The trouble with LHINs

Posted on August 12, 2010 in Health Delivery System

Source: — Authors: – Opinion/Editorial
Published On Thu Aug 12 2010

When the Hamilton-area local health integration network (LHIN) passed a bylaw allowing board members to hold private discussions on closing emergency rooms, it flouted provincial legislation requiring public meetings.

And when a board member claimed that conversations on his private golf course constituted “community engagement,” he displayed the utter contempt with which the Hamilton Niagara Haldimand Brant LHIN viewed the very idea of public consultation.

Ontario Ombudsman André Marin’s report on the LHIN, released Tuesday, highlighted these concerns. It has provided further evidence that local health care decision-making, while sound in principle, is still a long way from working in practice.

The Hamilton-area LHIN’s “sneaky” (Marin’s word) actions have undermined public confidence not only in itself but also, by extension, in the 13 other LHINs across the province that have adopted the same bylaw. Marin argues the Hamilton-area LHIN may also have left itself vulnerable to court action over its decisions. “These meetings were plainly illegal,” he says.

Troublingly, Marin also reported that the Hamilton-area LHIN failed “to grasp the significance of its transgressions” and was reluctant to alter its practice. The province, belatedly, stepped in to ensure that private meetings for “educational” purposes can’t be used in the future to hold closed-door discussions about consolidating health services.

With rising health care costs threatening to crowd out other services, difficult decisions will have to be made about what health services communities need and what taxpayers can afford. LHINs were set up to coordinate and rationalize health-care spending on the basis of local priorities instead of one-size-fits-all decisions imposed by Queen’s Park. It is the right way to go, but to work it requires communities to be involved and have faith that the decisions are being made in their best interests. Secret meetings are no way to achieve that goal.

However, Marin’s report is no cause to scrap Ontario’s 14 LHINs, as Opposition Leader Tim Hudak has argued.

Certainly the LHINs will have to work doubly hard to regain public trust now. But restructuring of our health-care system won’t happen overnight, and now is not the time to change course on decentralization of decision-making.

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