Reducing health care and spending limits in the first budget of the government of Doug Ford could mean "a huge, disturbing change" for the Simcoe Muskoka district health department and its partners in the community, said dr. Charles Gardner, a healthcare professional in a health unit.
In general, spending on health care is a modest 1.6 percent in the regional budget for 2019 – still below the inflation rate – although the province is promising to reduce the cost of $ 1 billion in health care over the next three years.
Ford's government expects to save $ 350 million with the planned creation of a new health superagency, Ontario Health – brings together 20 existing organizations that include local networks for the integration of health and cancer treatment of Ontario; and another $ 200 million through unspecified "labor productivity optimization".
There are also plans to cut $ 200 million from the public health budget – a measure that has increased some red flags with some.
At present, 35 public health units are operated in Ontario, managed by a health committee providing first-run health services – including vaccination, public health check-ups in hospitals, universities and schools, monitoring water quality and food safety, and tracking communicable diseases.
The budget proposes "streamlining" the system for setting up 10 regional public health authorities and 10 new regional health committees "with a common management model" by 2020-21. It also calls for a reduction in the number of laboratories – they promise to "improve public health programs and the effectiveness and durability of back office services, while ensuring consistently high-quality services".
The shift from 35 health committees to 10 in just two years would be a "big, disturbing change", Gardner said, and doubted how committees could continue to fulfill their mandate, especially with less resources, and fewer laboratories.
"Our mandate is to prevent disease, protect and promote health."
At present, the health unit of Simcoe Muskoka district is involved in childhood immunization programs – "One of the biggest advances in public health in our time," which has led to the control of former common and potentially deadly diseases, he said – and the protection of drinking water. inspecting small drinking water systems, monitoring the levels of bacteria on beaches and wells, and introducing food programs.
The health unit works in the field of food safety – it examines all kitchens serving the public, provides training for food suppliers, and traces and addresses the breakthroughs of foodborne diseases.
"We also do a lot of work in diseases that are transmitted by vectors such as Lyme disease," said Dr. Gardner, as well as the virus for Western Nile and Rabies – monitoring and mapping the location of cases and providing these data to family doctors.
Currently, the province finances 75 percent of public health spending, accounting for $ 743 million each year, "which is why the reduction of $ 200 million is quite high," Gardner said. "This will actually stretch us out."
He was also concerned about the proposed closures and reductions for laboratories, "of which we depend on the response of communicable diseases and the testing of water borne diseases."
The medical doctor praised the new dental plan for low-income elderly people in the country, which in the five years amounted to $ 90 million.
"For many years now we have been advocating that the province take over the dental care of older people with low incomes," said Gardner. "They deserve credit for this."
But he wanted the province to think before planning a reduction in public health.
"Public health is a great value for money. This gives a huge return on investment, "improving health outcomes and reducing fatal and health costs, he said.
He cited, for example, that the Ontario Campaign to Promote Cancellation of $ 500m saved the Province of approximately $ 5 billion in costs associated with death, illness and healthcare.
Gardner was in favor of the region's desire for greater efficiency, but he asked whether major super-committees would achieve this goal.
"We still need to see what it will do in terms of local access," he said, and links with the municipalities.
Municipalities are currently playing an important role in public health with their policies, infrastructure and implementing regulations, and health committees work with these governments on everything from the state of emergency to tobacco control to social housing.
Can these bonds be preserved – especially if municipalities are required to take up a higher share of public health costs – it still needs to be seen, he said.
There was another worrying area: Ford's apparent attachment to alcohol.
The budget includes an increase in beer and wine sales in local corner shops, an early start (9:00), alcohol sales in restaurants, alcohol use in public spaces, and a permit for "boot luggage" before sports games.
"Our health committee has long been committed to controlling alcohol," Gardner said. "Liberalization of access and use of alcohol is working against it."
He warned of an increase in impaired driving, crime and even fatalities, indicating that "increased sales revenues would exceed those revenues."
The proposed 2.05% increase in funding for hospitals has received cautious support.
"We are pleased that we have received additional funds for hospitals. We still do not have details about what this will specifically mean for Southlake, "said Chairman and Executive Director of the Southlake Regional Health Center, Arden Krystal.
"We are excited about the vision to transform the healthcare system, announced by the minister (Christine) Elliott in February," Krystal added. "The very necessary reforms will enable us to better partners with community organizations in order to provide patients and families with more integrated care and a smooth transition to all parts of the health system."
The budget includes $ 267 million for home and community care, from personal support workers and supportive lives, to therapy and nursing, and more support for transitional care and partnerships.
"While last year we worked with patients and families for our strategic plan, we have consistently heard that transition from one part of the health system to another can be difficult," Krystal said. easier transition from hospital to home for patients, often older with complex needs, who need permanent care at home.
"This is an example of how a better partnership can really have a positive impact on patients and families."