Oxford County hoping for alternative public health model that includes voluntary mergers

By Heather Rivers, Woodstock Sentinel-Review

The Oxford County Administration building in Woodstock.

The Oxford County Administration building in Woodstock.

Oxford County is calling for the voluntary merger of small urban and rural public health units as an alternative to legislating health units into large regional entities to ensure more equality across municipalities.

The comments are part of a report that County Council will review Wednesday for submission to the Ministry of Health and Long-Term Care regarding the Expert Panel Report: Public Health within an Integrated Health System.

The comments need to be submitted by end of the month.

Headed by chief medical officer Dr. David Williams, the expert report released in June recommended the establishment of 14 regional public health entities based on alignment with the province’s 14 Local Health Integration Networks.

Currently the province has 36 public health units mostly based on municipal borders.

Recommendations included better integration of public health within the health system, a reduction in the number of health units to address issues faced by smaller units, a consistent public health governance model, as well as more consistency among board of health members.

“The current organization of public health units has a negative impact on the capacity of smaller health units,” the Ministry of Health report said. “Boundary changes are necessary to enhance public health capacity and effectiveness, and to help public health be more integrated with the rest of the health system. At the same time, it is important to maintain the strengths associated with public health's close relationship with municipalities.”

According to the Oxford report, if their recommendations are accepted by the health ministry it would result in Oxford County public health merging with Middlesex-London, St. Thomas and Perth health units, rather than the legislation of health units into a large regional entity that would also include Grey and Huron counties.

“The voluntary merger of small/urban health units with similar characteristics and population demographics has a greater potential to ensure a more equitable balance of resources, programs and services for communities served,” the Oxford report read.

Oxford said the model they are recommending would result in reduced overall administrative costs, increase critical mass and surge capacity, as well as increase the ability to attract and maintain highly skilled professionals.

While Oxford may not always have the capacity to deliver some of the programs and services available at larger units, according to their report it has not impacted their ability to retain a skilled workforce and address public health issues in the community.

“In fact, we have been very successful in working with Public Health Ontario and academic institutes in addressing complex situations in innovative ways,” the Oxford report read.

The report also points out that while regional boards could result in operational efficiencies, “it is unclear how these large entities result in improved services for Oxford residents or increased connectivity with our local health, municipal or other area partners.”

They also worry about how a 14-member board would provide equitable representation from across all the municipalities and the “significant costs” associated with salaries and benefits.