Ontario Ombudsman André Marin today released the results of his latest special investigation, calling on the province to improve the accountability and transparency of Local Health Integration Networks (LHINs) across the province.
In The LHIN Spin, the Ombudsman’s report on the use of “community engagement” in the decision-making of the Hamilton Niagara Haldimand Brant LHIN, Mr. Marin found the Hamilton Niagara Haldimand Brant LHIN illegally closed several meetings to the public for the purposes of “education” of its members. The meetings were related to two controversial hospital restructuring plans involving Hamilton Health Sciences and the Niagara Health System.
“It is a very serious matter to close a LHIN board meeting to the public,” Mr. Marin says in the report, noting that the legislation governing the LHINs only allows closed meetings in very strict circumstances. “While the LHIN may have been well-intentioned in holding its ‘education’ sessions, these meetings were plainly illegal.”
In a last-minute change of heart, the Ministry of Health and Long-Term Care advised the Ombudsman on Monday that it would direct the LHINs to cease what he called a “clandestine practice.” Mr. Marin welcomed the news: “I’m pleased the Ministry is going to direct the LHINs to change their bylaw, as I recommended. The public should never have been shut out of these meetings.” He noted that the Ministry also proposed new guidelines to all LHINs about three weeks ago, aimed at clarifying their obligations to be open and engaged with the public.
The investigation, which involved interviews with representatives from several LHINs across the province and Ministry officials as well as local stakeholders, was conducted by the Special Ombudsman Response Team (SORT) in response to about 60 public complaints that the LHIN failed to adequately consult the public about the Hamilton and Niagara restructuring decisions. The Ombudsman found that “community engagement,” while required by law, was “undefined and inconsistent.” One LHIN board member counted his discussions with people on the golf course or in line at the grocery store as “community engagement” – meanwhile, the LHIN relied on community outreach done by health service providers with little scrutiny or documentation.
“Many who complained to our office were left frustrated, confused and dissatified by the public consultation process,” the Ombudsman added, noting that the LHIN has done little to change its attitude. “The LHIN’s apparent failure to grasp the significance of its transgressions – and its reluctance to alter its practice – do not bode well for the integrity of its decision-making in future.”
The Ombudsman’s investigation focused on the LHIN’s decision-making process and how it could be improved, not on the details or implications of the restructuring plans themselves. His office oversees the Ministry of Health and Long-Term Care, as well as all of the LHINs, but has no direct jurisdiction over hospitals.
LHINs were established in 2006 amid promises that they would ensure the public would be directly consulted about difficult health-care restructuring decisions, Mr. Marin noted. However, he said his investigation indicated “the reality of community decision-making has fallen far short of the political spin.”
“LHINs make difficult and sometimes unpopular choices about health services,” he said. “Unless this process is open, the decision may be transparent, but the reasoning behind it will remain opaque and the public will be left confused, frustrated and dissatisfied.”
The HNHB LHIN investigation is the 25th systemic investigation by SORT since the team was created by Mr. Marin in 2005. He began his second five-year term as Ombudsman on June 1. SORT investigations have sparked government reforms to, among other things, screening of newborn babies, the property tax assessment system and the security of the lottery system.