Change is not demolition

Ontario’s health-care strategy receives a thumbs down from an HR perspective
By John Butler
|Canadian HR Reporter|Last Updated: 03/03/2005

Big changes are afoot in Ontario’s health-care system. Spearheaded by Ontario’s Ministry of Health and Long-Term Care and its minister, George Smitherman, the plan is to improve service in two ways: by reforming the way doctors provide front-line care (so they are rewarded for working in a team context with other front-line health professionals), and by creating 14 local health integration networks (LHINs) that will eventually be responsible for allocating funds to health agencies in their areas. The creation of LHINs is meant to ensure that funding only flows to agencies that work in partnership with other agencies to meet the needs of patients, rather than working in isolation in their areas.

These initiatives are laudable and overdue, but several recent developments suggest the government may be mismanaging the transformation in terms of human resources in the highly labour-intensive health-care system.

First, the government botched negotiations with the Ontario Medical Association about how doctors will provide services in future. A tentative fee-setting agreement with OMA was rejected by doctors, largely because older physicians who are accustomed to working solo rather than in a team context saw too little financial gain in the agreement. While the agreement did call for fee increases for solo practitioners, these were loaded in the second half of the contract’s time frame rather than at the beginning. As well, the agreement’s proposal to reward doctors for reducing unnecessary prescriptions was seen by many physicians as an intrusion into their ability to make independent clinical judgments.