Ombud weighs in on LHINs
By David Fleischer
August 16, 2010
You can expect more health care transparency following a provincial order calling for an end to secret meetings.
The move by Health Minister Deb Matthews came in response to a damning 44-page report by Ontario Ombudsman André Marin over what he found to be a lack of transparency in the Hamilton-Niagara region’s local health integration network.
At issue is Bylaw #2, which lays out public meeting requirements, noting,
“A meeting of board members for social, educational or purposes other than conducting corporation business is not a board meeting”.
“Unfortunately, this practice is antithetical to the LHIN model,” Mr. Marin wrote in his report.
“It serves to undermine the integrity and credibility of the LHIN’s decision-making and, in my view, is simply illegal.”
There are 14 LHINs provincewide that plan, fund and manage health services, including hospitals, Community Care Access Centres (CCACs), support service organizations and mental health and addiction agencies.
The Central LHIN, within which York Region falls, was one of 11 networks to use the bylaw.
Ms Matthews’ order requires LHINs to amend a bylaw that allowed a network’s board to meet without informing the public, so long as the meeting was deemed to be for “educational purposes”.
“The public must be assured that the LHIN decision-making process is open, accountable and transparent,” the heath minister said in response to Mr. Marin’s report.
The Central LHIN’s board of directors has always complied with bylaws and legislation set out by the province, chief executive officer Kim Baker said.
The local network has educational and other informal sessions, but not to discuss matters related to decision-making, she added.
“They’re not meetings. We don’t call them meetings,” she said.
It remains to be seen how the bylaw will be amended. LHINs and the Ministry of Health and Long Term Care will have to set up a review process, Ms Baker said.
“Any efforts we can undertake to build confidence with the community, we have to do that,” she added.
Ms Baker touted the Central LHIN’s commitment to transparency, citing the large volume of documents on its website and its involvement, along with two other LHINs, in a provincial study on how to improve community engagement by establishing performance indicators.
For example, surveys could be used to obtain feedback and track the LHIN’s progress, she said.
Because of how important engagement is to the LHINs’ proper functioning, the minister should set out more specific guidelines of what that entails, the ombudsman suggested.
“At present, ‘community engagement’ is a rather nebulous concept, which individual LHINs are left to interpret and apply, based on assessments of their local community needs,” he wrote.
Rather than simply adding another layer of bureaucracy, the LHINs were supposed to provide a means for health care to be customized for the demographic needs of different regions in Ontario.
What’s actually happened is they’ve provided a shield for the government to say what goes wrong isn’t its fault, Thornhill Conservative MPP Peter Shurman said.
The Central LHIN stretches from North York north to Lake Simcoe and local residents receive less per-capita health care funding than those south of Steeles Avenue, he said.
“York Region residents are getting the short end of the stick.”
“This model isn’t working,” Mr. Shurman said.
Conservative Leader Tim Hudak was quick to attack the Liberals, saying a Conservative government would abolish the LHINs. The Tories have also asked for a judicial review of how many closed meetings were held provincewide, at the same time scolding the premier for postponing a scheduled review of LHINs until after the 2011 election.
Premier Dalton McGuinty acknowledged LHINs are still relatively new and need stronger direction. They must be accountable, he said, because that is why they were created in the first place.
“They are still kind of learning how to run,” Mr. McGuinty said. “And we’ve got to make sure that we provide appropriate guidelines as they carry out their responsibilities.”
At the end of the day, inclusiveness in the decision-making process is a key to what the Central LHIN does, Ms Baker said.
“We’re still young organizations ... there’s still a lot of work to be done,” she said.
This article is for personal use only courtesy of yorkregion.com - a division of Metroland Media Group Ltd.