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Public Health andHealthcare in Ontario
A Made in Ontario Solution for Public Health and Healthcare
Andrew PapadopoulosDirector, 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 under-
funded 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 under-
funded 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