Step it up.
Give family doctors more responsibility. Make them the gatekeepers for assessing a person’s need for long-term care and getting them into that care. That will mean more staff in doctors’ offices. Pay for those staff.
Meaningful capacity increases without meaningful spending increases seem unlikely
Devlin’s report talks about the need for electronic records. Surely, surely we can produce one system that connects all health-care providers on a common platform. Again, government has to pay for it.
And there we come to the central conundrum of improving health care in Ontario. Sure, the system can be made more efficient, but meaningful capacity increases without meaningful spending increases seem unlikely.
The whole problem comes back to the fact that government never likes to talk about. Like all Canadians, Ontarians have a health-care rationing system. Government doesn’t pay for the care we need. It pays for the care it can afford. Devlin notes that Ontario spends less per capita on health care than any other province. Yes, Canadian health care overall overspends and underperforms compared to most other major countries, but within the Canadian context spending less per person than any other province just might be a reason why Ontario is short of just about every type of health service. Any chance the government will address that?
Health care needs to be made more efficient, but capacity needs to be increased, too. The financial implications of that are a great concern for government, and taxpayers, but the so-called super agency is not a magic cure. More likely, it will prove to be an expensive distraction.
Randall Denley is an Ottawa political commentator and former Ontario PC candidate. Contact him at randalldenley1@gmail.com
https://nationalpost.com/opinion/randall-denley-so-called-super-agency-not-a-magic-cure-for-ontarios-health-care-woes
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