By Chad Ingram

The Haliburton Kawartha Pine Ridge District Health Unit has concerns about the implications of funding and potential accountability changes coming from the province.

Last fall the health unit learned it would be one of 28 of the province’s 36 health units to have its funding frozen for the foreseeable future. The bulk of the health unit’s $18 million budget comes from the Ministry of Health and Long-Term Care and the health unit signs agreements based on performance indicators with the province.

“With the freeze it’s going to be increasingly difficult for us to achieve compliance . . . as our costs increase on an annual basis” Dr. Lynn Noseworthy medical officer of health for the health unit told the paper.

Changes proposed under the Ontario government’s discussion paper Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario would see the province’s Local Health Integration Networks become responsible for the allocation of public health funding.

“It doesn’t say public health ‘unit’ funding so we don’t know what that means” Noseworthy said.

Proposals in the Patients First paper also call for the health unit to sign its agreements with the LHIN rather than directly with the province. The HKPR Health Unit is in the area covered by the Central East LHIN one of 14 integration networks in the province.

“The board is very concerned about the maintenance of programs and services” Noseworthy said adding that decreased local decision-making is also a worry. So too is an overall decrease in the role of public health agencies and focus on public health.

“That is a concern from my perspective” Noseworthy said.

Public health involves working with a number of non-health care partners such as school boards and social agencies. While acute care is patient-focused “we deal with populations groups of people” Noseworthy said adding that public health deals with the social determinants of health –
education income etc. – and keeping people healthy.

A staff report submitted to the City of Toronto in January is critical of proposals contained in the Patients First document and makes a number of recommendations including maintaining independent governance of public health through local health boards and ensuring that any provincial funding directed to boards of health through the LHINs cannot be reallocated to other health services and that there be a transparent budget process