While the province may have pressed pause on plans to merge health units across Ontario, the Simcoe Muskoka District Health Unit (SMDHU) is still hoping to have its say at the provincial table concerning possible future changes to public health.
In a letter sent to the province and provincial special advisor Jim Pine by SMDHU chair Anita Dubeau on Nov. 20, Dubeau references the change in tone from the province, and affirms the health unit’s current stance on potential changes that may come in the future.
“Given this, I am writing on behalf of the Board of Health for the Simcoe Muskoka District Health Unit to recommend that the Simcoe Muskoka District Health Unit remain as an independent health unit operating within its current boundaries and under its current governance structure,” wrote Dubeau.
Medical officer of health Dr. Charles Gardner says the health unit initially got word back in May that the province was looking to create 10 regional public health units, down from 35.
At that time, the Simcoe Muskoka District Health Unit was informed it would be disbanded next year and merged with neighbours to the north and south as part of a provincial consolidation into larger public-health units. The Simcoe County portion was to be merged with York Region operations, while the Muskoka component was to be folded into an area covering a vast geographic region in the northeastern area of Ontario.
“We weren’t told. We discovered it by reading the (provincial) budget,” Gardner said this week in an interview. “It was concerning to us.”
According to the 2016 Census, 540,249 people were living in the service area of the SMDHU. According to Dubeau’s letter and current literature on the issue, this population size is consistent with evidence demonstrating the ideal population size to realize public health outcomes serves a population of about 500,000.
Overall, Gardner says there is some public confusion about the role of health units in Ontario and their importance.
“The rest of the health care system sees people one at a time to deal with illnesses and assessment,” said Gardner. “That’s very important, but it’s also important that we look at how we can change our living conditions so we can promote health in the first place.”
Some of the responsibilities of the health unit are overseeing vaccines, testing drinking water, restaurant inspections, enforcing the Smoke-Free Ontario Act, nutrition at schools and dealing with public health emergencies.
“For example, if we have a large-scale outbreak of an infectious disease, we deal with that. A good example would be the recent legionella outbreak in Orillia. We led in that investigation,” he said.
“A lot of it is bigger scale, but not really noticed or appreciated by people until you have an event, or a disaster or an outbreak,” said Gardner. “Then, it comes really high-profile. So it’s important that these things happen and they be done well. For them to be done well, you need a strong public health system.
“If you’re going to make changes to the system, it needs to be done carefully,” he added.
In October, the province announced it was appointing Pine as a special advisor for renewed consultations on strengthening and modernizing public health. Pine is chief administrative officer of the County of Hastings and former member of the board of directors of the Association of Municipalities of Ontario (AMO).
Pine will be undertaking new discussions between the Ministry of Health and public health, emergency health and municipal stakeholders.
“We wanted to advocate to the province that we want to remain as we are with our present boundaries and present governance approach,” said Gardner.
Gardner said the health unit has received verbal communication from the province that the consultations will conclude by the spring of 2020. Part of consultation will be with the public with an online survey, which is expected to be released in the coming months.
