Health 102 Tut 1 Assignment
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Health Science
Date
Feb 20, 2024
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Lacelle 1
Jack Lacelle
21061823
Health 102
Moses Tetui
January 29th, 2024
Introduction
In Ontario, Local Health Integration Networks (LHINs) are regional organizations
designed to address local healthcare inequities, improve coordination, and decentralize
healthcare decision-making in order to create a more flexible and patient-centered healthcare
system. The Ministry of Health and Long-Term Care announced the creation of the 14 LHINs in
September of 2004, and the Act came into force in March 2006 (Šimunović et al., 2013). The
formation of LHINs was the beginning of a significant shift in the organization and facilitation of
healthcare services in Ontario.
Ontario had a centralized healthcare system that had trouble adjusting to the wide range
of demands of its people before LHINs were established. In order to decentralize
decision-making and bring healthcare decision-makers closer to the communities they serve, the
government established LHINs in response to the need for a more responsive and locally-driven
approach (Marwaha et al., 2021).
The main goal of the formation of LHINs was to improve healthcare coordination. With
Ontario’s vast geographical and demographic diversity, a one-size-fits-all approach proved
inefficient. LHINs were designed to address these vast differences by designing healthcare
services to meet the specific needs of different communities. Each LHIN was granted the
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responsibility to strategize, coordinate, and finance healthcare services within their designated
regions.
The necessity of addressing regional healthcare disparities was a key factor in the
creation of LHINs. The people of Ontario live in both urban and rural settings, each of which
presents different healthcare issues (Kurdyak et al., 2014). The idea behind LHINs was to ensure
a more fair distribution of resources and services by identifying and responding to the unique
healthcare requirements of various regions (Marwaha et al., 2021).
The goal of LHINs' decentralization of decision-making was to improve local
accountability and transparency in the planning of healthcare. In order to develop a more
adaptable and inclusive healthcare system, LHINs engaged local stakeholders, such as citizens,
community organizations, and healthcare providers.
Mandate and Functions of LHINs
The mandates of Local Health Integration Networks (LHINs) include critical tasks
related to budget distribution, community involvement, and coordination within their particular
regions. The LHINs were assigned the duty of facilitating the smooth coordination of healthcare
services, guaranteeing the effective distribution of resources, and cultivating significant
interaction with the local populations. In theory, LHINs have control over funding for healthcare
institutions like hospitals and community care access centers totaling more than $20 billion. In
actuality, though, the money comes directly from the government to hospitals and other
healthcare providers, giving LHIN officials very little control over how it is allocated (Marwaha
et al., 2021b).
Analyzing the effectiveness LHINs have in accomplishing these objectives reveals
examples of successful projects where collective efforts result in better community satisfaction
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and healthcare performance. On the other hand, implementation issues like inequalities in
resource allocation or bureaucratic roadblocks might have made it more difficult to achieve the
goals of LHINs. A thorough examination of LHINs' performance sheds light on the challenges
and successes they faced in carrying out their required duties, providing an understanding of the
overall influence these organizations have on Ontario's healthcare system (Fooks & Hylmar,
2015). Some common challenges that arise with LHINS are: bureaucratic complexity, unfair
funding allocation to different LHINs, communication challenges, and political interference in
different areas (Pilon, 2019.)
The Doug Ford Era and Changes to LHIN
In 2019, Doug Ford began a significant development for Ontario's healthcare system. The
Premier Doug Ford-led administration took on a change to the bureaucratic organizations known
as Local Health Integration Networks (LHINs), which, as discussed, are in charge of organizing
healthcare services locally. Doug Ford proposed the establishment of five regional oversight
bodies. The proposed organizations would be responsible for keeping an eye on the costs
incurred by long-term care facilities and hospitals throughout the province.
At the time, LHINs were in charge of managing the health ministry's yearly operational
budget of around $20 billion, which was distributed to hospitals, assisted living facilities, and
community health clinics. They also act as the main point of contact for patients looking to be
placed in a provincial nursing home or get publicly subsidized home care. This shift brought up
concerns about the reasons behind the adjustments and their possible effects on the healthcare
system in Ontario. The consolidation of regional oversight, possible effects on local healthcare
decision-making, and the effectiveness of the suggested model in accomplishing the intended
objectives are among the factors to be taken into account.
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The funding and planning for the health system duties of the LHINs were merged into
Ontario Health on April 1, 2021. In order to better align with its targeted service delivery
mandate of offering home care and long-term care home placement services as well as
facilitating access to community resources, LHINs have rebranded their operations to Home and
Community Care Support Services (
Local Health Integration Networks (Operating as Home and
Community Care Support Services)—Public Appointments Secretariat
, 2024).
