Andrew Dreschel wrote in "Lots of grist for watchdog's LHIN probe" (Hamilton Spectator, Mar.27, 2009, here):
"Let's be absolutely clear.
Ontario ombudsman Andre Marin is not investigating the Hamilton Health Sciences restructuring plan that calls for closing Mac's emergency room to adults and making it a kids-only department.
As much as the outspoken Marin might want to probe HHS's record of community consultation, the legislation that governs his office does not give him the power to investigate hospitals.
Marin has never hidden his irritation over that gaping hole in his mandate.
But so far, his protests have fallen on stone ears in the McGuinty government.
What Marin is investigating is the decision-making and "community engagement" process that the Local Health Integration Network followed when it gave its go-ahead to the HHS plan last year.
So, this is not about the HHS plan.
It's about the LHIN process.
It's like coming at the controversy sideways.
Because this is the first time the ombudsman has scrutinized one of the province's 14 LHINs since they were formed in 2006, Marin's recommendations are sure to be precedent-setting if he decides a systemic issue needs to be addressed.
To recap: Without a green light from the Hamilton-area LHIN, the controversial HHS plan would have come to a shuddering halt.
As with HHS, the LHIN was roundly criticized for its alleged lack of public consultation before giving the thumbs-up.
One of its board members, Stephen Birch, even resigned over the issue.
Those criticisms form the basis of Marin's probe because provincial legislation requires LHINs to participate in "community engagement" by way of informing their decisions.
The tricky thing for Marin, however, is the legislation is silent about what "community engagement" should look like. It offers no specific details of what needs to be done.
Juanita Gledhill, the LHIN chair, says it would be inappropriate for her to comment on the amount of community input her organization sought now that it's the subject of a review.
But, interestingly, Marin is also probing the LHIN's decision-making, which includes examining how the board came to its verdict.
On the day of the vote, several observers had the distinct impression that the board was rubber-stamping the HHS plan rather than subjecting it to a rigorous public assessment.
The staff presentation gave short shrift to community concerns or the impact the decision could have on Hamilton's ambulance service.
Vice-chair Jack Brewer even suggested he was basing his support for the plan on the opinions of his golfing buddies.
All of this should be grist for the half-dozen or so people from Marin's office working on the file.
The investigators have the power to subpoena all notes, files and records linked to the case, as well as interview the complainants and anyone connected with the LHIN.
Once the investigation is complete and Marin arrives at his findings and opinions, he has the option of approaching the LHIN with a solution without going public.
But Linda Williamson, Marin's director of communications, says given the large public interest involved that's not likely to happen.
She says Marin will first share his preliminary findings with the LHIN and the Ministry of Health and give them an opportunity to respond.
The report will then be finalized and most likely publicly released, perhaps in a couple of months.
The ombudsman is not a judge. He can't order people to do things. He only has the power to make recommendations.
But as Williamson notes:
"Pretty much any recommendation he's made, especially in these major investigations, has been accepted and implemented by the government." "
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It is interesting to compare Dreschel's Mar.27, 2009 story above, to Ray Spiteri's Jan.28, 2010 story here.
Dreschel wrote "this is the first time the ombudsman has scrutinized one of the 14 LHIN's"; and Spiteri wrote also that this is the "first ombudsman investigation into one of the province's 14 LHIN's".
Dreschel was writing about the HHS (Hamilton Health Sciences system); while Spiteri was writing about the NHS (Niagara Health System).
The themes were similar: two hospital emergency rooms in Niagara were closed, and Hamilton's McMaster ER was closed to adults. The LHIN's apparent lack of "community engagement" in regards to the closure process was at issue.
The common link here is that both the HHS and the NHS are under the same supervision - their master is the Hamilton Niagara Haldimand Brant Local Health Integration Network, the political supra-health bureacracy created by the incompetent George Smitherman.
Seeing that Smitherman was a rabid health care monopolist, it is quite interesting to see how his bait-and-switch Liberal government carelessly sloughed off the public's concerns about the callous decisions made by the Liberal-created LHIN - while concurrently continuing to force the Liberal's no-other-choice-by-law single-payer authoritarianism onto patients. The LHIN did its job of protecting the Liberals - just as Smitherman had intended - in Hamilton, in Port Colborne, and in Fort Erie. We don't know what the LHIN did for the patients.
The Ombudsman's office announced the investigation into the Niagara LHIN back on Mar.24, 2009 - (see here):
"Ontario Ombudsman André Marin announced today he is launching an investigation into the decision-making process of the Hamilton Niagara Haldimand Brant Local Health Integration Network (HNHB LHIN), including its approach to its mandate of “community engagement” when it deals with proposals for the restructuring of health services.
The investigation will be conducted by the Special Ombudsman Response Team (SORT). In recent months, the Ombudsman has received a total of 37 complaints about the HNHB LHIN, from residents, community associations, health care professionals and a local MPP. Of those, 24 complaints concern the LHIN’s consideration of Hamilton Health Sciences’ “Access to Best Care” proposal and 13 were about the Niagara Health System’s Hospital Improvement Plan.
“There is a lot of public concern about the accountability and transparency of the LHIN,” Mr. Marin said. “Are those concerns justified? That’s what we’re going to find out.”
While the Ombudsman does not have jurisdiction over hospitals, he does have jurisdiction over the province’s 14 LHINs, which are responsible for disbursing about $20 billion in funding – or about two-thirds of the province’s health care budget – to local health care systems. The Ombudsman will not assess the merits of the Hamilton and Niagara restructuring proposals themselves. Rather, his investigation will focus on the LHIN’s role in the decisions made and alleged problems with the process, including complaints of insufficient consultation.
The HNHB LHIN is the second-largest in the province, covering 1.4 million residents. This is the first Ombudsman investigation into one of the LHINs, which were created in 2006. The Ombudsman expects the evidence-gathering phase of the investigation to take about six weeks."
Well - that was said in March 2009; it's now May 2010 - WHERE IS THIS REPORT ?!
Also note the following passage from Dreschel's above story:
"Once the investigation is complete and Marin arrives at his findings and opinions, he has the option of approaching the LHIN with a solution without going public.
But Linda Williamson, Marin's director of communications, says given the large public interest involved that's not likely to happen.
She says Marin will first share his preliminary findings with the LHIN and the Ministry of Health and give them an opportunity to respond.
The report will then be finalized and most likely publicly released, perhaps in a couple of months."
So is this what happened - the LHIN had been approached with the report, and now, whatever was in this investigation will NOT go public? In other words, was this pre-ordained and skewed to be a cover-up from the get go?? Why shouldn't the Ombudsman's report be publicly available regardless of the LHIN's response?
Although Williamson said that 'not going public' was "not likely to happen" - is this exactly what has happened?
What other explanation is there for this continued delay?
Ray Spiteri's Jan.28, 2010 report noted that the Ombudsman's report was ALREADY COMPLETED!!
Williamson also said that the "LHIN and the Ministry of Health" would be given an opportunity to respond: so - HAVE THEY ?! Will they? When?
Has Liberal health minister Deb Matthews responded to anything?!
Has the HNHB LHIN chair responded??
Have any Liberal MPP's - such as Kim Craitor, or Jim Bradley - responded?
Initially, this was all (supposedly) about transparency and accountability - so why all the protracted secrecy?
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