McGuinty renders community engagement ‘meaningless’: Ombudsman

Report from Andre Marin refers to the ‘LHIN Spin’

By Ontario Health Coalition –

The Ontario Health Coalition applauds Ontario Ombudsman Andre Marin’s report, “The LHIN Spin”. But the Coalition is deeply concerned that the McGuinty government has evaded its legislative requirement to conduct a full review of its Local Health Integration Networks (LHINs) and the legislation that governs them and is continuing a major round of health system cuts and restructuring while shutting out virtually all public advocates that have expressed concerns or criticized their reforms. Ironically, though the Ombudsman gave credit to the Ministry of Health for belatedly setting proposed standards for LHINs’ public consultation, the Ministry has not consulted with public advocates who have experience trying to work with the LHINs regarding these standards.

Ombudsman Andre Marin reported that the McGuinty government-appointed LHINs have rendered community engagement “meaningless”. He stated that LHIN board members counted conversations on golf courses and in grocery stores as public consultations. He noted that they relied on presentations of the provider organizations to make decisions affecting access to health care for tens of thousands of residents. He was particularly critical of the LHINs for adopting illegal by-laws to meet behind closed doors.

But the Ombudsman is limited in his mandate to review only the application of public policy, not the policy itself. After cross-province public hearings attended by more than 1,150 residents, and after reviewing 487 written and oral submissions this spring, the Ontario Health Coalition concluded:

“In particular, we determined that the LHINs are so lacking in public confidence, so flawed in their size and confused in their mandate, that we have recommended that the province change direction and create new accountable regional planning bodies closer to home with a principled and clear mandate. We also determined that hospital planning is so erratic, so short-term and short-sighted, that the risk of closure of needed services in small and rural hospitals is now very high. As a result, we have heeded the many calls from communities to recommend that the province set standards for hospital services and distance to care.” To see the full report and recommendations, go to www.ontariohealthcoalition.ca

“The McGuinty government has instigated the deepest health care cuts that we have seen since the hospital restructuring 15 years ago,” noted Natalie Mehra, director of the Ontario Health Coalition. “From the outset the government has obscured its plans and the situation has only worsened in recent years. Since the departure of George Smitherman as Health Minister two years ago, the Ministry of Health has adopted a “closed shop” mentality. The LHINs’ behaviour, so criticized by the Ombudsman, is entirely consistent with the Ministry of Health’s practice of shutting out to all public interest advocates that might disagree or raise concerns with their hospital cuts and restructuring. This is a short-sighted and deeply undemocratic approach to governance. It has made for poor and deeply unpopular decision-making that threatens access to vital health care services. The McGuinty government must change its approach to embrace democratic discussion that is a requirement for sound policy making.”

“The fact that the Ministry of Health has belatedly removed the illegal by-laws adopted by their appointees in the LHINs does not go far enough,” she continued. “The McGuinty government must conduct a full review of the LHINs as is required in their own LHINs legislation. This review cannot merely consist of a consultant’s report – it must include full public consultation including municipalities and local health advocates that have experience trying to work with the LHINs. The Ministry of Health must conduct a full review of recent LHIN decisions that have resulted in deep cuts to needed hospital care.”

–  The McGuinty government must heed the call of the municipalities,
MPPs, physicians, nurses, and all public interest health care groups
in Niagara to send an Investigator under the Public Hospitals Act into
the Niagara Health System to evaluate and re-assess the restructuring
plan that has resulted in the closure of emergency and acute care
hospital services in Port Colborne and Fort Erie and ongoing cuts in
Welland and Niagara Falls. In our cross-province consultations we
found among the worst areas in the province for access to hospital
care in Niagara. Patients and families reported that they have waited
in some cases four days in emergency departments on stretchers.
Nurses, paramedics and physicians described conditions as unsafe and
in crisis.
–  Similarly, the decision to push through major cuts and restructuring
that has been opposed by physicians, nurses, support workers,
community groups and patients alike in Hamilton must also be reviewed
and re-evaluated with full public consultation.
–  The McGuinty government must evaluate and consult with the public on
recent decisions by LHINs in Peterborough and Cobourg to force through
deep hospital cuts that affect access to vital hospital care. In
Cobourg the cuts have deprived thousands of residents access to Canada
Health Act covered rehabilitation services and diabetes care. In
Peterborough, the LHIN has just approved a draconian set of hospital
cuts without ever requiring the hospital to outline the impact of
cutting 182 nurses and front-line support staff on hospital services,
including how many hospital beds would be rendered unusable as a
result, nor how many diagnostic tests would be cut.
This summer, McGuinty government-appointed LHINs are making decisions about closing emergency departments overnight in Petrolia and St. Marys. The coalition will be releasing a full report this fall on hospital cuts that continue across Ontario.