Tim Hudak right about reforming medical bureuacracy | Columnists ...

Doctors perform surgery at the Ottawa Hospital's Civic campus (Tonyl Caldwell/Ottawa Sun file photo)

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Closing the Local Health Integration Networks across the province isn?t a new idea for Tim Hudak. But this year he?s back at it with more details to bolster his argument. The failure of the Champlain LHIN to meet many of its goals may make more Eastern Ontario voters see things Hudak?s way.

In the 2011 election, part of the PC leader?s proposals to reduce the size of government included closing the LHINs and the Ontario Power Authority. This was a first stab at tackling the hundreds of provincial agencies, corporations, etc., that were running amok.

The 14 regional LHINs were created by the Liberal government in 2006 to ostensibly make health care more responsive to local health needs. They would bring the various local threads of health care together to work collaboratively for the benefit of a region. But a lot of people were left scratching their heads wondering how exactly an extra layer of bureaucracy could result in less bureaucracy, and more direct community involvement.

The goal with axing the LHINs, as Hudak told me in a phone interview, is to ?put the patient at the centre of health care.? His view is that they ?hold a lot of meetings, rent a lot of conference centres? but don?t necessarily deliver the meat and potatoes. This portrays the LHINs as possessing the typical traits of a middle man who argues he?s integral to the process but, when you step back and look at the situation, only serves to muddy things.

?You?ve got to fight like hell to get anything done,? Hudak notes, of the way patients are funnelled through the system, from GP to specialist to hospital. ?It shouldn?t be like that in a province like Ontario.? But do any statistics back this up?

The Champlain LHIN is responsible for Eastern Ontario. They?ve only hit two of their 14 performance indicators, according to a recent report. Most of these involve decreasing wait times and lengths of stay ? key indicators of improved performance. They were hoping to get to hip replacements by 222 days ? but instead are at 295 days. The knee replacement target was 182 days ? but came in at 242 days. Two months longer.

Healthcare is one of the sacred cows of provincial funding (the other is education). Currently almost half the tax dollars collected in Ontario are spent on health. That is, of course, expected to increase.

Oft proposed ?across the board? cuts exclude health-care. This is because the conversation around health funding incorrectly assumes that any cuts mean cuts to front-line service. But if there are now, to use Hudak?s example, middle managers and conferences that weren?t around before 2006, it?s fair to say there are savings to be had that won?t impact front-line care.

These ideas were put forth in the third of a series of discussion papers the party has introduced since last year?s election. While this one focuses on health care, the first two were on energy and the labour market.

There are legislative proposals in these documents, but they also read like a slow roll out of core philosophy. Hudak, who has admitted flaws in his election performance, acknowledges he is now ?laying out step-by-step how we will change things.?

As a tip of the hat to bloated operations, Dwight Duncan?s 2012 budget did include a cut to administration budgets for health corporations including the LHINs. But keep in mind the McGuinty Liberals are responsible for creating the full LHIN budget in the first place.

Those of us who have been urging Hudak to double-down on fiscal conservatism and reduce the size of government should be pleased to see such investigations. That said, his plan to replace the LHINs and Community Care Access Centres with local ?health hubs? should be viewed cautiously. Poorly managed, any new hub or network or whatever you call it will just face the same challenges as the LHINs.

Are Local Health Integration Networks a waste of money?

Source: http://www.ottawasun.com/2012/09/29/tim-hudak-right-about-reforming-medical-bureuacracy

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