The Ford Government’s revamped approach to restructuring Ontario’s public health system is being met with cautious optimism in Cornwall after the government promised to be much more open to outside input than during its first attempt.
Although the Progressive Conservatives still plan to amalgamate Ontario’s 35 public health units into 14 regional entities, other controversial policies such as cuts to land ambulance funding are being dropped entirely.
The new approach is being welcomed by the Eastern Ontario Health Unit, which was very critical of the changes to public health when they were proposed early this year.
“I’m feeling better. I feel that out concerns are being responded to and that they felt the pressure from the backlash, as well as the information and feedback that we gave them,” said Dr. Paul Roumeliotis, medical officer of health for the EOHU.
“We are all headed towards a more efficient, modern public health system, but now they will take the time and the consultation needed to do so.”
It remains to be seen, however, what Cornwall’s city council will make of the new funding formula that would see more of the cost of running public health programs downloaded onto municipalities.
The government’s representatives came to the Association of Municipalities of Ontario (AMO) conference in Ottawa on Monday to explain how they would be changing the way they approach “modernizing” public health after being forced to back down earlier this year due to immense pushback from health units and municipalities.
Health Minister Christine Elliot admitted the first attempt had not gone well when she spoke to delegates on Monday, but said the government had taken the criticism to heart.
“Our proposed approach caused widespread – and I would say spirited – discussion,” said Elliot. “So I want to be clear: we are a government that listens.
“We heard about the need for more time, not only to accommodate changes to cost-sharing arrangements, but also to ensure a seamless transition to new regional entities. We also heard the need to consult more broadly.”
To address those concerns, the government made a number of promises to AMO delegates on Monday.
The first is that there will no changes to the funding model until the start of 2020. This will give municipalities time to find ways to pay for their new increased share of the cost, instead of changing the formula after many communities had already passed their annual budgets.
The new funding formula will split the cost of all public health programs 70-30 between the province and municipalities. Currently, most public health programs are entirely funded by the provincial government, with some specific programs being split between the province and municipalities.
For the health unit, this new proposed formula is good news. The government is no longer calling for public health budgets to be reduced, noted Roumeliotis, which means it can continue to do its work as before while the larger questions of structural reform are decided.
“From our point of view, it doesn’t look like our budget it will be cut. They’re just downloading it, so we’ll see how that works moving forward. But we will still be looking for ways to save and be more efficient,” said
What the funding changes mean for Cornwall is much less clear. Under the current formula, the City of Cornwall contributed just under $750,000 to the Eastern Ontario Health Unit in 2019. But determining how much more the city will have to pay is impossible, because it’s not known what the size of the new regional public health entity would be or what communities would also be paying into it. The province is also promising that no public health unit’s budget will increase by more than 10 per cent in the first year.
Mayor Bernadette Clement, who is a member of the health unit’s board of directors, echoed Roumeliotis’ sentiment the formula is good for that organization, but said it is something council would need to discuss to determine the municipality’s position.
The second major concession the government is making to critics is it will be significantly more open to consultation and input on what the overhaul of the public health sector would look like.
Both Clement and Roumeliotis said this was a significant development for Cornwall. The fear has been the city would be lumped in with Ottawa, where its public health issues would take a back seat to the capital’s. Now it appears it may be possible to convince the province to not let that happen.
The government will be issuing a discussion paper with proposed boundaries for the new public health entities in them, but Elliot stressed that they are in no way final, and will be up for negotiation.
To oversee the creation of that paper and the extensive consultation process that will come after, the government is promising to hire an expert adviser who will be knowledgeable about municipal issues. This is an appointment the city will be watching closely.
“We don’t have the name of that person yet, but we will be interested in knowing the background of that person. More consultation is not a bad thing,” said Clement.
Another concession is that the government is backing away entirely from its plans to amalgamating Ontario’s 59 land ambulance dispatch services into just 10. Elliot said the province will not be reducing funding for EMS and instead will be increasing the funding given municipalities for those services by four per cent this year, with promises of further increases to come.
Clement also said this news was welcomed by Cornwall delegates at the conference.