Regardless of decision, consultation should have occurred

August 29, 2008

While a panel of judges has ruled the Central East Local Health Integration Network (CE LHIN) acted lawfully in not consulting the public before approving changes to the Ajax-Pickering hospital, as a public institution it, and especially the hospital board, should have done so.

The changes included the controversial movement of 20 mental health beds from the Ajax-Pickering to the Centenary hospital, which together make up the Rouge Valley Health System (RVHS). The Ontario Public Service Employees Union (OPSEU) took the CE LHIN to court over the matter, and the panel of three judges of the Divisional Court of the Ontario Supreme Court of Justice dismissed OPSEU's application for a judicial review.

"The LHIN did not require approval of the specific measures proposed by RVHS, as that was an internal hospital decision," the ruling stated. "What (the) LHIN decided was to fund RVHS on the basis of its representations in the respect of fiscal improvements aimed at eliminating the budget deficit."

The last line is interesting in basically stating the decision was made to save money. Was it then just a happy coincidence that the removal of the mental health beds from Ajax to Scarborough would also mean better service for the patients and residents of Ajax-Pickering, as former hospital board chairman Tom Atkins and Rik Ganderton, Rouge Valley president and CEO, stated after the public furor? Was it one, the other or both?

The first line, it could easily be argued, confirms suspicions that the LHINs were created as a buffer to further distance the public from the provincial ministry of health and local health-care decision-making.

Regardless, the issue is that the general public was kept out of the loop and there was no public consultation whatsoever until media pressure forced it.

The hospital board had the opportunity, well before the decision was put in place and approved, to explain to the community what was happening, when and why. When this occurs after the fact, the average citizen is rightly suspicious, even angry, as occurred in this case.

As we said in a previous editorial, consultation does not necessarily mean the public will determine what occurs at the hospital and, specifically in this case, how the budget deficit should be addressed. Joe and Jane public are simply not qualified to offer that kind of input.

However consultation would have allowed Mr. Ganderton to make the case for the beds move before the media coverage of the public's outrage. He did this as damage control in a letter to the editor, stating that "lost is the fact the new model (for mental health care) will improve mental health care by" etc.

It was his and the board's job to ensure this message was not lost, even if members of the public didn't believe him.