Cathy Majtenyi: Health care discussions don’t belong in backroom

It was a dramatic scene at Queen’s Park on Jan. 31: NDP Leader Andrea Horwath waving a copy of The Health System Efficiency Act 2019, a leaked bill that would see the Ontario government create a “super agency” to manage the province’s health care system.

This body would reportedly integrate more than 20 health agencies, such as Cancer Care Ontario and local health integration networks, into one centrally managed entity, a move Horwath says gives the government “unprecedented power to farm out” services to private companies.

A flurry of denials and counter-claims by Health Minister Christine Elliott ensued. She emphasized that the legislation is only a draft and that “the NDP have been crying wolf about the privatization of the health care system,” among other comments.

This situation is extremely worrying for many reasons, not only because of the spectre of privatization but the way in which the views of Ontarians are being squeezed out of this controversial policy direction.

Setting up, and managing, a cost-effective yet efficient health care system that ensures universal access is a huge challenge. It’s the type of undertaking that requires input from a wide range of front-line professionals who have expertise in all aspects of health care, and from those who are deeply committed to preserving the concept of “universal.”

While Elliott is claiming that broad health care consultations have, and are, taking place, doctors’ and nurses’ associations claim that not only has the Ontario government neglected to approach them, but politicians have “completely ignored” the groups when they did reach out.

Instead, health care professionals are speaking through the press, expressing the opinion that a centralized system could erode patient care, increase wait times and treatment costs, and make “the wealthiest the healthiest.”

In wake of the leak, Elliott has promised more consultations on what she calls the “early draft” bill. But can we be sure these “consultations” will be anything more than window dressing?

This skepticism is based on another document — dated Jan. 17 — that Horwath revealed several days after she exposed the draft health care bill. This second document says cabinet had already approved the agency that will fully integrate health care and that an interim board of directors had already been assembled, leading Horwath to call the bill “a done deal.”

And in a Feb. 5 report, the Toronto Star confirmed that last month the Ontario government incorporated an entity called the “Health Programs Initiatives.” This new body, according to one source close to the government, is “one and the same” with the super agency outlined in The Health System Efficiency Act 2019.

That revelation, combined with the leaked Jan. 17 document, indicates that the government is much further along the process of centralization than merely being in the “consultation” stage.

This is not the first time that such lack of transparency has taken place. On July 3 last year, Ontario officially announced it had cancelled the province’s cap-and-trade program, an initiative of the previous government to combat climate change by creating a system that set a limit on gas emissions a company could emit before it had to purchase allowances from companies that were below their limit. 

The idea was to encourage an overall reduction in the amount of greenhouses gases that businesses and institutions would emit. But legislation ending cap and trade was passed at the end of October, with Environment Minister Rod Phillips saying the program was dismantled in response to a “mandate that we got from the people of Ontario.”

Now fast forward three months, when Environmental Commissioner of Ontario Dianne Saxe reported that less than one per cent of the 11,000 submissions made during the consultations fully supported cancelling the cap-and-trade program. It’s clear that the government intended to proceed with its dismantling plan despite what Ontarians said in these “consultations.” 

Will it be any different when it comes to health care management?

Catholic social teaching unequivocally states that governments — tasked with building the common good, promoting human dignity and protecting human rights — are accountable to the people they serve.

“Civil society, therefore, cannot be considered an extension or a changing component of the political community; rather, it has priority because it is in civil society itself that the political community finds its justification,” says Section 418 of the Compendium of the Social Doctrine of the Church.

Accountability requires that government cast aside ideologies and pre-packaged, speedy solutions when confronting policy challenges and instead bring in front-line professionals, patients, labour groups and other stakeholders as equal partners in the overhaul of the health care system. The potential opening up of the health care system to mass privatization is simply too important to be conducted in backroom discussions.

It’s a shame that Ontarians found out about the government’s early steps towards centralization through press conferences rather than open communication. 

(Majtenyi is a public relations officer who specializes in research at an Ontario university.)