Trio of eastern Ontario public health units exploring merger

Three public health units in eastern Ontario are considering merging into one, in response to the provincial government's recent efforts to consolidate public health units across Ontario.

Kingston, Frontenac, and Lennox and Addington Public Health, along with the Leeds, Grenville and Lanark District (LGLD) Health Unit and Hastings Prince Edward Public Health, said in a joint news release last week that they would begin investigating the feasibility of a potential merger in January.

Altogether, the three health agencies provide services for communities stretching roughly from Prince Edward County, Ont. to Cornwall, Ont.

Back in 2019, the province announced plans to combine 35 public health units into 10, but those plans were put on hold when the COVID-19 pandemic hit in 2020.

In August, Health Minister Sylvia Jones said the province will offer funding to those that voluntarily merge as the government works on a long-term approach to the structure of the health-care system.

Peter McKenna, chair for the LGLD board of health, said now is a good time for public health units to consider whether a merger could work.

When the province first announced the merger plans in 2019, McKenna said LGLD wasn't entirely on board. But now it has the chance to make the choice on its own terms.

"We have an option of a voluntary merger with health units that are contiguous to our geography that we've probably worked with in the past," he told CBC Radio's All In A Day.

A chance to 'strengthen' services

McKenna said his board is obligated to look at how services will be delivered locally in the long term.

"We're about 100 staff and [have a] $14-million budget. That's very small in the health-care sector today, and our revenues were growing below inflation — but our costs were exceeding that," he said.

McKenna said the three boards will be considering if they'll be stronger together.

"What if one plus one plus one actually equals four? [Will] the three of us coming together strengthen our capacity to better serve our population?" he said.

"That's the theory. We wouldn't have gone down that road if we didn't believe it's quite possible."

Ontario Health Minister Sylvia Jones, seen here in January, announced in August that the province would be providing one-time funding and support to public health units that voluntarily merge, as part of government efforts to restructure the public health systen. (Frank Gunn/The Canadian Press)

Centralization a 'bad idea,' says advocacy group

Merging public health units is a "bad idea," said Ross Sutherland, a retired registered nurse and chair of both the Kingston Health Coalition and the Ontario Health Coalition.

"This centralization — especially of public health —  is, I think, harmful to the way we deliver public health. Public health has to be rooted in community, it's just by its nature," he said.

No two communities are the same, Sutherland said, and similar health issues may be addressed differently — especially between rural and urban areas.

Centralizing public health comes with the risk of losing connection with the community, he added, especially since health boards will cover much larger geographical areas.

But that doesn't mean public health units shouldn't look into ways they can work together, Sutherland said.

"There is lots of room for public health units to co-operate on programs, and I think that the province should be encouraging that," he said, adding that could help them share resources and knowledge while maintaining their individual structures.

Won't change front-line care, says health unit

If all three boards go forward with a voluntary merger, a proposal will be submitted to the Ministry of Health by March 2024 and will be subject to the ministry's approval.

Front-line health workers would not be affected by any merger, McKenna said.

"I can speak for all three health units. All of the front-line services that the public expects from us will continue," he said. "All of the staff who deliver those services, and where they deliver them, will continue in the same way."