The following text may have been generated by Optical Character Recognition, with varying degrees of accuracy. Reader beware!

0 That the province give consideration to the circula- tion of its task force report to all regional municipali- ties, counties and districts in Ontario with the request that comments on the report and recommendations be prepared in duplicate copy with one copy sent to the province and on to the Imu- nicipal liason committee; 0 That no action be taken to implement the recommen- dations now before the proâ€" vincial government until the municipal liason committee has the opportunity to re ceive from its members a response regarding the gov- ernment's task force report and until the Iiason commit- tee has a chance to formu- late a position having regard for the impact on municipal areas: Mayor Rolling recom- mends the following: For a couple of years the‘ idea has been to have a dis-‘ trict health council to advise; provincial o f fi cl 3 l 5 who i would run everything. This‘ year some new proposals‘ have been made to add 8| district management board which would share the admi-! nistrativc function with ai Health Ministry director and his staff. ; The latest addition to thei provincial re-organizaâ€"i tion proposals is January's} "Report of the Health Plan- ning Task Force" known as,‘ the Mustard Report. It is' so named because the group‘ of medical, economic, ac-‘ counting. management. mi-‘ nistry and academic peoplei that prepared it was head-v ed by the dean of Medicine} at McMaster University ini Hamilton. I ROLLING’S INVOLVEMENT E a s t Our {-a '“The Ministry of Health {felt the reportabilify should Gwiilimburylbe directly to the Ministry Mayor Rolling, besides as envisaged by their re-or- a member of York Region! ganization (plan) while the Council, also is a top execu-i Department of Municipal tive of an Ontario municl- l Affairs. spun-ed no doubt by pal organization and speaks on health matters for locali governments on the 19-mem- ber municipal liason com- mittee with members of the Onta- rio Cabinet. Mrs. Rolling recently prepared a stateâ€" ment on the provincial-local medical services situation and presented it to a meetw ing of the town and villages division of the Association of Ontario Municipalities. She was elected of this organization in Au-‘ gust of 1973. Mayor Rolling is worried about the Mustard Report's proposal to wipe out the York Region health set- up as it now exists and to form a new health district combining York with Sim- coe County and Muskoka. The Regional health juris- diction was only organiz- ed three years ago when the regional municipality was formed. It was only a short while before that when everything was re- organized here in the forming of a York-Oshawa health unit. The health set-up keeps being chang- ed over and over again. vice-president ‘ which meets every‘ second Friday of the month‘ apprehension and non-accep- tance expressed by the mu- nicipalities. felt it was io- gical the new regional gov- ernments formed in the pro- vince should have this res- ponsibility Since they (the |regions) wesre concerned wuh local affairs and were ‘charged with considerable unancral responsibility for community health services. VIRTUALLY PARALYZED "This situation remained ‘through January 1973 when itile neath planning task force was appointed . . . and has continued through until the early part of 1974 when the report of the task 3force was tabled. it is im- portant to appreciate the Ministry has been virtually paralyzed during this period of time because members of the old Ontario Services Commission continued to perform a caretaker func- ition while not being aware ‘ the past ‘phone rings and of (its) reporting responsibi- lities or whether or not, in tract. their jobs would be phased out. The mood of several years is characterized by the tired joke: if the it’s your best rather boss. get his name. The situation is highly complex. Changes being con- templated apparently would restructure health services from top to bottom. right from the office of the local doctor â€" through the local hospital administrations and the municipal corporations - to the specialist and teach- ing institutions. THROWN TOGETHER The local hospital adminis- trative establishments would be combined with every- thing else to do with medi- cine and health into a whole new scheme of things on a district basis. The reason for the existence of local health committees or boards of municipal and provincial ap- pointees, such as our York Region Board of Health and Committee, would disappear at least for the present. Some time ago there was a tentative move to promote establishment of a district health council here. But it didn't catch on and there apparently hasn't been any further push lately. How- ever, it is generally believed there is likely to