The goal of this change was to make sure the network's financial, material, and human resources
are managed effectively and efficiently and to report to the Minister on how the resources are
being used. Lastly, to offer medical and associated social services, as well as supplies and
equipment for the care of individuals in their homes, communities, and other places; also, to
offer products and services to support caregivers in providing care for these individuals (
Local
Health Integration Networks (Operating as Home and Community Care Support
Services)—Public Appointments Secretariat
, 2024).
Overall, I support this decision to integrate the LHINs into Ontario Health. Ontario is
such a geographically and ethically diverse province, and as mentioned, LHINs provide many
disparities for various communities based on location and population. Challenges arose, such as
speed and efficiency of healthcare, as well as fairness, and I believe the integration back into
Ontario Health allows focus on distribution to all Canadians.
Future Directions and Recommendations
I think there are very many lessons that can be learned from the past structures of LHINs
to consider for the future. I think the fact that Canada is such a diverse country, specifically in
Ontario, means that we must approach different community scenarios differently; areas may need
more or less resources allocated, and we must ensure that there are no disparities and that the
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needs of Canadian citizens are being met. Some things I believe would make for good future
directions are as follows: Ensuring accountable and transparent governance. We must improve
governance frameworks to guarantee accountability, openness, and public confidence.
Establish systems for ongoing assessment and input from the community and healthcare
professionals to gauge how well LHINs or other models are working. Next, ensuring
financial support for mental health services. Given the significance of mental health for the
general well-being of the community, prioritize and fund mental health services within the
framework of healthcare coordination.
Conclusion
Overall, during this assignment, I learned about the creation of LHINs nearly two
decades ago and their initial goals. I learned about the pros, such as giving authority to different
regions to take care of their people and create a more fluent health system in Ontario; however, I
also observed the cons of the original LHINs, such as disparities in funding, lack of efficiency,
etc. Furthermore, we discussed the Doug Ford lead conservative government change from the 14
LIHNs to the five new community care support services, which hope to get rid of the cons in the
original framework of Ontario Health. To wrap it up, it is extremely important to continuously
evaluate our health-care system and to make adjustments accordingly to the demands of our
population. Canada is a continuously growing and changing community with a very diverse
atmosphere; therefore, it is extremely important to keep up with our healthcare system, ensure
we are being equitable and fair, and ensure the well-being of our lovely population is
maintained!
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References
Fooks, C., & Hylmar, S. (2015). Are LHINs influencing the patient experience in Ontario?
Healthcare Management Forum
,
28
(6), 251–254.
https://doi.org/10.1177/0840470415598329
Kurdyak, P., Stukel, T. A., Goldbloom, D. S., Kopp, A., Zagorski, B., & Mulsant, B. H. (2014).
Universal coverage without universal access: a study of psychiatrist supply and practice
patterns in Ontario.
PubMed
,
8
(3), e87-99. https://pubmed.ncbi.nlm.nih.gov/25426177
Local Health Integration Networks (operating as Home and Community Care Support Services)
- Public Appointments Secretariat
. (n.d.). https://www.pas.gov.on.ca/Home/Agency/647
Marwaha, S., Marwaha, S., & Marwaha, S. (2021a, July 15).
LHINs and the governance of
Ontario’s health care system
. Healthy Debate -.
https://healthydebate.ca/2011/06/topic/cost-of-care/lhins-2/
Ontario Newsroom
. (n.d.).
https://news.ontario.ca/en/release/54585/ontario-taking-next-steps-to-integrate-health-car
e-system
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Lacelle 7
Pilon, M.
Accountability in Ontario’s Health Care System: The Role of Governance and
Information in Managing Stakeholder Demands.
(2019.)
https://sprott.carleton.ca/parg/wp-content/uploads/ThesisPhDMarcPILON201909.pdf
Šimunović, M., Stephen, W., Kelly, S., Forbes, S. S., Cadeddu, M., Thabane, L., Grubac, V.,
Lovrics, P., DeNardi, F., Prodger, D., Tsai, S. S. H., & Coates, A. (2013). Quality
improvement in colorectal cancer in Local Health Integration Network 4 (LHIN 4)
Project (QICC-L4): Integrated Knowledge Translation in a large geographic region.
Annals of Surgical Oncology
,
20
(13), 4067–4072.
https://doi.org/10.1245/s10434-013-3218-9