Reforms will make Ontario health care more seamless, says Eric Hoskins

Ontario Health Minister Eric Hoskins unveils health-care reforms to help patients get quick access to doctors and home care

Thestar.com
June 2, 2016
By Rob Ferguson

Patients should get quicker access to family doctors and enjoy a smoother ride through the health-care system under long-promised reforms, says Health Minister Eric Hoskins.

New legislation called the Patients First Act is aimed at ensuring patients can see doctors or nurse practitioners in a “reasonable period of time” and make home care more seamless, he told reporters Thursday.

More than half of Ontarians cannot see their family physicians within two days and home-care waits have proven a lightning rod for complaints, with overall health-care service levels varying from one region of the province to another.

The legislation would also disband the oft-criticized system of 14 Community Care Access Centres - which make front-line decisions on patients needing home care - and move those services to Local Health Integration Networks.

“We expect to find significant savings,” Hoskins said, refusing to reveal a dollar figure for savings on management and administration that can be put back into patient care.

In the past, the CCACs, which serve about 700,000 mainly frail and elderly patients, have been singled out for high executive salaries and dense bureaucracies.

The LHINs have also been the subject of criticism. Created by a previous Liberal administration in 2006 to streamline the health-care system with more local integration of services, they were targeted by auditor general Bonnie Lysyk in her latest annual report for meeting just six of 15 performance targets.

Lysyk found growing gaps in service levels between Ontario’s 14 LHINs, which divvy out half the province’s almost $52-billion annual health-care budget, and that the health ministry does little to hold them accountable.

Nevertheless, Hoskins said he’s “confident” the organizations can handle increased responsibility for improving the performance of family doctors and nurse practitioners and the planning of health-care services to best meet local needs and improve outcomes.

“We’re creating an implementation team of experts that will help this process go forward ... we’re working very closely with our LHINs to make sure they’ve got the ability to do this,” he said.

New Democrat Leader Andrea Horwath said she has “little confidence” the legislation will live up to the promises from Hoskins given the history of challenges with the Local Health Integration Networks.

“It’s another sign that this government has no idea what it’s doing,” she told reporters. “It’s very, very worrisome.”

Progressive Conservative MPP Jeff Yurek (Elgin-Middlesex-London), a pharmacist and his party’s health critic, said he hopes the bill has its intended impact.

“We have to see how it’s actually going to translate into improved patient care,” Yurek added, expressing concerns about the LHINs as an extra layer of bureaucracy.

Hoskins, a family physician, said he pictures an improved health-care system in which a family health team of doctors, nurses and other health-care providers working together in an office would have a home-care official on site.

“As a doctor, I might have a patient who’s 85 years old and for the first time we agree that she probably needs some support at home,” he explained.

“Instead of giving her a phone number on a sticky (note) and sort of keeping my fingers crossed that they’re going to be able to connect ... I can walk her down the hall to a care co-ordinator working with our office and do the hand-off, with the confidence I know she’s going to get the support she needs.”

The government is also aiming to change the health-care system so that patients “only have to tell their story once” because all of the medical professionals they encounter will have access to their health-3care plans online.

That will fix the “silo approach” that has too many of a patient’s health-care providers working without knowledge of what others are doing, Hoskins said.

There will be a renewed push to get every Ontarian a family doctor or nurse practitioner close to home, with a single telephone number to call for help.

The legislation comes as the government tries to reach a contract with the Ontario Medical Association, representing thousands of doctors, after months of acrimonious negotiations that have broken off at times.

Hoskins’ bill was applauded by the Registered Nurses’ Association of Ontario as “bold change.”

“No one is served well by a system with disparate parts that doesn’t bring providers together,” said chief executive officer Doris Grinspun.

The bill was developed after months of consultation around the province, with many elements foreshadowed in a discussion paper released late last year.

Hoskins and Premier Kathleen Wynne have been under fire from opposition parties, which accuse the government of shortchanging hospitals and forcing them to lay off 1,440 nurses since the beginning of 2015.