Health experts are warning that Ontario’s proposal to dismantle government agencies such as Cancer Care Ontario and the Trillium Gift of Life Network could erode patient care, as more details emerge about the province’s plans to overhaul the health-care system.
On Monday, the NDP released another set of confidential documents about the government’s proposed health-care changes – a development that saw an unnamed bureaucrat fired and the Ontario Provincial Police called in. An OPP spokeswoman said Tuesday the force’s anti-rackets branch is now reviewing the matter.
Three days earlier, the NDP released draft legislation outlining how the government plans to centralize patient care under a single “super agency,” folding several groups into one. Some health experts fear the loss of independent agencies could mean important matters such as cancer care and organ donation will get lost amid competing health priorities, such as reducing emergency room wait times.
“I’m really concerned about the future of Ontario cancer care and also the future of transplant care,” said Bob Bell, a former head of Toronto’s University Health Network and a vocal critic of the government’s proposals. “As a cancer surgeon, I’ve seen what Cancer Care Ontario has done to improve the system.”
Cancer Care Ontario develops best practices for clinicians, uses data to spot problems with patient care and creates evidence-based guidelines. It’s a “leader” in cancer care in Canada – and making significant changes to its reporting structure and mandate could threaten that, said Kerry Kuluski, a scientist at the Lunenfeld-Tanenbaum Research Institute in Toronto.
“They’ve exemplified what an integrated system can look like,” Dr. Kuluski said. “We don’t want to lose some of the things these institutions have done and how it can inform what’s done.”
Being independent means they can respond quickly to emerging issues, such as providing advice on new cancer drugs that come on the market, Dr. Bell said.
He also expressed concern about the future of organ donation in the province. The Trillium network co-ordinates transplants from beginning to end and has helped make Ontario a leader in the field, Dr. Bell, who was also a former deputy health minister in Ontario from 2014 to 2018, said. But it’s a relatively small part of the health-care system, so it may no longer be seen as a priority under the new super-agency system and may not receive the same resources or be as effective, he said.
“There are a very small number of transplants in Ontario, so what problems are going to get priority? New organs or emergency department waiting times?” Dr. Bell asked.
Donald Carlow, the former chief executive of the BC Cancer Agency, said in an e-mail that Cancer Care Ontario is envied throughout Canada and internationally and that dismantling it would be going in the “wrong direction.” The government should leave it alone, he wrote.
Richard Klasa, a retired medical oncologist with the same agency who worked there when the B.C. government put it under the control of a regional health board, said the change meant the agency no longer had a direct line to the health minister, which created delays and unnecessary red tape.
“It made us a little less nimble,” he said.
Michael Sherar, the CEO of Cancer Care Ontario, said the province’s cancer system is working well and that, even if the structure changes, the priority should be on maintaining “an excellent cancer-care system."
In a statement, Trillium CEO Ronnie Gavsie said provincial support has helped the network become an international leader and that it remains committed to saving lives.
Health Minister Christine Elliott told reporters Monday that “no patients are going to fall through the cracks” as a result of the government’s changes.
Other documents released by the NDP Monday indicate that Premier Doug Ford’s cabinet has already approved the new super agency and the appointment of three board directors. NDP Leader Andrea Horwath said the documents reveal the government is on a path to privatize aspects of the health-care system.
Ms. Elliott has said the government does not intend to create a two-tier health-care system. She would not confirm whether cabinet has approved any aspect of the health-care transformation plan.
Prior to the confirmation that a government employee had been fired, Ms. Horwath also expressed concern that the government would be calling in the OPP. She said it raises more questions about the appointment of Mr. Ford’s friend Ron Taverner as the next OPP commissioner. Mr. Taverner has put his swearing-in on hold as the Integrity Commissioner investigates whether the appointment constitutes a conflict of interest.
“It does raise the question: If Mr. Taverner were in the role of the OPP, could we all be confident that it would be an independent decision of the OPP?” Ms. Horwath said.