Transcript Public Health and Healthcare in Ontario

Public Health and
Healthcare in Ontario
A Made in Ontario Solution for Public Health
and Healthcare
Andrew Papadopoulos
Director, School of Occupational and Public Health
January 20, 2005
The Public Health System
 Health Unit Structure and Funding



Ontario served by 36 boards of health
Set the budget, paid for by the municipalities
served
A grant of 55% is provided by the Minister of
Health resulting in a 55/45 funding relationship



Will eventually become a 75/25 split
set up as apolitical bodies for the health of the
public
have strong advocacy role
Shifting Ideologies
 Focus of public health has shifted in past few
decades


Move away from direct contact and more of a
focus on population health
A move toward chronic disease prevention
 Communicable disease outbreaks have
moved the focus again

Walkerton water outbreak, West Nile virus,
SARS
The Inquiries and their Reports
 Walkerton
 The public health system is chronically underfunded and its role has been diminished
 Haines Meat Inquiry
 Public health’s role requires enhancing and
solidification for the public’s interest
 SARS
 The public health system is desperately underfunded and is not a system
 Greater involvement in health care required
Provincial Public Health Initiatives
 The establishment of:




The Agency Implementation Task Force
The Local Public Health Capacity Review
Committee
A website for the Provincial Infectious Disease
Advisory Committee
The Public Health eHealth Council
 Increased funding to local Boards of Health
 Enhanced tobacco legislation
 Increase in publicly funded vaccines
Public Health Agency of Canada
 New approach in collaboration with provinces
and territories on efforts to renew the public
health system in Canada and support a
sustainable health care system
 Focused on efforts to:


prevent chronic diseases, prevent injuries and
respond to public health emergencies and
infectious disease outbreaks
keep Canadians healthy and help reduce
pressures on the health care system
Public Health Agency of Canada
(continued)
 Headed by the Chief Public Health Officer
who will report to the Minister of Health
 Separate from Health Canada although both
will be part of the health portfolio
 Initial projects include a public health human
resources strategy and a development of
core competencies for public health
personnel
Local Health Integration Networks
 Government believes we need fundamental
changes to the system
 Community based, responsive to people’s
needs and accountable
 Investment in five key areas:





long-term care;
home care;
primary healthcare through 150 family health
teams;
community mental health; and,
a revitalized public health system focused on
prevention
More LHINs
 Purpose is to integrate and coordinate services
at the local level
 Not intended to be service providers

Fund the healthcare system
 Used ICES study of hospital referral patterns to
determine the 14 boundaries
 Local partnerships will be self-organized
 Improve population health

Primary healthcare reform?
LHIN Governance
 Governed by Order-in-Council appointed
Board of Directors

CCAC model
 Board to oversee




Planning
System integration and coordination
Evaluation of performance through
accountability agreements
Funding
LHIN Priorities
 Patient Care Integration




Integration of mental health and addictions
across the full care continuum
Planning for integrated services for seniors
Bridging health care delivery from hospitals to
community care and support services
Community support services in an integrated
system
LHIN Priorities (continued)
 Administrative/Support Services
Integration



Common health record and electronic
exchange of information
Governance ensuring accountability to
community
Maximizing human resources potential
through innovation and integration
Next for the LHINs
 Work is currently underway in each of the 14
LHIN communities to prepare and submit
their Integration Priority Report
 It is the MOHLTC's expectation that members
of the public and the full spectrum of health
care providers in each LHIN community be
engaged in the work
 Reports due 75 days after the local workshop
 Will form the foundation for LHIN integrated
health system planning
A Revitalized Public Health System
 Ontario Health Protection and Promotion Agency
 The enhancement (creation?) of a public health
system
 Creating greater independence for the Chief
Medical Officer of Health through legislation
 Building capacity at the local level
 Determining the division of responsibility between
federal, provincial and local levels of public health
 Determining the local level
A Revitalized Healthcare System
 A focus on the determinants of health

Have the system think and act as a system
 Community decision making
 Fiscal accountability
 Prevention first, not an after thought
 Find synergies where possible and recognize
local differences