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Update on Local Health Integration Networks (LHINs) March 28, 2006 - Bill 36 received Royal Assent.
IT IS REALLY IMPORTANT THAT YOU CONTINUE TO: Call, fax or email your MPP and tell them that you want this legislation amended. Do it right now! If you have already done it, do it again!
Read Local 79's letter to David Zimmer, MPP and our Deputation on Bill
36 Click here for the template LHIN letter to editor (CUPE Ontario web site)
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LOCAL 79 DEPUTATION ON BILL 36 TO THESTANDING COMMITTEE ON SOCIAL POLICYFebruary 8, 2006 Hansard extract: CANADIAN UNION OF PUBLIC EMPLOYEES, LOCAL 79
The Vice-Chair: Now we invite the Canadian Union of Public Employees, Local 79. I believe the president, Ms. Dembinski, is here, and I believe there is somebody is with you. State your name, please. Mr. Tim Maguire: Tim Maguire. I'm the second vice-president and chief steward. The Vice-Chair: Thank you very much. When you're ready, you can start. You have 15 minutes. You can use it all for your deputation or you can divide it between questions and answers. Ms. Ann Dembinski: Thank you for the opportunity to speak to you today. I just wanted to tell you a little bit about CUPE Local 79. We represent city of Toronto workers, Bridgepoint hospital members and also the Toronto Community Housing Corp. We are the largest municipal local in Canada, with 18,000 members, and probably the largest local anywhere in Canada outside of even the municipal field. Some of the areas we work in are homes for the aged, public health, social services, parks and recreation, housing and court services. We are hospital workers, long-term-care workers, RNs, public health nurses, child care workers, city planners, ambulance dispatchers, etc. We're here today to speak to you about this legislation. The stated purpose of this legislation, according to the act, is "to provide for an integrated health system to improve the health of Ontarians through better access to health services, coordinated health care and effective and efficient management of the health system at the local level by local health integration networks." In the preamble, the act states that the government is "establishing local health integration networks to achieve an integrated health system and enable local communities to make decisions about their local health systems." CUPE Local 79 will always support any measure that truly enhances and improves the delivery of health care services within a public, not-for-profit health system. However, we have a number of concerns about the proposed Bill 36. We question whether the proposed legislation will ensure that the stated intentions are fulfilled, or will Bill 36 in fact hinder the declared purposes? The boundaries for the local health integration networks governing the city of Toronto health care facilities defy all logic. The configuration of the LHIN boundaries means that Toronto is served by five LHINs. Only one LHIN is totally contained within the municipal boundaries. The city of Toronto's 10 homes for the aged and related services will report to five separate bodies for planning and funding purposes. Each of the city's homes for the aged has already developed critical linkages and work relationships with health, social service and community partners. These relationships have strengthened the care and service the homes provide. For example, at present, a municipal home for the aged in the far west end of the city may collaborate with a downtown hospital for purposes of providing a particular type of program. In the new configuration, the hospital and the home would be in different LHINs. The homes for the aged are already fully integrated with their local communities and have strong historic relationships with them. The consequences of dividing Toronto among several LHINs will mean not only a loss of accountability to the respective communities currently served, but also to the city of Toronto within whose municipal boundaries all these homes are located. The city of Toronto is a unified community already doing what the LHINs advocate. The city of Toronto accurately determines community needs and priorities and recognizes the diversity of interests and communities. The city of Toronto is accountable to the communities it serves and has developed effective community engagement mechanisms. The city of Toronto builds on the successes of existing coordinating networks and accumulated knowledge to coordinate health and social services into a coherent system. Some of these LHINs cover only limited portions of the city and include substantial portions of suburban and rural areas surrounding the city. This raises the distinct possibility for integration decisions being made by LHINs whose composition is not city-friendly and whose orientation is suburban or rural. These LHINs will have little to no understanding of the specific and unique needs of our richly diverse communities, including multilingual needs. 