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From District Health Councils to the LHIN's our decades struggles on how to manage health governance continues.  The 10 minute discussion on CBC is worth a listen.

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Ottawa Morning with Robyn Bresnahan

 In defense of the LHIN

Jan 18, 2019

The CBC has learned province is putting Ontario's fourteen regional health agencies on the chopping block. Bob Bell, former deputy minister of health and long-term care, is with us.

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Here is a bit of an update on status of ministry change, including a leaked document that at least provides a sense of what is being planned by the government.   

I suppose all, a wild dance of how policy and politics... are made to then operate in our everyday lives?


PREdraft legislation


CMHA Ontario shared this report which focus's on improving community based services  

Government advisory council recognizes need for community-based mental health and addictions services

... Decentralization can also contribute to duplication in processes and procedures, which can slow down access to health care services. One example of duplication in the health care system is in the assessment process. Approximately 11% of time spent on care coordination is used to conduct assessments and re-assessments for community and home care services.[42] Assessments are also done by service providers and hospitals, while primary care providers often have detailed and up-to-date patient records that could be used to inform care planning and delivery, and prevent patients from having to repeat their stories.

"The staff have all been kind and professional…the negative issue would be the constant need to provide basic information like address, date of birth, medications, family doctor, allergies, and more. It is very frustrating for a senior to be asked the same questions."

– Patient Survey Response

In addition to barriers to information sharing, some of the unnecessary duplication in the assessment process is driven by the separation between the coordinator role and front-line care. These kinds of system-design issues have a real impact on patients, since it is not always clear which service provider is responsible for delivering care.

It is also important to remember that the delivery of children’s health care is different from adults. The current system does not recognize this very well, and children receive health care in even more settings, like schools, primary care, home and community care , and of course with their families.

Patients and health care professionals alike are frustrated by the lack of communication between professionals, health care organizations, and patients. This lack of coordination and duplication in some roles and functions is costing the system in both time and money, and may not always translate into getting patients access to the care they need.

Stronger lines of accountability would help make the health care system more efficient, and also help ensure Ontario gets a greater value for what it currently spends on health care. Currently, the government spends about 42 cents of every tax dollar on health care.[43] Although this is the lowest per capita spend on health care compared to other provinces and territories, the system could work smarter and use this same amount of money to achieve better health outcomes.[44] When compared to similar countries in the world, Canada generally spends more on health care, but scores lower on some key performance indicators.[45] With performance based incentives that link investments to outcomes, Ontario could shift the focus of health care spending to high-value, instead of high-cost. With clearer lines of responsibility and accountability in the health care system, Ontario could move towards strengthening the entire system and solve the problem of hallway health care. ...


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  • PREdraft legislation
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