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Funding re-allocation causes concern.

A move away from institutional care - care in hospitals and nursing homes - to community-based health care is the new direction being taken by the province's health ministry.

"We want to move away from using large institutions," says Bruce Skeaff, a communications officer with the Ministry of Health.

"The government is not trying to abandon hospitals, as they do provide essential services. We want to give local communities more choice and the means to provide specific care for community needs," he explains.

Part of the government's restructuring plan for the health-care system involves a redirection of funding from institutions to the community, explains Skeaff.

Hospital officials such as Warren Chant of Port Arthur General and Carl Roy of Sudbury General say they do not oppose the community-care concept. However, they are concerned about the reallocation of resources and the ultimate provision of services.

"I'm not sure that all of the resources are there to support this new direction," warns Chant.

John Harwood, president of Sault Ste. Marie's Group Health Centre, the province's largest and longest-established consumer-oriented health-care service, agrees.

"You have to create a community base before you can de-institutionalize," Harwood says. "The government does not have the money to do this."

Established in 1963, the group health centre is a multi-specialty, ambulatory-care facility with diagnostic services. Its services include family medicine, cardiology, gynecology, internal medicine, neurosurgery, obstetrics, oncology, paediatrics, psychiatry, counselling and physical therapy.

Harwood says the centre is funded on a per-client basis by the health ministry. About 10 to 15 per cent of its funding is derived from fees for service which are either paid by the ministry of private insurers.


Provincial Health Minister Frances Lankin admits that there is no new money available. However, she believes that community-based health care can be funded with savings produced by changes to the Drug Benefit Program and the out-of-country payment service, and by a review of Ontario Health Insurance Plan (OHIP) funded services.

"We want to prevent unnecessary hospital admissions by providing the right range of services in the community," explains Lankin.

In addition to the cost-savings, Lankin says community-based health care will allow chronic-care patients to live at home longer.

"Community attitudes are changing. People want to be at home rather than in a sterile environment," responds Margaret Chyrsler, Sudbury branch manager for Kimberly Quality Care.

Kimberly supplies registered nurses, assistants and care aids to the community. It is funded primarily by private insurers, as OHIP does not pay for home nursing services.

Chyrsler believes that demand for services would increase if provincial funding were provided.


The concept of decentralizing health services to encourage community participation in the provision of health care is supported by both profit and not-for-profit health-care providers in the private sector.

A draft report prepared for the Algoma District Health Council by Toronto-based Ernst & Young also supports increasing the community's involvement in the delivery of health care.

Ernst & Young's review of the area's health services identified a somewhat fragmented community-based system which is typical of many other centres, according to company spokesman Steve Raiken.

If these community services were more organized and coordinated, Raiken says a more efficient delivery of health care could be provided.

John MacLeod, president of Thunder Bay-based Health North, supports the government's new direction, and he believes that it will increase the demands placed on private insurers and employers.

Because government funding is limited, MacLeod believes the reforms are necessary to ensure that public dollars are used for those who cannot afford private insurance.

Health North, a for-profit health-care agency, provides referrals, reporting, co-ordination and consulting services on behalf of insurers, employers and others for injured individuals requiring health care, home care, or counselling. It offers a network of rehabilitation specialists which include doctors, physiotherapists, nurses, psychologists and home-care providers.


Medical testing laboratories have also expressed support for the government's plan. However, they are concerned about the possibility of cuts in OHIP funding.

"One has to recognize that there is a complimentary role for commercial labs," says Paul Gould, president of the Ontario Association of Medical Laboratories.

"Commercial labs respond to the needs of physicians in the community," he adds. "We go into nursing homes and private homes so that testing can be done."

Gould states that commercial labs are more cost-efficient, and he points to a Sunnybrook Hospital study to support his claim.

Gould is urging the ministry to clearly define the role of hospital and commercial laboratories in its restructuring plans.
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Title Annotation:health care and hospitals' funding
Author:Campbell, Joan
Publication:Northern Ontario Business
Article Type:Industry Overview
Date:Aug 1, 1992
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