Commission on the Reform of Ontario's Public Services

Chapter 5: Health
There are more than 2,500 funded health organizations in Ontario, many with their own
leadership teams and boards of directors. In the health care system’s current state, it will be
very difficult for the LHINs to do the job the <strong>Commission</strong> has set out for them because, in order
to have a truly integrated system, the LHINs will need to broker relationships with every
agency. In addition, the LHINs will have to deal with all the individual FHTs, FHOs, etc.
Similar health care groups, for example, the 155 hospitals, 14 CCACs, 200 FHTs or over 600
long-term care homes in the province, must further consolidate either organizationally by
forming merged leadership and boards, or physically by forming merged agencies.
This network of streamlined relationships should have the following features:
� A regional physician network that has:
• Joint accountability for primary and acute care that leverages the talent, infrastructure
and capacity of hospitals while leveraging the comparative advantages the CCACs
have built in the areas of collective purchasing and IT infrastructure;
• Co-ordinated leadership through a body like the Ontario Medical Association (OMA) to
act as the interface with the LHINs, contribute to quality assurance policy development
with bodies such as Health Quality Ontario (HQO) and ICES, and keep their fellow
doctors and other primary caregivers abreast of new developments;
� Further amalgamation of hospitals and reduction in the number of boards; and
� The creation of an entity that represents the network of long-term care homes.
Recommendation 5-13: Consolidation of health service agencies and/or their boards should
occur where appropriate, while establishing any new consolidated agencies as separate legal
entities to limit major labour harmonization and adjustment costs.
Recommendation 5-14: Establish an advisory panel in each Local Health Integration Network
with appropriate representation of the regional health care stakeholders, including community
hospitals, physicians, community care and long-term care homes.
The LHINs need to have leaders who are savvy to political and community issues at play in
the regions. Do not appoint them through Orders-in-Council, but rather hire them using
executive search best practices to ensure independence and that an appropriate combination
of skills and expertise is brought to the table.
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