Published on February 25, 2019

November 6, 2017

By Megan Stacey

The city is pushing back against a provincial proposal to dissolve local public health units and create mega-sized agencies instead, joining a wave of opposition across the province.

A panel of experts appointed by Health Minister Eric Hoskins is recommending the province establish 14 health units to replace the current 36.

The boundaries for the units would be the same as local health integration networks (LHINs), meaning London and Middlesex would become part of a massive health unit stretching from Tobermory to Long Point if the province adopts the panel’s recommendations.

One of city’s chief complaints — outlined in a staff report that heads to politicians for debate Tuesday — is a loss of independence.

The proposed regional units may leave health professionals with less control to address pressing needs in London, local leaders said.

Problems unique to London, such as the city’s high HIV rates, may not get the same attention when there are crises across a vast region to consider, they say.

Coun. Jesse Helmer, who chairs the board of the Middlesex-London Health Unit, said the agency is already doing a good job creating “integrated” health solutions, a key provincial goal.

“We’ve got a good track record of agencies working together. It’s not as though the health unit is off on its own in isolation. One of the reasons I think that’s working so well in London is the size and geography,” Helmer said.

He cited the HIV leadership table as an example of that collaboration, where hospitals, harm-reduction specialists, public health workers and other health professionals work closely to address the problem.

“I think we have to wonder if we can actually deliver that kind of integration, that kind of local collaboration, when we make the scale so much bigger,” Helmer said of the massive regional public health units that are being suggested.

The city is raising the alarm not only around the size of the regional units, but the loss of local control and potential challenges in forming strong relationships at the community level.

Then there’s the question of cost. What would the province pick up and what may be downloaded to municipalities?

There aren’t any answers yet, but the city — and local public health board — is concerned.

The County of Middlesex is sharing in that worry, jointly submitting a response with the city of London, once approved by council.

“It’s a pretty united front in terms of feedback to the province on this expert panel report,” Helmer said.

Jeff Yurek, MPP for Elgin-Middlesex-London and the Progressive Conservative health critic, has been vocal about his opposition. He said he shares the same concerns as those outlined by city staff in the report to council’s community and protective services committee.

“You’re going to really see a slow reaction time to any health crisis that does emerge. I think you’d also see the flexibility of health units to tailor their services to the local needs will be inhibited. Each area within our larger jurisdiction is different,” Yurek said.

London is one of many municipalities taking advantage of this time to weigh in on the plan during a consultation phase.

After that, it’s a waiting game while the Ministry of Health reviews feedback to the report released in July.

“I’m waiting to hear. I will continue to hope that the government is going to listen to the concerns of this sector of the health care system,” Yurek said.