Northeastern Ontario health units fear provincial funding cuts post-pandemic

Some municipal taxpayers in northeastern Ontario are shelling out a lot more this year for public health units.

And they could be paying even more in the coming years if the province doesn't keep up COVID funding after the pandemic subsides. 

Algoma Public health is getting an extra $470,000 from cities and towns in the district, a hike in its overall budget of about 10 per cent.

Blind River mayor and health board chair Sally Hagman says she knows politicians will be under extra scrutiny with municipal and provincial elections this year. 

"This is an election year, so you're going to hear a lot of pushback from residents about the cost of doing business, both municipally and provincially," she said.

"And rightly so. Money doesn't grow on trees."

But she says this extra money is needed to hire new staff to do everything health units do, a list that includes COVID response but also all the health protection and promotion programs that are now resuming after two years of the pandemic.

"It is money well spent," said Hagman.

"COVID more or less shone a light on public health ... a lot of people just took it for granted that public health was there, not really knowing what we do."

Public Health Sudbury and Districts also asked for an extra seven per cent or about $593,000 from cities and towns in Sudbury-Manitoulin this year.

The North Bay-Parry Sound Health unit is getting an additional two per cent from municipalities, but refused to discuss its budget until it knows how much it will receive from the province, which often doesn't happen until later in the year. The Porcupine District Health Unit told CBC that its budget for 2022 is $11 million, but provided no other information.

Carman Kidd, the mayor of Temiskaming Shores and chair of the Timiskaming Health Unit, says they managed to keep their municipal increase to two per cent this year.

But like most other health units, he worries about what will happen if the province doesn't keep up its COVID mitigation funding next year.

Kidd says it has filled most the gaps left by provincial cuts and changes to public health funding formula leaving cities and towns with 30 per cent of the bill just before the pandemic in 2019, but fears it won't be continued into 2023.

"I imagine with the election over they might not be too concerned with providing that additional funding and I'm sure they'll drop it altogether," he said.

Kidd says Timiskaming public health would then have to choose between cutting services or asking municipalities for an extra 25 per cent.

"There'll be a lot of people pretty upset. Because that does hit their budget pretty hard," he said.

Kidd says the province also hasn't given up on the idea of consolidating health units to save money, even though it hasn't been mentioned much during the pandemic. 

"It's still on the backburner. You talk to the ministry people and within the staff, it's still on their backburner, they're still looking at it," he said. 

"People still think they can save some cost."

Dawn Armstrong, the regional vice-president with the Ontario Nurses' Association which represents almost all public health workers in the northeast, says their members are "still walking on egg shells" expecting post-pandemic consolidation.

Her union is instead calling for a boost in public health funding in the provincial budget expected in March to help with COVID response, but also with the opioid crisis and all the routine public health work that's been short-staffed in recent years.

"There are not enough public health nurses to provide a robust response to our regular immunization programs, school children immunizations," says Armstrong. 

The Ontario Nurses' Association hopes to make public health funding an election issue, but municipal leaders like Hagman think it's more likely voters and opposition parties will focus on long-term care and other public health-related topics.

Joe Lyons, a professor at the University of Western Ontario and director of the local government program, says the pandemic has raised the profile of health units, but that doesn't mean the province won't still argue for consolidation and further cuts.

"It could go either way," he said.

"It's also perhaps easier to have a uniform policy across the province if the province has more control over more regionalized health units."

But Lyons says that would mean a loss of "local responsiveness and local accountability" including the "scrutiny" of public health spending during "municipal budget season."