Doug Ford’s omnibus health Bill removes community control and public oversight

This guest blog was written by Natalie Mehra, Executive Director of the Ontario Health Coalition.

Doug Ford’s new health care omnibus bill does not open a single new health care service. Not a single surgery to help tackle waitlists. Not a single new nursing home space. Not one new nurse, health professional, or doctor. 

We have an excellent quality public health care system. We have the most highly educated doctors, nurses, health professionals and staff in the world, according to international studies. We can be proud of our public health system and its principles grounded in equity and humanitarianism. But we do have a serious capacity problem. We need more care, desperately. Ontario has the fewest hospital beds left of any province in the country and of any developed nation, leaving patients to wait for days on stretchers.

Every large hospital, according to the Ontario Auditor General, has operating rooms that are closed for weeks, months or even permanently. Yet patients are waiting far too long for needed surgeries. We also have the second fewest long-term care beds of any province while waitlists number 33,800.  Community care too, faces rationing. Everyone has heard of the recent plan to cap autism care, for example. Clearly cuts and rationing have gone too far. 

We have plenty of room to improve. Ontario actually funds health care at a lower rate than any other province. We have a long way to go, even just to meet the average of the rest of the country. 

In fact, in the election, Doug Ford traversed the province promising more – not a wholesale dismembering of the health system.

What is in Premier Ford’s health care omnibus bill is a new “Super Agency” forged out of 20 existing agencies. This includes 14 LHINs, Cancer Care Ontario, the organ donation system, Health Quality Ontario, the labourforce supply agency, and more – an array of agencies with widely disparate mandates, histories, levels of effectiveness, and cultures. So that is, at the central level, a planned mega-merger that is huge and risky.

But that’s not all. Written in the new law, and what neither Doug Ford nor Health Minister Christine Elliott have admitted, are vast powers that the government has given itself and its political appointees in the new “Super Agency” for a wholesale restructuring of our local hospitals, long-term care, home care, community care, mental health and so on. Restructuring powers are defined in the legislation as not only service coordination but also mergers, amalgamations, transfers of all or part of a service, closures of a service, and entire closures of service providers. In the law itself these are not simply “voluntary,” as the Minister describes them. Health Minister Christine Elliott has talked about what her intentions may be, but what is actually written in the legislation is a set of virtually unfettered powers that take away any last remaining vestiges of local control.

And, yes, this plan poses a serious risk of for-profit privatization of our public and non-profit health care services. The Minister and the Super Agency between them have the power to order transfers and closures of an array of services. Written into the legislation is an overt plan to contract support services to some sort of company. Cabinet also has significant new powers. The for-profit surgical and diagnostic clinics are included in the legislation and will be looking for expansion opportunities, as will the for-profit chain nursing home and home care companies and other large chains and transnational corporations that will see this legislation as a way to expand. 

Most tragic perhaps is the opportunity cost of this legislation. Already the attention of every CEO and manager in the health system has turned to restructuring. The reality is the large and ambitious, the empire builders in the health system, will turn their attention and resources to planning takeovers of other services. The large chain for-profit corporations will seek to expand their “market share” and profits using the new opportunities afforded in this legislation. The Provincial Auditor reported that the last hospital restructuring cost $3.9 billion to layoff nurses and staff, close down local services, then rebuild them elsewhere. This is money lost from frontline care.

At the end of the years of mergers and takeovers and partnerships and so on, the current Minister envisions 30 to 50 giant health care conglomerates running virtually all services for up to 15 million Ontarians. Each conglomerate would be made up of hundreds of mergers, service transfers and takeovers, but also some separate entities. Each conglomerate will need a new tier of administration to run the relationship between its various parts of the conglomerate. That equals 30 to 50 new uber administrations plus the mother Super Agency, as compared to the current 14 LHINS and 6 agencies. Furthermore, the administration of the conglomerates will be owned by the providers themselves in their interest, not public oversight in the public’s interest. This is worse, not better, and you can see why the leadership of chain companies and large CEOs are salivating.

It also bears noting that virtually all the democratic protections – paltry as they were – that we won in previous legislation have been stripped in the new omnibus law. There are no open board meetings. No public right to access restructuring documents. No appeals. The language in the Bill includes only the weakest possible community engagement (that’s what they now call democracy and public input). There is no evaluation system for the vast new restructuring. There was no public consultation prior to this Bill and there is no opportunity for any meaningful public input into the health system that the public funds that should be ours, as the people of Ontario.

Another half decade or more of upheaval and takeovers will be devastating to a workforce that has been stretched for decades to do ever more. In the strongest terms possible we urge the Ford government to hit “pause,” to engage in proper public consultation and to make a new priority of actually improving access to public health care services for the people of our province. We will fight this legislation, and if they pass it, we will fight the mega-mergers and service privatization inch by inch. We will defend our public health care against this profoundly undemocratic and dangerous new restructuring plan. 

We are working with the Council of Canadians, patient advocacy groups, health professionals, doctors, unions, seniors' organizations, ethno-cultural groups, students and many others to pull together a massive show of strength outside the Ontario Legislature on Tuesday, April 30 at noon. We hope that you will spread the word and join in.

Natalie Mehra is the Executive Director of the Ontario Health Coalition. She has served at the leadership level of the Ontario Health Coalition for 23 years.