Ontario public health organizations brace for restructuring

ONTARIO – The Ontario government is expected to soon announce the details of cuts to public healthcare agencies in the province, a move that has Toronto Board of Health chair Joe Cressy warning of dire consequences.

“People will die. This is not rhetoric, it is a fact,” tweeted Mr. Cressy recently, perhaps calling to memory the E. Coli outbreak during the Walkerton water crisis—first identified by that region’s medical officer of health—and virus outbreaks that have been thwarted by public health agencies.

In the Manitoulin and Sudbury area, officials with Public Health Sudbury and Districts (PHSD) have been looking at the impending cuts, the details of which have yet to be announced, with a certain sense of apprehension.

“Many questions remain, and the full scope, financial details and specific timelines for these changes have yet to be communicated, but we anticipate the impact will be immense,” said PHSD board of health chair René Lapierre in a news release issued last week.

Although information about the cuts remains scant, the details that are known were contained within the recent provincial budget. The plan is to reduce Ontario’s 35 public health units and 35 boards of health will be dissolved and replaced with regional entities by 2020 to 2021.

There are also to be funding cuts of $200 million in each of the next two years, something PHSD stated may mean reductions in provincial cost-shared program grants by as much as 27 percent. The health unit added that a new provincial funding formula enacted in 2015 had already reduced some of PHSD’s funding and that these cuts will pose even more significant challenges.

PHSD has begun enacting a number of policies based on the information contained within the provincial budget. Their strategies include a hiring freeze and a total stoppage of non-essential spending, with an increased focus on its core services.

“Public health programs and services are essential to the health of local communities,” said Dr. Penny Sutcliffe, medical officer of health for Sudbury and districts. “We will continue to offer the full scope per the Ministry of Health and Long-Term Care’s Ontario Public Health Standards, without interruption and for as long as possible,” she added.

Mr. Cressy projected the loss to Toronto Public Health to be $1 billion over the next decade. This figure has not been confirmed nor denied by the province, which accused Mr. Cressy of misrepresenting the facts of the matter. In a tweet, Minister of Health and Long-Term Care Christine Elliott’s director of communications Travis Kann stated that the overall aim of the legislation was to give municipalities a more prominent role in healthcare.

“We are working with (municipalities) as we slowly shift the cost-sharing funding model over the next three years to reflect this stronger role,” stated Mr. Kann. “Contrary to today’s fear mongering, we have every expectation that all public health units across Ontario will continue to be properly funded, including Toronto.”

The province has also stated the revamped public health model would make service delivery more consistent across the province and better align its resources with provincial healthcare. 

Some of the services run by public health agencies that may be cut as a result of these changes include school breakfast programs, immunization programs, food and water safety monitoring, daycare inspections and sexual health programs.

PHSD, however, may be in a position of at least a marginal advantage in the face of the impending cuts. It currently has partnerships with its four neighbouring public health units—Algoma Public Health, North Bay Parry Sound District Health Unit, Porcupine Health Unit and Timiskaming Health Unit—which are all members of the Northeastern Collaborative Shared Services Project.

This association is designed to explore possible collaborations with the goal of improving overall capacity and efficiency. There is hope within the district that the five organizations may be able to continue working together through the consolidation period, although the level of funding each of the new health units may receive is not yet known.

Public health organizations across Ontario continue to wait for further clarity on the future of the services they provide to the many communities that rely on their presence. More than 100 hospitals and healthcare facilities hosted a ‘Health Action Day’ yesterday, April 23. Employees wore stickers advocating against health privatization and distributed pamphlets with a message advocating against the Ford government’s cuts.