County councillors push back on provincial changes to healthcare

Pembroke — Renfrew County councillors are worried about a lack of local input as the province moves to take away local control of the Health Unit and the paramedic service.

“There are huge impacts to every health unit and district in Ontario,” Killaloe, Hagarty and Richards Mayor Janice Visneskie Moore told Renfrew County councillors last Wednesday, pointing out the $200 million cut in funding will mean a greater burden on municipal taxpayers.

The provincial changes to both the health unit and paramedic service were announced a few days before council met and local politicians were reeling at the impact, noting this would remove local control over how both public health and paramedicine are managed.
Mayor Visneskie Moore, who chairs the Renfrew County and District Health Unit, said she was on a conference call earlier in the morning with the chairs of the boards of health from across Ontario. All are opposed to the reduction of public health units from 35 to 10 under this proposal and concerned local municipalities will also be tasked with contributing a greater share of the cost.
“Right now it is funded 75 per cent by the province and 25 per cent by municipalities,” she explained. “They are talking about shifting the funding to 70 per cent and 30 per cent.”

Petawawa Mayor Bob Sweet asked if the Association of Municipalities of Ontario (AMO) has taken a stand on this issue yet.

“Or is this so fast AMO has not had a chance to react to it?” he asked.

Renfrew Reeve Peter Emon, who sits on an AMO board, said the association has been actively pushing the province to speak to AMO about decisions like this.

“These amendments are dropped quickly into the public domain,” he said.

Local municipalities need to have some governance of how these services are managed, he stressed.
“The municipal partners contribute a significant amount to these services,” he said. “I have a problem with the cost of these services going up, especially if the province appoints board members. When they are talking about 10 health units, I would think there would not be much of a municipal presence.”
Mayor Sweet said the county could be faced in a position with negative repercussions if the province begins to reverse uploads of costs which had previously been downloaded.

“This is the small tip of the iceberg of a bigger problem,” he said. “Where are we going with this?”

Mayor Visneskie Moore said the Renfrew County District Health Unit is expressing concerns but also wants an opportunity to work with the province and is trying to look at a positive approach.
“One thing that did come that was positive was dental care for the disabled, low income and seniors,” she said.

Admaston/Bromley Mayor Michael Donohue said there are some programs through the health unit which are funded 100 per cent by the province. He said the future of this funding remains unknown amidst the $200 million cut to health units.

“There is no statutory obligation for the province to contribute to public health,” he cautioned.

The role of public health is very important and is affected by local influences, he added.
“These vital services are upstream of the health care system,” he said.

Mayor Donohue said the consolidation of these services into more centralized locations does not fit the needs of rural Renfrew County.
“Our input will be diminished with having to put more money on the table,” he said.

Laurentian Valley Reeve Debbie Robinson said municipalities could not afford to pay more for what should be a provincial responsibility.
“If the expectation is municipalities will pick up where the province leaves off, that is not going to happen,” she said. “The reality is services will be cut. We cannot afford this.”

Warden Jennifer Murphy said this is an issue for municipalities and counties across the province.

“If we are sitting here as 17 of the 435 municipalities in Ontario, you cannot tell me at some point municipalities cannot pick up the funding and there will be service cuts,” she said.

Council passed a resolution asking the province to maintain the current level of funding for the health unit, eliminate the planned $200 million cut and stop the planned reduction of public health units from 35 to 10.

Paramedic Changes

Councillors also expressed their concern about the provincial plan to see 59 paramedic services in the province reduced to 10 through restructuring, as well as the 22 dispatch centres reduced to 10.

In a resolution, county council expressed a desire to continue with plans to design and build a new paramedic base and purchase five ambulances despite the provincial announcement. The resolution noted the county developed the emergency services program in 2001 and contributes 38 per cent of annual funding, with the City of Pembroke contributing an additional 12 per cent. As well, the county has funded $10 million in infrastructure investments.

“Rural communities have the most to lose, given the socio-economic and population health disparities that are pervasive in the province and amplified in the County of Renfrew,” the resolution stated.

Mayor Donohue said he was concerned with how quickly these changes, as well as the entire health care modernization has unfolded.
“The province has shown a disregard for municipal funding partners,” he said. “It does not recognize the mature level of government that is municipal government.”

Warden Murphy said she is concerned about the changes being made which affect local people yet have no local consultation.
“When we speak of long-term care homes and paramedic services, we are the people with boots on the ground,” she said. “I wonder how this will flow down to social services and education as well.”

The warden questioned how many more changes would be coming from the province.

“We are dedicated to delivering the services we need,” she said. “In the meantime, we surge forward. We are going ahead with the ambulance base and ambulance purchases.”

Reeve Emon said he was also very concerned about the provincial plan to consolidate Emergency Medical Services (paramedics) which would eventually lead to privatization according to a document EMS Vision – Ontario 2050.

“This is a scary act,” he said. “There will be financial repercussions.”

The end goal is having the service contracted out to the “best agencies” with no indication of how this will be done, he said. As well, some of the examples used in the document were directly taken from a similar document written in the United States, he said.

“We pay more, receive less and have less say,” he concluded.

“It speaks to a lot of privatization which is a very American model,” Warden Murphy said.