While jobs, taxes and accountability have dominated the Ontario election campaign so far, health care is an issue that has not been far from the surface, and each of the three main parties has offered a different plan to address Ontario's patient-care system.
The Ontario Medical Association, which represents the province's doctors, on Friday called for health care to be the No. 1 issue in what remains of the campaign.
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PC leader Tim Hudak has vowed to scrap Ontario's Local Health Integrated Networks, which he says are nothing more than middle management corporations that employ 2,000 bureaucrats whose pay checks would be better spent on frontline workers.
"Go into your local LHIN and ask them to check your blood pressure. Tell them you have a sore throat or a bad back and see what they do," Hudak said in Woodstock last week. "They don't actually spend any time with patients. They're health bureaucrats who spend time going from the inbox paper to the outbox."
Hudak said he would eliminate LHINs — not-for-profit corporations that work with local health providers and community members to determine health services priorities — entirely and funnel that money into frontline services by replacing them with a new system of what the PC party calls "health hubs."
The PCs explain that "health hubs" would be more localized groups directly linked to regional hospitals and would consist largely of frontline experts.
The PC party believes shutting down the LHINs, as well as Community Care Access Centres, will bring significant savings in administrative, payroll, real estate and overhead costs. Together, the party says these organizations cost $800 million a year.
Last week, NDP Leader Andrea Horwath said that the focus of her campaign would be about the fundamentals in the health care system and making sure that people start getting "the care that they need when they need it."
When it comes to the LHINs, Horwath has sided with PC leader Tim Hudak in the past on the need to scrap them.
But in her current campaign, the NDP leader has only committed to a review of the LHIN system, with the goal of improving accountability. Recently, Horwath NDP criticized the fact that only half of LHINs have been able to meet the five-day target to deliver home care.
The Liberals make only one reference to LHINs in their platform released on Sunday, and that is in a promise to also review LHINs, along with Community Care Access Centres and Public Health Units, to make sure they use resources "in the most efficient way."
LHINs have their defenders
The LHIN system was created by the Liberal government in March, 2006 with the goal of increasing the lines of communication between local health providers and community members and helping patients work their way through a complex health care system.
Right now, 14 LHINs operate within Ontario, including the Toronto Central LHIN, which is responsible for providing funding to 174 health care providers in Central Toronto.
Since 2012, the Toronto Central LHIN says it has connected 10 per cent more people who were without a primary care provider to a family physician, in addition to 17 per cent more "vulnerable" patients who were connected with primary care.
Angela Robertson, executive director of the Central Health Community Centres, said her organization, which provides a range of medical services, has worked closely with the Toronto Central LHIN in recent years and has seen first-hand the benefits of a program that is more in tune with local community needs.
Robertson added that if provincial candidates plan on scrapping the LHIN system, there will still be demand for a similar regulating body to stand in its place.
"At the end of the day for me, if any government comes in saying they will do away with the LHIN as the current structure, there will always be a need for a body that will have this role," Robertson said.
"One government may call it the LHIN, another government will call it something else. But no government can suggest that there should not be a place that does this coordination and planning.