Russ Ford's Blog

How Dryden has Become the Battleground for Health Care Reform



How Dryden has Become the Battleground For Health Care Reform
 
Last week we took you to the sandy shores of Georgian Bay to tell a story about how local providers had come together to build a model, that could be best described as, where health care reform should be heading.
 
It is a collaborative model putting structures in place to address the root causes of ill health.  It was looking at the issues relating to poverty and social support.
 
This week we head to the, literal and figurative, rocky shores of Lake Superior where the local health integration network (NWLHIN) seems bound and determined to take health care back in time when hospitals ruled, community accountability was non-existent and the "system" was focussed on fixing people rather than keeping them healthy.  The contrast is stark and which model wins out will determine the fate of health care in this province for many years to come.
 
The NWLHIN intends to merge all of the health care providers into one of the five area hospitals.  The NWLHIN will then contract directly with the five hospitals.  The only boards that will remain are those of the five hospitals and the board of the NWLHIN. In other words, community or citizen involvement will cease to exist.
 
The forced march to merger begins in Dryden Ontario, where the local community health centre in Ignace has been told its time is up and they will now be "integrated" into the Dryden Hospital.
 
It is fair to say that residents of Ignace are none too happy about this.  Not only are they fearful of the loss of clinical services in their town, but also the loss of the centre's community programs.  How long do you think the community garden in Ignace will continue to get funding from the hospital in Dryden?
 
That is not a knock against the hospital.  Community development is simply not their function and neither are they in the business of addressing the social determinants of health.  Hospitals treat and/or fix people and there is no targeting of its services.  A hospital deals with whoever comes through the door.
 
Some will argue that mergers like this will save money which can be better used to address health care.  Unfortunately, that argument is an opinion without knowledge.  There is no evidence to support economic efficiency.  In fact mergers often cost more money, usually due to severance payments to staff that are then deemed redundant.
 
To be clear, Ignace is not against a merger.  A proposal to merge Ignace with the community health centre in Thunder Bay was rejected by the NWLHIN.  Seems that their efficiency argument only applies if the merger is to a hospital.
 
The NWLHIN's plan to retrench the region back into a disease, and not a health system with the community at the centre, seems out of step with the general claims by the government around reform.
 
So far, neither the Ministry nor the Minister has made any public comments about what is happening at the gateway to the west.  That silence cannot continue.  This is essentially a hostile takeover of the community sector by the hospital, aided and abetted by the NWLHIN.
 
Ignace will not go quietly.  They will appeal to the Minister who will then have to decide which fork in the road to take.
 
Should he allow the NWLHIN the autonomy to destroy the community health centre, health care reform will die a very quick death.  The government has, over the last ten years, done much too voluntarily bring the community and institutional health sectors together.  All that work will be severely undermined unless it stops the NWLHIN.
 
If the government does not act and protect the community sector, it will lose all credibility and trust. In the absence of trust, engagement will become minimal and only when necessary.  Research and evidence based work will be further sacrificed at the altar of back room politics.
 
The NWLHIN has provided the government with an opportunity to show its commitment to true reform by not allowing them to proceed.
 
 It is time to for Queen’s Park to be silent no more.

Comments

Dryden

Historically, the MOHLTC only trusts hospitals--despite the fact that when an Health Service Provider Organization is over budget it is almost always a hospital and despite the fact that when there is a preventable death due to poor quality performance, it is almost always a hospital.

This hospital-centric mindset is what is driving the silly hub&spoke model in the NWLHIN, and in most LHINs. Your example of an enlightened LHIN in North Simcoe Muskoka that takes a more prudent approach to Collaborative Governance in their Health Link demonstrates that making the hospital the centre of the system is not necessary.

Here is a test: if the hospital CEO has been actively involved for the past three years in their local Health Link, maybe they have earned the respect and confidence of the local partners. If, on the other hand, they have been missing in action, why should they pretend that they are leaders among equals. Or, are they more equal?

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