The Ontario government has received an enthusiastic response to one aspect of its overhaul of the health-care system, with more than 150 ad-hoc groups of hospital leaders, doctors, home-care providers and others applying to become Ontario Health Teams.
The avalanche of applications means it is a “possibility” that Premier Doug Ford’s government will eventually establish more than the 30 to 50 teams it envisioned when it announced the sweeping reforms in February, Health Minister Christine Elliott said.
“We were extremely pleased, both in terms of number, but also [in terms of] geography,” Ms. Elliott said of the kickoff of the health-team plan. “We’ve received applications from all parts of Ontario.” Ms. Elliott made the comments in an interview with The Globe and Mail on Friday.
She was joined by Bill Hatanaka, the first chair of the board of directors of Ontario Health, the new superagency that is absorbing the duties of six health agencies, including Cancer Care Ontario, and 14 Local Health Integration Networks, or LHINs, the regional authorities that co-ordinate home care and manage the waiting lists for long-term care.
In his first interview since taking the job, Mr. Hatanaka, a former chief executive officer of the OPSEU Pension Trust and a wide receiver in the Canadian Football League in the 1970s, said he was struck by the amount of “duplication and overlap” in Ontario’s disjointed health-care system.
“What I see is immense complexity,” Mr. Hatanaka said. “And I also see an unbelievable number of caring people within the organizations, all trying to do the right thing. But it’s the navigational component – and the patient experience – that’s uneven.”
The government plans to name seven to 10 teams as early adopters of the concept in the fall.
Ontario’s health restructuring is supposed to centralize management in Ontario Health while devolving co-ordination of on-the-ground care to new teams made up of hospitals, long-term care homes, home-care agencies, family health teams and community health centres, among others.
Chris Simpson, a Kingston cardiologist and medical director of the Southeastern Ontario Academic Medical Organization (SEAMO), said the application process for Ontario Health Teams has so far been a “bit of a Wild West environment" – and necessarily so.
SEAMO, which represents about 350 academic physicians affiliated with Queen’s University, is one of approximately 60 organizations that have joined forces to apply for a team designation in southeastern Ontario, Dr. Simpson said.
“The government is saying, ‘Look guys, this has to be led by health-service providers.’ In fairness, that’s what we’ve been telling them for years and years. To successive governments we’ve said, ‘This has to be led from the ground up.' "
Others are not as keen on the health-team concept.
Alvin Fiddler, Grand Chief of the Nishnawbe Aski Nation, which represents 49 First Nation communities across northern Ontario, said his people, “were never included in any of the discussions leading to this proposed change.”
Rather than apply to join a team, Mr. Fiddler said he intends to keep working toward the promise of a 2017 agreement with the Ontario and federal governments designed to put Indigenous people in charge of their own health-care delivery in NAN territory.
Travis Kann, a spokesman for Ms. Elliott, said the Ford government has reiterated its commitment to improving First Nations’ health “through dedicated trilateral processes and relationship agreements, including existing agreements.”
Other Indigenous organizations are involved in the first phase of health-team applications, Mr. Kann added by e-mail.
The 12-member board of Ontario Health has been meeting behind closed doors since March, without posting agendas or minutes as the now-disbanded boards of the LHINs were required to do.
Mr. Hatanaka would not commit to make future meetings public, but said the board was looking into it.
He also refused to say how deep the budget cuts have been at agencies that are being swallowed by Ontario Health.
After first insisting the reforms were only about improving the co-ordination of health services – not saving money – the government revealed in its April budget that it expects the mergers to eventually save $350-million a year.
When it came to spearheading the restructuring of a $63.5-billion health system, Mr. Hatanaka said he saw parallels with his time as a business leader and a football player: “Those are all full-contact professions."