March 2010 - Hot Topic

Public Health and LHINs: LHINC providing a new way forward

In 2006, 14 Local Health Integrated Networks (LHINs) were formed in Ontario to plan, fund, and integrate health care services locally[1] . Since their formation, those working in public health and health promotion have been asked “to engage the LHINs, or not to engage?” Now, the establishment of LHINC provides a new opportunity for primary care and public health/health promotion to work together.

The Local Health Integrated Network Collaborative Council (LHINC) was formed in late 2009. It is:

“an advisory structure formed to work at a provincial level to strengthen relationship among health service providers (HSPs), their Associations, and the LHINs collectively, and support system alignment. LHINC provides a system to engage HSPs on system-wide health issues. LHIN is led by a Council and supported by a Secretariat.”[2]

Council members include representatives from a variety of provincial stakeholders such as community care and support, hospitals, primary care, community health centres, and public health. Tracy Allan-Koester, Director at the Perth District Health Unit, sits on the Council representing the Association of Local Public Health Agencies (alPHa) as well as OPHA.

Currently, LHINC is supporting activities primarily related to hospitals and primary care:

  • service accountability agreements;
  • developing and implementing indicators related to those agreements;
  • implementing an enhanced role for Community Care Access Centres (CCAC); and
  • participating in the MOHLTC’s long-term care homes funding review.
In 2010 however, one emphasis will be on developing a consistent/common approach for engaging HSPs not funded by the LHINs: this includes public health.

Establishing this approach will facilitate the development of collaborations between the LHINs, public health, and their community partners, increasing the synergy between secondary prevention and health promotion activities. The establishment of the LHINC itself also provides new opportunities in communicating and engaging with the LHINs at a systems/provincial level, laying the groundwork for stronger collaboration between primary health care and public health.

We will be receiving ongoing reports from our representative, Tracy Allan-Koester, as work of the LHINC unfolds.

 

The McGuinty Government’s Throne Speech

On March 8, 2010, the Ontario government's five-year Open Ontario Plan was unveiled in a Speech from the Throne delivered by The Honourable David Onley, Ontario's Lieutenant Governor. The speech marks the opening of the second session of the province's 39th parliament.

The speech was a combination of old and new: highlighting the government’s previous achievements as well as announcing new initiatives. After setting the context of the impact of the economy on Ontario (which was referred to as the “Great Recession”), Mr. Onley introduced the McGuinty government’s five year plan: Open Ontario.

The emphasis of the Open Ontario plan is job creation, green initiatives, education, and health care reform. Open Ontario has two key elements: the first is a $32 billion investment in infrastructure (namely roads, bridges, transit, and energy retrofits for schools) and the expansion of spaces at post-secondary institutions. The plan shies away from cost-cutting and deficit-reducing appraoches, emphasizing the need to continue to create jobs and build the economy before such measures can be taken. Key components of this plan include tax reforms, developing the “Ring of Fire” in northern Ontario, making Toronto an elite world financial centre, and developing new ways to strengthen the not-for-profit sector.

Much of the Throne Speech focused on changes in two main areas: health and education. Changes in education include the previously announced full-day learning program for 4- and 5-year-olds and the creation of the Ontario College of Trades, increasing available post-secondary spaces by 20,000 this year, and establishing a new Ontario Online Institute for post-secondary distance learning.

In regards to health care, Mr. Onley highlighted several truly sobering statistics. Twenty years ago, 32 cents of every dollar of government spending was allocated to health care. Today, that figure stands at 46 cents, with an expected rise to 70 cents over the next 12 years. The government intends to identify how they can fund the “best health care” without “crowding out” other important funding priorities such as education and poverty reduction initiatives. The directions mentioned in the speech concern wait times, clinical practice guidelines, and primary care institutions. The already established French Language planning tables were also mentioned.

A significant omission in the speech is, that despite the emphasis on reducing health care costs and expenditures, there is little mention of chronic disease prevention and health promotion activities. In the two pages of the speech dedicated to health, only this sentence spoke to the work of prevention and promotion:

“Your government will work with the public and private sectors to develop a strategy to promote better health for our children.”

No mention was made of the recently launched Healthy Communities Ontario approach or any of the other significant strategies and initiatives designed to improve the health of Ontarians.

With health care costs steadily rising, and with the government’s statement of commitment to reduce these costs while preserving the quality of the health care system, the time to act for those working in chronic disease prevention, health promotion, and public health is now. This is an opportunity to show how what we do will improve the health of Ontarians, lessen health disparities, and reduce overall health care expenditures.

 

 

References

[1]  LHIN Ontario, Home Page.

[2]  LHINC Council Meeting Key Messages, February 5, 2010.