Legislation will undermine hospital boards

“The potential for the micro-management of Ontario hospitals by government raises the concern of a loss of local accountability.”
- McMillan Binch report: Moving from Accountability to Government Control in Health Care

Despite months of hearings, and criticism from the health-care sector, the Ontario Government now has all the pieces in place to begin implementing legislation that gives the Minister of Health sweeping powers over local hospitals and their boards.

Bill 8 – the Commitment to the Future of Medicare Act – passed in the Ontario Legislature last June, by a vote of 62-22. I voted against it – as did PC and NDP members.

During committee hearings, hospitals, their boards and associations all told the government that while the legislation’s title refers to “accountability”, it accomplishes the opposite.

And although we all support the enhancement of hospital accountability to taxpayers in Ontario, it is the manner in which Bill 8 attempts to enhance accountability that is opposed.

Of particular concern are the sweeping powers this act gives the provincial Minister of Health, especially in regard to “accountability agreements”.

Previous to the committee hearings that saw some minor changes to Bill 8, I received a series of letters from a number of local boards and stakeholders with their concerns, including:

· Brant Community Health Care System – this is the Paris Willett and Brantford General Hospital - on February 20th wrote, “the bill will have the opposite effect and fundamentally undermine Medicare in Ontario”
· Norfolk General Hospital on March 3rd wrote, “this legislation may actually decrease accountability to our communities by undermining the role of local, voluntary governance in public hospitals in Ontario.”

Despite government amendments to the legislation that now call for the Minister and health care providers to “negotiate” the terms of an accountability agreement, the legislation still provides the Minister with the ultimate authority to impose those agreements if they are not reached in a timely fashion.

Throughout committee hearings, the Liberal majority ignored amendments suggested by former Health Minister Elizabeth Witmer for the possibility of referral to a third party dispute resolution mechanism.

To direct a hospital to sign an agreement that has not been agreed to, but unilaterally imposed, effectively eliminates the input of the community in the fundamental decision-making process regarding hospital services provided in their local community.

Clearly this legislation ignores the essential role that our local hospital boards – Norfolk General, West Haldimand, Haldimand War Memorial, Tillsonburg, Brantford – have, and continue to play, in the delivery of hospital-based health care services in Ontario.

These are voluntary boards – and as Tony Dagnone of the Ontario Hospital Association pointed out in committee hearings – “the members of these boards are community leaders, business people and others with a civic orientation to community service. Many of you will know them as your neighbours and friends. These people are entrusted with the oversight, fiscal stewardship, mission and strategic direction of their hospital with a single purpose in mind, and that is to create healthier communities.”

Unfortunately, when hospital boards are undermined communities are faced with situations where hospital decisions are taken out of the hands of those who best understand the needs of the local area.

While the draconian legislation is now on the books, I will continue to fight to support local governance through hospital boards for the betterment of health care across Haldimand, Norfolk, and Brant Counties.