STANDING COMMITTEE ON GOVERNMENT AGENCIES
COMITÉ PERMANENT DES ORGANISMES GOUVERNEMENTAUX
Tuesday 7 October 2008 Mardi 7 octobre 2008
We’re very pleased that we have a delegation. Welcome to Queen’s Park and to our committee. I should just say, by way of introduction, that we normally meet each week when the House is in session and consider either agencies themselves or appointments to agencies. You’ll have a sense of that this morning because we will be looking at the work of the committee by way of its committee reports as well as its intended appointees. I certainly hope you find being here useful.
The Chair (Mrs. Julia Munro): We will now move to today’s appointment review. I would ask for Leslie A. Benecki, the intended appointee as member, South East Local Health Integration Network. Good morning, and welcome to the committee.
As you might know, you have the opportunity to make a few comments, should you wish, and then we will have questions from the members of the committee. This morning, we will begin with the government members. But if you’re ready, please feel welcome to begin.
Ms. Leslie Benecki: Thank you for the opportunity to meet with you. For 20 years, I have worked in the health care sector and have been an active community volunteer. My graduate degrees are in management: one in health services administration, and the other in business. My work as a clinical dietitian has given me experience as an allied health care professional.
I have significant experience in community-based organizations, both as a hands-on volunteer and as a board member. For example, in Kingston I have co-chaired two school councils, and I’m currently on the board of the Canadian chapter of the American College of Healthcare Executives.
When the Kitchener Downtown Community Health Centre started, our organization was able to move forward quickly by fostering a shared vision, forming community partnerships and developing an environment of trust and mutual respect.
Another strength I bring to the board is a strong understanding of the various roles of government and the health care sector. I worked as a manager at Alberta Health and was responsible for implementing pilot projects on primary health care reform. At the community health centre, I was accountable for core funding provided by the Ontario government, as well as the transfer payment agency contract for midwifery services.
During my work as a research associate at Queen’s University, I conducted field work throughout the South East LHIN area on a project related to primary care for people with disabilities. This research, funded by the primary care health transition fund, was administered by the Ministry of Health and Long-Term Care.
I have been a part of several new initiatives, including the creation of a non-profit housing organization in the 1980s, working at Alberta Health during the 1990s when regionalization was initiated, and being the founding executive director of a community health centre in the early 2000s.
My capacity to focus on priorities, develop strategic plans, monitor progress and keep a broad long-term perspective has helped me to be successful, and I look forward to applying these skills at the South East LHIN.
Mrs. Liz Sandals: Thank you very much for appearing before us this morning. The government will be supporting your appointment. I think that with your background in health administration, your academic qualifications and your experience with a variety of boards and agencies, you will be a great asset to the LHIN board.
Ms. Leslie Benecki: Sure. When the LHINs were first announced in 2004 to the beginning of 2005, there were a number of public calls for board members. That’s how I initially heard about the board appointments. I think it was through the newspaper.
Ms. Leslie Benecki: Nobody asked me. I was interested in regionalization because of my experience in Alberta and thought that it was a really interesting opportunity. At the time, in 2005, I did put forth an application. However, by the time the interview process started for that, about six or seven months had passed and I had just started a new job at Queen’s University. The timing wasn’t very good for me at that point, so I said, “Maybe another opportunity will come up,” and here we are a few years later.
Mr. Peter Shurman: Can we spend a minute or two on the comparison between the Alberta model and the local health integration network model of Ontario? You have experience with the regional model of Alberta. Could you give us a bit of a comparative?
Ms. Leslie Benecki: I think that the regionalization process in Alberta was about 15 years ago now, and they took a somewhat more aggressive approach to regionalization in the sense that they disbanded the hospital boards and things and said, “We’re going to have these various regions.” Ontario has not done that and I think there’s a lot of good merit in doing that, because it allows Ontario to continue to form partnerships and maintain institutional history and build support through the local communities.
Ms. Leslie Benecki: I know the area, yes. I think one of the challenges that the South East LHIN has is that we have a very rural population, and that means the people have to go fairly long distances for health care unless you live right in that 401 corridor. Our wait times are not acceptable for some of our acute care services, and there will be efforts to work on that over time.
Ms. Leslie Benecki: I have attended several board meetings for the South East LHIN—as you may know, they’re open to the public, and I have availed myself of that opportunity. There have been lots of documents that have gone up on the website regarding the South East LHIN and I have looked at those. When the initial plan came out several years ago, I had the opportunity to provide comments on that, as all members of the public do.
The first thing I’d like to talk about is that, as you know, primary care physicians etc. are not included in the local health integration networks throughout Ontario, and I’d like to have your opinion on that. Should primary care be under the power of the LHINs?
