What Ontario's plan to reduce public health units could mean

The Ford government is consolidating local health units cutting their budgets by 27 per cent, a move that will mean a lot of pressure on those who deal with health and water inspections, infectious diseases and vaccinations. 

The cut from 35 to 10 local health units and the $200-million reduction in funding over the next two years were announced in yesterday's Progressive Conservative budget. 

"There's still a lot of details to be worked out, but public health work is important work," said Dr. Chris Mackie, the medical officer of health for the Middlesex-London Health Unit, which covers a large chunk of southwestern Ontario. 

"Public health teams help stop the spread of infectious diseases like SARS and meningitis, they inspect pools and spas, prevent the next Walkerton. We have programs that offer vaccinations, we support early childhood development, breastfeeding support, prenatal support. "

The $200-million cut equals an across-the-province reduction of 27 per cent, from $743 million. 

"That will put real pressure on administrative costs but also front-line services," Mackie said. 

Many questions

That sentiment was echoed in other parts of the province as community leaders wait for details about how the cuts will impact services. 

On the face of it, I'm troubled- Karen Redman, Region of Waterloo chair

"This government is very keen on centralizing things and I question accountability and service delivery," said Karen Redman, the Region of Waterloo chair.   

She points to the success her community's public health board had acting as early adopters of smoking bans in public places. Redman also questions what the changes will mean for supervised consumption sites with Kitchener waiting for site approval and Cambridge engaged in discussions. 

It's not clear yet if specific programs will be targeted by the cuts or if the cuts will happen across the board. 

"There are a lot of questions to be answered about how these consolidations will impact care," Mackie said.

Room for optimism

But Mackie adds the consolidation of 35 health units to 10 could be beneficial for some programs, he added. 

"There are lots of exciting opportunities there. You will get larger scale organizations that can integrate and coordinate across regions," Mackie said.

The budget document said the government's move to consolidate services would "protect what matters most by ensuring public health agencies focus their efforts on providing better, more efficient frontline care by removing back office inefficiencies through digitizing and streamlining processes." 

In southwestern Ontario, the new plan would likely dissolve the Middlesex-London Health Unit, amalgamating it with health units in the Bruce Peninsula and Elgin County areas, Mackie predicted. 

However, with looming cuts to health care, Mackie said the consolidation process has to be done "very carefully if we're going to avoid significant health impacts."