| Dec 02, 2010


Editorial by Jeff Green

Two weeks ago, Kingston General Hospital (KGH) awarded its food contract to a company that will prepare individual plates of food in Hamilton and ship them to Kingston to be reheated.

Local food advocates and even Kingston City Council had urged the Board of Directors of KGH, a group of unpaid volunteers, to reconsider, to try to turn KGH into an example of local agriculture providing healthy food to sick patients at a reasonable price. The board ignored these pleas to reconsider and awarded the contract to a Mississauga-based company called COMPASS - so named, it seems, to underscore the fact that they need one to find Kingston.

The KGH board has been reluctant to come out and say it, but they had no choice but to choose Compass or another similar off-site service provider for the food service contract at the hospital.

The initial press release from the hospital included the following statement: “KGH’s independent procurement arm, Shared Support Services of Southeastern Ontario (3SO), administered the procurement process on behalf of the hospital according to mandatory provincial guidelines. Five vendors submitted proposals in response to 3SO’s request for proposals.”

That initial press release and a longer statement by Chris Cunningham, the chair of the KGH board of directors, talks about many of the issues that were raised, and many of the interested parties who were involved, from the local food movement, to hospital staff, patients, even workers who will be affected by the change. Cunningham also referenced the fact that the hospital board had followed a “provincially mandated process” to find a food service provider.

However, there was one entity that neither Chris Cunningham nor the KGH public relations department mentioned, the Local Health Integration Network of South East Ontario (a.k.a. the South East LHIN)

This does not mean that the LHIN had nothing to do with the decision to look elsewhere for food rather than preparing it on-site; it means that the KGH board chose not to reveal the fact that the entire process was dictated by the South East LHIN. They preferred to take the flak from the public and leave the LHIN out of it because the LHIN, and not the public, controls their funding.

That “independent procurement arm, the Shared Support Services of Southeast Ontario (3SO)” is a classic LHIN creation.

The South East LHIN controls the funding for KGH, long- term care facilities, the Community Care Access Centre, homecare providers, and even community agencies delivering meals on wheels, throughout Kingston, Frontenac, Leeds Grenville, L&A and Hastings counties. The mission they have been given by the Ontario Ministry of Health is to save health care dollars by ensuring that efficiencies are found in the system.

Gerogina Thompson, the founding chair of the South East LHIN, who like all LHIN board members was a provincial appointee, likes to talk about how health care providers are too loyal to their own institutions and lose site of patient care. “They are stuck in silos,” she is fond of saying.

The LHIN has used its authority to force these providers to look outside their walls, to share their buying power with other institutions within the local LHIN or the province as a whole to save money.

So, if in the end the food at a hospital in Kingston or Toronto or Ottawa is all prepared and portioned out in a kind of food factory in Mississauga at a really good price, the LHINs have done their job.

I’ve never met Chris Cunningham, but I expect he joined the hospital board out of loyalty to his local hospital. I expect as well that he takes a financial loss by being the chair of the KGH board, but he has ended up wearing a decision that his board was forced to make by people who are well paid to run the health care system. The LHIN is taking no heat, and the McGuinty government, the author of this scenario, is politically removed from it entirely. Something about this doesn’t feel right.

The LHINs model is one of centralization and a curtailing of the authority of local boards to determine local practices. This is not only happening in health care; it is happening in all government departments.

In 2012, a provincially mandated request for proposal system will be faced by school bus drivers in our region. It will likely eliminate most if not all of the local school bus operators in favour of three large multi-national bus companies. In that case, the local school boards and the Tri-Board bus service (which serves the Limestone, Hastings, and Catholic district school boards) will be overseeing a process that they did not choose and do not favour.

It’s going to be déjà vu all over again.

 

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