A Kenora doctor says health care in the northwestern Ontario city is an "afterthought" in his province. His solution? Petition to bring Kenora under Manitoba Health's planning regime.
"I don't think this is a far-flung idea," said Dr. Clayton Hammett.
"Most of our health-care issues in Kenora centre around our problem with the [provincial] border, and our lack of accessibility into Manitoba's health-care system."
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The family physician and anesthetist has worked in Kenora, Ont., for a decade. He says the quality of patient care has dwindled in the past few years since more care services have had to flow through the North West Local Health Integration Network (LHIN).
Those networks act as regional care authorities for Ontario, and Kenora falls under the North West LHIN. That means patients who need care beyond what doctors can provide in Kenora — like treatment from an oncologist or cardiologist — are referred to Thunder Bay, more than 400 kilometres away.
But transferring patients to a city that's a nearly six-hour drive east, rather than sending them to Winnipeg — about 200 kilometres to the west — doesn't make sense to Hammett.
"There's not one patient I see in family practice who says, 'Oh, thank you Dr. Hammett for sending me on to Thunder Bay," he said.
"[Thunder Bay] tries their best to help their region, but they don't offer the same array of specialty services that Manitoba does."
Current funding agreement not enough
Ontario and Manitoba have reciprocal health-care agreements, like any other area in Canada. That allows patients to travel from one region to the next while maintaining Canada-wide health-care benefits.
But Hammett said Kenora needs more than that. To make a real difference, he says the city needs to be part of Manitoba's planning in terms of regional funding and resource allocation, rather than handling care for Kenora patients on a case-by-case basis.
"We're down to about half the number of family doctors we need in our community. We can't even look after the people in our community right now," he said.
No response yet to draft funding agreement
A spokesperson with Ontario's Ministry of Health and Long-Term Care told CBC News they met with Manitoba's government last fall on this issue. The ministry says there is a large number of in-patients from northwestern Ontario going to Winnipeg hospitals.
That causes ongoing challenges in transferring care for complex pediatrics and psychiatry, and issues returning stable patients back to their own province.
The ministry says it asked government officials in Manitoba to create an extra fund that would help pay for these services. It says Ontario's deputy health minister sent documents to Manitoba this summer for consideration, including a draft funding agreement.
"Unfortunately, due to health system reorganization that is underway in Manitoba currently, Manitoba Health has been unable to respond to these documents," a ministry spokesperson told CBC News in a statement.
Online petition started
Manitoba Health says it does not comment on discussions between provinces, but continues to work with Ontario to co-ordinate resources.
Meanwhile, Hammett is running an online petition, which he says he's sent to provincial and federal governments, calling for annexation of Kenora's health care by Manitoba.
"Regardless of funding, we just want to be part of the plan because where we are right now, we're not part of the plan," he said.
"I have to think that could change immeasurably if we were part of a relationship with Winnipeg."