A discussion paper on public health, local health integration networks, and regional health authorities

The Ontario Public Health Association (OPHA) requested the preparation of this discussion paper to assist the OPHA Board to engage in a discussion about the relationship between public health, LHINs and the experience with regional health authorities (RHA) in other provinces to inform OPHA’s position on public health renewal. [...] This includes establishing the Health Protection and Promotion Agency, improving the capacity of the Public Health Division, ensuring a critical mass of expertise in all health units, improving coordination among health units and the provincial level, improving units’ governance, leadership and planning, improving quality, and strengthening the public health workforce. [...] However, a change in public health unit boundaries to those of LHINs would result in enormous transition costs and be driving public health system design for the benefit of hospitals at the expense of the critical community partnerships public health requires with school boards, municipalities and others. [...] A list of key informants is provided in Appendix I. CONTEXT The Renewal of Public Health in Ontario The SARS outbreak exposed several gaps in the province’s public health system that were extensively described in subsequent reports.4-6 In response, the MOHLTC released Operation Health Protection, which outlined the government’s planned approach to strengthening the public health system in Ontario. [...] The board of directors is responsible for the management and control of the affairs of the LHIN and a Memorandum of Understanding (MOU) governs the relationship between the LHIN and MOHLTC.