Ms. Leslie Benecki: I think that’s an evolving process and that the work that’s set out for the LHINs right now is great and complex. The primary care physicians under the fee-for-service payments have traditionally worked in a different scope, and that has been the case in regionalization across the country. Over time, clearly there will be partnerships, and there are partnerships already forming with the new family health teams. Community health centres have primary care services and they are going to be under the LHINs starting next year. There will be a natural progression of partnership; whether or not they will come directly under the LHINs remains to be seen.
Mme France Gélinas: My second question is: If you’ve attended a few of the board meetings of the LHINs, you realize that they have some very tough decisions to make. I’m trying to get a little bit at your values with the next question and it goes something like this: One of the hospitals in your LHIN has presented a deficit budget. That was not acceptable. The LHIN would have asked them to submit a balanced budget in order to meet their accountability agreement. In order to balance their budget, they decided to divest their outpatient physiotherapy to a private for-profit that exists in the same community, down the street from the hospital. The hospital is now able to submit a balanced budget and meet the criteria of their accountability agreement, but physiotherapy is now available down the street at the private for-profit. They have looked and looked at their budget, and that was the only way that they could submit a balanced budget to the LHIN. How would you tackle that decision?
Ms. Leslie Benecki: I think one of the challenges there is that physical therapy is not traditionally covered, so if there is a private centre for physical therapy in a community, unless somebody has private health care insurance, they’re not going to be covered for that. I think that there are some real challenges there.
In terms of having a service that is provided in a community and then taking it away, it creates some challenges. It would be my thought that you would work very hard to see what services could be retained in the community instead of divesting of those.
Mme France Gélinas: I don’t know if you’re aware, but the Ontario Health Council yesterday released a report that shows a very aggressive drive by some US-led multinationals who want to set up private clinics in Ontario. The main drives have been in Toronto and Ottawa, but your area could certainly be next on the list. Kingston is a fairly big centre. I just wanted to have your views on that prospect.
Ms. Leslie Benecki: As you know, the Canada Health Act outlines five criteria for public health care services, including comprehensiveness, accessibility, and public administration, which is also one of them. With the Free Trade Act, my understanding is that once a service is provided and there is payment, that opens the door for that, and you can’t really shut it. I’ve worked in both systems—in the United States and in Canada—and I think that having a public administration reduces costs and can help streamline efforts. I would be very cautious about looking at that option.
Mme France Gélinas: I know that you have a very long waiting list for knee and hip replacement in your particular LHIN, and I had highlighted it, but I can’t find it right now. I think it says that in your LHIN, you have something like a 70% higher wait for hips and knees. Some of the private companies offer to take out some of that load and set up a private hospital in your area so that people wouldn’t have to wait so long for hip and knee surgery. As a member of the LHIN, would you support that decision?
Ms. Leslie Benecki: Again, I think that it would be very important to look at all of the aspects of that. You’re right. Hips and knees wait times are very high in our area. I think it’s 350 days for a hip; that’s a long time. But I also think it would be important to weigh off the costs of that, and the long-term implications of having a for-profit company come in and try to make a quick fix that might have long-term implications that might not put us in a position where we’d want to be.
Mme France Gélinas: I very much appreciate your answer, and I agree with you. I’m with the NDP, and we certainly oppose privatization at every step of the way. We need people like you to be on the LHIN board to make sure that you keep medicare the way it is—based on needs and not on the ability to pay. I will be supporting your appointment. Thank you.
Committee, I would just remind you that we may now proceed to concurrences. We will now consider the intended appointment of Leslie A. Benecki, intended appointee as member, South East Local Health Integration Network.
(3) That the research officers prepare a draft report on each agency, and that each draft report contain a summary of the agency presentation, a summary of stakeholder presentations and recommendations and possible draft recommendations for the committee’s consideration.
(8) That the subcommittee meet to consider a proposed meeting schedule for the committee’s ongoing agency reviews, and direct the Chair to seek authorization by the House of committee meeting time during the winter recess.
(9) That the clerk of the committee, in consultation with the Chair, be authorized, prior to the passage of the report of the subcommittee, to commence making any preliminary arrangements necessary to facilitate the committee’s proceedings.
Mr. Jim Wilson: I know I don’t get to vote on this, just being a last-minute attendee here, but I’m just wondering as a courtesy—Lisa MacLeod, who is a member of the committee, is speaking in the House in about four or five minutes. I was wondering if the committee, before you pass this, could take a recess so she could come down here and give you her two cents worth, just as a courtesy to her, because we are dealing with a substantive government motion in the House dealing with the standing orders.
Mrs. Liz Sandals: Actually, I’m not a subcommittee member. I’m also subbing for the subcommittee member, but I would ask the Chair if perhaps she could comment. My understanding was that there was all-party concurrence in the subcommittee report.
Is there any other business? Seeing none, the meeting is adjourned until 9 a.m. on Tuesday, October 21, again in committee room 228. That’s when we will resume our agency review of the Ontario Trillium Foundation. This committee stands adjourned until then.