Losing LHINs could reduce local power over health services, experts say

Experts are warning that the Doug Ford government's plan to restructure Ontario's health care system could lead to a loss of local decision-making power.

Local Health Integrated Networks were created in 2007 to coordinate health services

Local Health Integrated Networks manage operational funds for hospitals, long-term care homes and community health centres. CBC News has learned that the Doug Ford government is considering paring them down — and experts are concerned. (CBC)

The Doug Ford government's plan to restructure health-care services in Ontario could lead to a loss of local decision-making powers, experts warn.

CBC News has learned that the Ontario PCs are considering reducing the number of Local Health Integrated Networks (LHINs) from 14 to five, or possibly eliminating them altogether.

Dr. Rob Cushman was the first director of the Champlain LHIN — which covers a wide swath of eastern Ontario that includes Ottawa, Pembroke, Carleton Place, Cornwall and Hawkesbury — and called the plan "a step backwards."

"They should be given the tools to do what needs to be done," Cushman said.

"I think to centralize all of this stuff is just going to make it Toronto-centric and, because it's so much bigger, is going to make it more difficult to really deal with local needs."

Cushman said his work involved coordinating the delivery of health care services to hospitals, long-term care homes and community health centres.

While reducing the number of LHINs could help reduce duplication, Cushman said it's more important those regional bodies have the power to make the decisions they need to.

"If you're going to do this let's not make them just branch plants of the Ministry of Health," he said. "Let's give them the real authority ... so they can go on to do what they need to do."

Dr. Rob Cushman said LHINs did not have the authority to make decisions to respond to emerging needs in home-care and long-term care, but were able to find ways to be more efficient in service delivery. (CBC)

'A cautionary signal'

The LHINs oversee nearly $30 billion in annual operating funding for health services. They're also where patients begin the process of securing publicly-funded home care or a spot in a provincial nursing home. 

They were created in 2007 by then-premier Dalton McGuinty's Liberal government. 

Doug Angus, professor emeritus in health administration at the University of Ottawa, said Alberta's experience paring back regional health boards should serve as a "cautionary signal" for the Ford government.

About a decade ago, the Alberta government moved to a single health "superboard" called Alberta Health Services, which replaced nine regional and three specialized boards. 

However, that move didn't curb Alberta's health spending, which is the highest in the country per capita

"The regions really know their health needs a lot better than, say, somebody in the city of Edmonton or — in our case in Ontario — people in the city of Toronto," Angus said. 

Angus also said the higher francophone population in eastern and northern Ontario might be at risk of being overlooked if decisions are moved to Toronto.

The Ministry of Health has not confirmed or denied reports of its plans to restructure the health system.

In a statement, a spokesperson for Health Minister Christine Elliott said the government inherited "a fractured health care system" from its predecessors, one "built for bureaucracy and not for patients." 

"Our government believes that everyone in Ontario deserves to have access to the services they need at home, in the community or at a hospital. That's why we're working with partners in health care to develop our long-term transformational health care strategy," the statement said.