The decision by the Headwaters Health Care Centre’s board of directors to cease all further work and discussion regarding the possibility of a merger with William Osler and the Central West Community Care Access Centre (CCAC), was driven by two key factors presented at last week’s board meeting.

The first was a request from the Minister of Health and Long-Term Care, Dr. Eric Hoskins, to defer discussions on further governance inte- gration, and the second was because of an announcement from the Minister regarding plans for health care transformation.

During the summer, the boards of the three organizations were conducting exploratory discussions regarding the creation of a new umbrella corporation. At the end of September, the
boards passed a memorandum of understanding which would have them move forward to a study phase, which included due diligence, stakeholder consultation and public engagement. This step would allow them to determine if there was merit in deepening the partnership.

Following receipt of the minister’s letter last Tuesday evening, the Headwaters directors voted unanimously to cease any further work or discussion surrounding full integration. The partnership being discussed was grounded in a commitment to improve patient care to the community.

The Minister’s plan, presented during a speech at the 2015 Health Achieve Conference on Novem- ber 4, goes further than the scope of local partnership, outlining a high-level plan that includes putting Local Health Integration Networks (LHINs) as the local body to drive a broader transformation of the health system.

“The well-being of patients – putting patients first – is what motivates me as the Minister,” said Dr. Hoskins in his speech. “It’s what motivates me as a family doctor and as a public health specialist. …That commitment that we all share, to the well-being of our patients, must drive system transformation.”

He continued, stating that “by embracing new ways of doing things, we can build a system that better understands and meets the needs of our patients – no matter their background, their income, or where they live.”

He added that together, as partners and health care professions, they would need to embrace true system transformation.

“We will embrace change,” he said. “Change that is bold. Change that doesn’t just tinker around the edges. Change that improves the structure of our system in a profound way, always focused on better access for our patients and better care when they need it most.”

During his speech, he shared with attendees of the event why he believes we must undertake structural change to our healthcare system, and how he intends to meet those goals. The why, he broke down as being fairly simply – health equity; the promise that every person, no matter who they are, where they live or much they earn deserves equitable access to health care. He identified one of the areas requiring improvement as closing the gaps which exist between different geographic areas of the province.

“When you see [the] data, you see that geography is only part of the story,” said Dr. Hoskins. “We’re talking about gaps in our success at treating populations with low socio-economic status. We’re talking about populations where we haven’t done enough to address the social determinants of health.”

According to Dr. Hoskins, how to close the gap and achieve that level of health care comes largely through local governance.

“I believe that a system that best meets the needs of patients in an equitable way is one that is truly population-focused, and that is deeply integrated at the local level,” he said. “That was the driving force behind the creation of our Local Health Integration Networks – that local governance is the best way to meet a population’s local needs, not by managing everything from our offices here in Toronto.”

From speaking with many of the LHIN boards across the province, Dr. Hoskin explained that he was impressed with their depth of knowledge, as well as the capacity each LHIN has shown in being ‘true local managers’ of their health care systems.

“LHINs know the needs of their population — and they know the partners and service providers who care for that population,” he said. “They’ve become much more sophisticated and they must continue to evolve. LHINs have the capacity to play a role that better acknowledges the true importance of local decision-making and local management.”

The Headwaters board and Health Care Centre will not be shying away from the existing partnerships they have implemented in order to help increase patient care.

“We will continue with our existing partnership initiatives, including the innovative back-office integration and our many clinical collaborations,” wrote Cara Francis, Regional Director, Public Relations for Headwaters Health Care Centre, in an email on Friday. “[This includes] our Hospital 2 Home (H2H) initiative, surge planning, and more, to enhance patient care in our region.”