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Section: Editorial/Opinion

FOR A bunch of politicians who promised to be different if elected, the McGuinty Liberals sure like to repeat history.

They’ve set the wheels in motion for another health care rollercoaster ride in pursuit of that most attractive illusion, integration, and the so-called financial savings that politicians’ dreams are made of. Dream on.

It hasn’t been that long since Mike Harris’ Health Services Restructuring Commission roamed the province, merging and closing hospitals. That experiment with integration did not rein in costs. In fact, costs rose. Many of the restructuring plans were so extreme they did not get off the ground. Others left a shambles for exhausted and demoralized hospital staff to clean up.

Yet the revolutionaries in the Liberal caucus are intent on “transforming” health care once again, through local health integration networks or LHINs.

There will be 14 of these beasts, some with boundaries that are enormous. LHINs will have the power to fund — and restructure — hospitals, long-term care and home care services. With integration as their top priority, these government creatins will almost certainly centralize services, moving jobs and services like food preparation out of local communities.

But why would they care? Despite their name, LHINs will be accountable to the minister of health, not the local community. Anyone who has had to deal with a community care access centre knows how this ride ends.

Right now, hospitals are based in our communities. They have fought cutbacks to ensure care for communities. Community care access centres did the same until the province took them over. Their resistance died instantly — as did the funding increases they had been able to win with community support.

There’s not a lot of evidence from recent attempts to integrate other provincial services that it actually saves money.

In the 1990s, two large, centralized jails were built along with a new centralized facility to cook and chill their meals. The result?

Existing institutions actually produced food more cheaply. And the new cook-chill facility was only able to supply six institutions instead of the promised 10. Despite a decline in the average inmate count, operating costs for institutional services increased by 19% over four years.

Government logic simply assumes that health care integration will save money. That’s far from certain. Other provinces have integrated health care services, but it’s Ontario hospitals that have proved to be the most efficient in the country.


Part and parcel of the Liberal plan for health care integration is the attempt to sneak privatization in through the back door.

That’s what happened with home care. Huge corporations have replaced agencies like the VON and Red Cross, which have decades of experience. The Liberals have already completed two massive public-private partnership (P3) hospital deals that will see more than 1,000 hospital jobs turned over to corporations.

Besides profiting from the public purse, privatization works against integration. It adds myriad players operating on different principles — for-profit principles — from the ones that guide public health care. When you contract out health care, you contract out the power to control it and the cost of providing it.

The Liberals need to make up their minds — will the public control health care or will the government hand over its power to private corporations? Will hospitals, long-term care facilities and home care providers be accountable to the communities they serve or to a board of political appointees?

We need to send a strong message now, before the damage is gone and another bumpy health care ride goes off the rails — no to eroding community control, no to moving services and jobs out of our communities and no to privatizing health care delivery.