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'Funding' decision to move beds

Union challenges Local Health Integration Network on its own guidelines

July 13, 2008 - 04:45

By Kristen Calis

TORONTO -- Three judges will decide whether the Central East Local Health Integration Network defied its own mandate when approving a decision to transfer 20 mental health beds out of the Ajax-Pickering hospital.

The Ontario Public Service Employees Union took the CE LHIN to an Ontario Superior Court of Justice Divisional Court at Osgoode Hall in Toronto Friday. OPSEU believes the court should order the CE LHIN to revoke its decision and properly consult the public before approving the RVHS’s plan to move the beds from Rouge Valley Ajax and Pickering Hospital to Centenary Hospital in Scarborough to help relieve its massive debt.

OPSEU representative, Elizabeth McIntyre, argued private talks between the Rouge Valley Health System and the CE LHIN took place in secret only to push the hospital’s agenda through as soon as possible. The hospital’s plan was made public on March 25, and was passed by the CE LHIN three days later. Although the decision was discussed at the LHIN’s meeting just before approving it, Ms. McIntyre argued little time was spent on it, and the public could not speak up. And although the CE LHIN ordered a 30-day consultation period with the public, OPSEU argued there’s a difference between consulting the public before making a decision and discussing the plans with the public after the decision was made to simply educate them.

“It’s a fundamental purpose of the LHIN...to engage the community,” she said.

The Rouge Valley Health System (also in court as an interested party) argued the decision the LHIN made was based on funding. While it approved the transfer of 20 mental health beds, it was part of a bigger plan each hospital must agree to in order to receive funding from the LHIN. RVHS had to show its plans to get a balanced budget. Also, RVHS would have made its decision to move the beds anyway, RVHS lawyer William Carter said adding the board does not have to consult the LHIN for moving services around within one hospital system.

“(That) is an indoor management decision,” he said.

The CE LHIN’s lawyer Kim Twohig said the decision to move the beds was one of many difficult ones RVHS had to make in order to start eliminating its debt. Plus, she said, the LHIN already did consult the public and didn’t change its mind.

“In this case if the so-called decision of the LHIN is set aside in order to have public consultation, nothing will change, nothing will be gained because public consultation already occurred,” she said.

Since the Province of Ontario, which used to be responsible for funding allocation, never used to consult the public when making funding decisions, why should the LHIN? Mr. Carter argued. He said the meetings that took place between RVHS and the CE LHIN before presenting the decision to the public was with the finance committee.

“In my submission this was a funding decision, not a planning decision,” he said, adding the hospital could have gone through with the decision to move the mental health beds without the LHIN’s approval; it was simply showing it had plans to eliminate its deficit.

But Ms. McIntyre fired back, arguing funding is involved in just about every decision the LHIN makes regarding hospital decisions. On top of that, she added, closing mental health beds is a substantial decision.

“You can always characterize any decision as a funding decision,” Ms. McIntyre said.   

Mr. Carter pointed out Ms. McIntyre continuously referred to the hospital’s plans as “closing” beds as opposed to “transferring” them.

“The deficit elimination plan is not something which constitutes a wthdrawl or cessation of services; in fact it’s increasing services,” he said, referring to the pooled mental health resources Centenary will get as a result, and adding RVAP’s mental health beds are usually only at an occupancy rate of about 70 per cent.

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