ACTING ON THE ADVICE of Ontario’s health minister, the board of directors of Headwaters Health Care Centre has wisely abandoned its exploration of the pros and cons of becoming part of a single entity encompassing the Central West Community Care Acess Centre and the other two hospitals in the Central West Local Health Integration Network (LHIN), Brampton Civic and Etobicoke General.

We’re not sure what might have been gained by such a quasi-merger, but it was fairly clear to us what would be lost, namely local governance.

Apart from that, we would see replicated the same sort of problem that confronted Peel when the mainly-rural county with just two small towns (Brampton and Port Credit) and a few villages became a region in 1974 with the cities of Mis- sissauga and Brampton and the Town of Caledon. As we see it, there never is much long-term hope for independent local governance in a three-unit region with nearly all the population (and votes) in the two large units.

As matters stand, Brampton Civic Hospital – (608 beds) and Etobicoke General (262 beds) are both much larger than Headwaters Health Care Centre, and so, too, will be the new, chronic care Peel Memorial Centre when it opens.

In the circumstances, there is little doubt that an umbrella organization responsible for health care in north Etobicoke and all of Brampton would have to devote most of its time and energy to the health needs of those municipalities.

There’s no doubt that hospital mergers have been occurring, particularly in the Toronto area, where the University Health Network exists as a clinical health-care and medical research orga- nization that owns and operates Toronto West- ern Hospital, Toronto General Hospital, the Princess Margaret Cancer Centre and the Toronto Rehabilitation Institute, and they are affiliated with the Faculty of Medicine at the University of Toronto.

Similarly, in south Peel we now have Trillium Health Partners, a three-hospital group comprising the Credit Valley Hospital, Mississauga Hospital, and Queensway Health Centre.
Such mergers seem to be working well, with each hospital tending to have its own specialty and keeping its reputation intact.

However, in a recent speech, Dr. Eric Hoskins, Ontario’s Minister of Health and Long-Term Care, suggested that the best future for health care in the province lies in “a more patient-centred system,” and that a key element of such a system must be “strong local governance.”
That, he said, was the driving force behind the creation of LHINs, which he contends have become “true local managers of the health care system,” and doing it better than was possible when the system was run from Queen’s Park.

“LHINs know the needs of their population – and they know the partners and service providers who care for their population.”

Of course, “local” is a relative term, and the Central West LHIN, as an example, serves a population bigger than those of New Brunswick and Prince Edward Island.

As matters stand, the Central West LHIN has a single Community Care Access Centre responsible for home care throughout the jurisdictional area, and there is close collaboration among hospitals in and beyond the Central West Region. For example, cancer patients in Dufferin and Caledon can have their chemotherapy at Headwaters supervised by Brampton-based oncologists and can have their choice of Southlake and Credit Valley hospitals for radiation.

If any change is needed, it’s in the area of equipping the LHINs to do more toward ensuring equitable access to health care – something the current minister wants to see happen.

“As we move forward with implementing our primary care guarantee that every Ontarian who wants one will have a primary care provider, and with our commitment to significantly improve sameday or next-day access to care, I look forward to consulting with all of our health care system leaders on the best way to achieve this transformation,” he said in the speech to the Health Achieve Conference Nov. 5.

“But make no mistake, I believe that if we are to transform our system to one that is focused on population health and equitable access, the time is right for more local governance, and for our LHINs to play a much greater role.”