The Ontario Health Coalition's open letter to the Premier
August 11, 2010
Attn: Premier Dalton McGuinty,
We are writing in support of the findings of the Ontario Ombudsman in his report released yesterday, “LHIN Spin”. We are very disappointed to see the comments of the Health Minister today in response. Yet again the Ministry of Health is refusing to listen to legitimate concerns raised about your government’s hospital cuts and LHINs.
The findings of the ombudsman are just a fraction of the major decision-making problems we have witnessed in the hospital restructuring of the last few years. In fact, the Ontario Health Coalition held a set of cross-province hearings last spring. Our non-partisan panel included representatives active in every major political party. It was comprised of doctors, health professionals, and nurses, and representatives of every geographic region of the province. More than 1,150 people attended our hearings and we received almost 500 written and oral submissions. Based on these, our panel was unanimous in our findings about the LHINs and hospital restructuring as follows:
“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
In our hearings we heard of shockingly undemocratic behaviour by LHINs as they made decisions to cut and close local hospital services. Almost without exception the mayors, reeves and municipal government officials that appeared before our hearings testified that they were not consulted about major changes to their local hospitals. Local health professionals have also been cut out. The communities affected have been ignored. We included in the report many examples of unwarranted secrecy and poor decision-making. In every case of major restructuring that we have seen, LHINs failed to get a full costing of the renovations and restructuring costs that would be entailed in the cuts and closures they have approved. In every case, the LHINs have made decisions without full information and have failed to obtain a full assessment of the services lost and the impacts on access to care for the local communities.
Premier McGuinty, we cannot overstate to you the depth of public animosity at the LHINs and the deep hospital service cuts that are happening in every region of Ontario. The public sees LHINs hiring expensive consultants to write reports with forgone conclusions. They see exorbitant salaries both within the hospitals and in the ever-growing LHIN staff forces. They see tiers upon tiers of administration. At the same time, they are watching their local nurses and front-line hospital support staff being laid off. They are seeing hospital services needed by thousands of local residents cut and their small local hospitals gutted. The public sees lots of PR and spin, but they see that it is wasting our public money to cover up irrational and poor decision-making. The current health restructuring in Ontario is entirely out of keeping with the public’s values and priorities.
We are requesting a full and proper response to the ombudsman’s findings and the concerns we have raised as follows:
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. Your government should cease to delay a full review of the LHINs as is required in your government’s 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 including the following:
I. Your 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.
II. 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.
III. Your 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.
Our local hospitals and access to vital public health care services are priority public issues in every community across Ontario. We sincerely hope that you take the opportunity to re-evaluate the priorities and poor decisions we are seeing in our health system.
Sincerely, Natalie Mehra
Ontario Health Coalition
15 Gervais Drive, Suite 305
Toronto, ON M3C 1Y8