Christine Elliott, deputy premier and minister of Health and Long-Term Care, announces the Government of Ontario’s plan for a long-term health-care system at Bridgepoint Active Healthcare in Toronto on Tuesday.
Tijana Martin / THE CANADIAN PRESS
What are Ontario Health Teams? Made up of local health-care providers working as a co-ordinated group, the teams will guide patients between providers and through transitions, Health and Long-term Care Minister Christine Elliott said on Tuesday. Teams will likely include family doctors, hospitals, home care, long-term care and may include other providers such as support for mental health and addictions. The teams will be funded for a given population of patients, and will be responsible for care plans, service provision and outcomes, and are to provide navigation services to patients 24 hours a day.What does the province believe is the major problem with the current system? Agencies work in silos in the current “patchwork” system, said Elliott. The province has added new agencies and health-care programs, but has not integrated or co-ordinated them. Agencies often focus on specific patient populations or illnesses “while the reality is that people are whole individuals who span multiple groups or areas of focus,” said Elliott.How many health teams will there be across the province? Elliott expects 30 to 50 teams to be created, each serving as many as 300,000 patients. The teams will not create another layer of bureaucracy, she said. Leadership will come from specialists and agencies already in the community, and teams with proposals are expected to come to the province voluntarily. According to Elliott, about 30 interested unsolicited proposals have already been presented. It is believed that there will be some early adopters who will take the lead, and the province has said it will be flexible to account for local conditions. The first teams may be geographically based or they may specialize in certain conditions, such as the frail elderly. Over time, it is expected that more and more institutions and agencies will be folded into the teams.Who will be responsible for overseeing the teams? A new agency called Ontario Health, which will be a “single and harmonized home” for the programs and operations of existing provincial agencies. It has already been dubbed the “super-agency,” by critics who fear the reforms will lead to increased privatization.What happens next? The government introduced new legislation Tuesday to consolidate multiple health-care agencies and organizations under Ontario Health. If passed, six agencies are slated for “transition”, including Cancer Care Ontario, Health Quality Ontario, eHealth Ontario, Trillium Gift of Life Network, Health Share Services Ontario, HealthForce Ontario Marketing and Recruitment Agency. As well, the 14 local health integration networks will be consolidated into five regional agencies of Ontario Health. It is expected that it will take years for the LHINs to be dissolved because of the role they currently play in co-ordinating local home care.Will the changes open the door to more privatization? Elliott told reporters the primary objective of the plan is to strengthen the publicly funded system and that universal access to health care is not up for debate. However, she noted that home care is currently delivered by both public and private agencies. She doesn’t see that changing.How many jobs will be lost? That’s not clear. Elliott told reporters that the point of the plan is to put more people on the front lines and not to “conduct a financial exercise.” Still, she expects that the plan will eventually save money. Job losses are likely to happen in administration. The province noted that there are multiple provincial agencies that offer clinical guidance, evaluation, public information and health sector analysis and some of their work is being duplicated. Each of these agencies also has a full senior management team and office support. Will there be buyouts? That will be up to local teams, Elliott said.Unions are concerned. The Ontario Council of Hospital Unions and the Canadian Union of Public Employees Ontario announced Tuesday that they will begin escalating actions to protest the reforms. The unions say what they have heard so far suggests the government plans to privatize clinical and support services, concentrate services away from small towns to large urban centres, create mega hospitals and add another level of bureaucracy.How does technology come into play? Under the new system, patients who want to will be able to securely access digital health services, make online appointments, talk to a specialist virtually and have access to their own health records, says the province. In the U.S., the integrated managed care consortium Kaiser Permanente, for example, performs just over half of medical encounters virtually.How long will the transition take? Elliott wasn’t specific, but stressed it will take some time to bring the agencies together. Health Ontario will begin to take shape this spring, and more information about how to become a Health Care Team will be announced in March.Will patients still be able to choose their own health-care providers? Yes. The funding will follow the patient, so it will also be portable. Health-care providers will also have more care choices because digital care will give them quick access specialist advice and clinical supports, said the province. The process will be “seamlessly phased in.”Will patients and caregivers have a say? The Minister’s Patient and Family Advisory Council, which provides advice on health-care priorities that have an impact on patient care and experience, will become a permanent advisory body.By the numbers30 per cent: How much above the national average Ontario has spent on health administrative expenses in the past five years42 cents: How much out of every dollar spent by the province goes to health care300 per cent: Increase in average wait times to get into long-term care since 2003, from 36 days to 146 days1,800: Current number of health-care provider organizations in Ontario, including provincial and region agencies and clinical oversight bodiesSource: Province of Ontario ALSO IN THE NEWS:Ontario sets stage for health-care transformationWoman starts her week at casino, and it pays offClark Davey, 1928-2019: ‘The true journalist of journalists’