1110 It is conceivable that CUPE Local 79's membership might be dispersed and integrated into service providers whose primary focus is outside of the city of Toronto, controlled by employers whose head offices are located outside of the city. It's possible that these for-profit service providers could be from outside of Canada. CUPE Local 79 is not alone in these concerns about the jurisdictional structure of the LHIN boundaries. We've heard that there has been similar apprehension voiced throughout Ontario. The impact of Bill 36 on our members -- I just wanted to speak about this. Local 79 has made several presentations recently on the proposed OMERS legislation, and it almost seems that I'm here more than I am at city council. That's really quite alarming, when I'm spending my days up here. Certainly, I can tell you that's not what our members expected, to see me up here all the time, fighting this government on their behalf. We highlighted during the OMERS presentation the inequitable situations created by the legislation which would affect our members, especially those earning modest wages. Many of these members work in homes for the aged and at Bridgepoint hospital. The majority are women. A significant number of them are also women of colour. This government is again jeopardizing our members who work in the homes for the aged, and now our members who work at Bridgepoint hospital, this time by creating five different LHINs. The impact of Bill 36 on our members will be severe as well as disruptive. Bill 36 allows bargaining units to be combined and forces the seniority among separate bargaining units to be merged. This is accomplished by the power and discretion of the Public Sector Labour Relations Transition Act. Local 79, better than anyone, understands the seriousness of labour-force impacts from its experience with the amalgamation of the city of Toronto. I see Mr. Balkissoon sitting here. He dealt with it. You were there when the chaos was created. That process has certainly been one of the most chaotic things we've ever seen. I think Kathleen Wynne was a community leader at that time, who, along with John Sewell, was very vocal about the damage that amalgamation would do to Toronto. I can say that Local 79 and the city of Toronto have not yet, eight years after amalgamation, sorted through all the issues of amalgamation. We urge this government to consider the experience that the city of Toronto had as it moves to finalize Bill 36. I want to just talk a bit about the new city of Toronto act, which states: "The purpose of this act is to create a framework of broad powers for the city which balances the interests of the province and the city and which recognizes that the city must be able to do the following things in order to provide good government: "(1) Determine what is in the public interest for the city. "(2) Respond to the needs of the city. "(3) Determine the appropriate structure for governing the city. "(4) Ensure that the city is accountable to the public ... " There are others. "The assembly recognizes that the city is a government that is capable of exercising its powers in a responsible and accountable fashion. "The assembly recognizes that it is in the interests of the province that the city be given these powers." The proposed legislation removes Toronto's ability to plan and deliver the city-operated and funded health services that are included in the LHIN legislation. Toronto's power as a government is being severely eroded by Bill 36. Again, this government is creating jurisdictional chaos with the LHIN boundaries. CUPE Local 79 strongly supports the city of Toronto's recommendation for the development of one LHIN, city-wide. If this model is not possible, we would support the city's position that the legislation contain clear authority to prescribe a five-LHIN/city of Toronto collaborative table, composed of equal representation from all five LHINs and Toronto to ensure joint decision-making about those services currently included in the LHINs legislation that are operated by, or receive funding from, the city. Without going into great detail, because I could, we again question why there are two sets of rules: one for not-for-profits and one for profit-making entities. There are many questions we could ask about that. It's not difficult to see a shrinking set of non-profit providers while the for-profits continue to gain new market opportunities as the system is restructured in this way. The proposed legislation will significantly alter the playing field from an unfair system, which already favours for-profit providers, to the two-tiered system that the government always denies it is advancing. CUPE Local 79 strongly opposes privatization of health care services, competitive bidding and contracting out. We believe this legislation promotes privatization in several ways and facilitates the spread of competitive bidding throughout the hospital system. The LHINs may move funding, services, employees and some properties from non-profit to for-profits. Cabinet may order the wholesale privatization or contracting out of all support services in hospitals. CUPE Local 79 members work in Bridgepoint hospital, which is Canada's largest and most extensive integrated health care organization for specialized complex care services: complex rehabilitation, complex care, long-term care and community-based care. Bridgepoint provides a continuum of care that links different services and facilities to ensure that people receive the right and best type of care at the right time. There is nothing in Bill 36 to prevent services in Bridgepoint from being contracted out to private sector providers. The government has given itself the power to define who is a service provider -- The Vice-Chair: Excuse me, you have one minute left, if you want to conclude. Ms. Dembinski: CUPE Local 79 urges you to give careful consideration and attention to our concerns and requirements. Again, we'll state that we think the proposed legislation must be amended to revise the boundaries for the LHINs. The Vice-Chair: Thank you very much for your presentation. |