be no fur- ther major medical or health service changes ap- proved until the new system is accepted and implemented locally. Additions to York Central and York County hespitais just got “in under the wire". Sarnia, Chatham plus Kent and Lambton Counties have been informed by the Ministry they must form one of the proposed new district health councils be- fore getting any approval for modernization, change, improvement and expansion of any hospital, nursing home, aged home or facility for the retarded and crip- pled. Proposed Health District Under Fire ln’York 0 That a reasonable At the same time Mayor Mrs. Gladys Rolling of East Gwillimbury Township north of Newmarket ventures the opinion that the provincial Ministry of Health has been virtually paralyzed since January 1973. She is backed up by at least one other local government spokesman, Mayor Paul Blundy of Sarnia, who recently blasted the ministry for erecting what he called “another wall of red tape” while attempting to coerce a group of Southern Ontario counties and urban municipalities into taking the first major step toward implementing the proposed sweeping changes. amount of time, possibly six out in favor of a blueprint Sarnia, Chatham plus tent and Lambton Counties ave been informed by the linistry they must form ne of the proposed new istrict health councils be- ore getting any approval or modernization, change, nprovement and expansion 1' anv hospital. nursing months and not the prov- for ince's present proposal -of three months, be given for the return of these respon- ses and consideration of them; 0 That upon receipt of these reports and conside- ration of them, the munici- the re-organization of health care services (like the one) presented by a Mi- nistry two years ago. The only new ingredient appears to be that for the establish- ment of an area health services management board and a re-evaluation of the One of the members of our infant York Regional Council with wide responsibilities as a representative of Ontario’s municipal governments is urgently advocating that the province stop and consult local authorities before trying to move forward with what appears to amount to a revolu- tion in the provision of medical and health services. a . 1‘! -n- I le “Almost six months later' a the required enabling legis- lation was presented to the ' ‘Legislature and enacted” 3‘ This was followed by an‘ outline statement of the re- ;organization of the Ministry Kl'to provide for more centra- " ‘ lized control and de-centra- lized planning. This was to‘ be accomplished by the es-; _ ‘tablishment of three assis-i 'eitant deputy minister posi-g 50‘ tions relating to standards! ls,lservice and finance. The ls‘basic building stone of this ,8 organization was to be a‘ 5‘; district health council whichl “I would be responsible for‘ 3‘planning and co-ordination‘, Eof all health matters at the} Ilocal level. ; ‘1 "However laudable this; $2 plan might have been, it re-' s ‘ mained in limbo because the L “t various key positions in the. {5 re-organization were only; '5 dimly outlined and indivi- P duals hadn't been appointed "l to them. At the same time i‘ there was a distinct diffe-E [lei rence of opinion at the Cabi- ; '; net level as to the control‘ le of the district health coun- cils in terms of reportabili-1 ty. t “. . . I understand that in the fall of 1971 a decision was made by the Cabinet . .. to expand 'the Ontario Hos- pital Services Commission and to bring responsibility for h05pital and medical care directly under the Mi- nistry of Health. This was at the same time that else- where in Canada provincial governments were consider- ing the setting up of com- missions to handle health ‘care matters, rather than (putting them under) exten- sions of government depart- ments. "This situation remained through January 1973 when the health planning task force was appointed . . . and has continued through until the early part of 1974 when the report of the task force was tabled. It is im- portant to appreciate the Ministry has been virtually paralyzed during this period of time because members of the old Ontario Services Commission continued to perform a caretaker func- tion while not being aware of (its) reporting responsibi- lities or whether or not, in fact. their jobs would be phased out. The mood of the past several years is best characterized by the rather tired joke: if the phone rings and it's your boss, get his name. “It is against the back- ground of this historical perspective and the gov- ernment's feelingr of im- potence over rising health care costs that the task force (Mustard) report should be evaluated. To put it bluntly, the govern- ment must act in some way and make a defini- tive statement of where it intends to go on health care matters. In a word, I believe government will have no choice but to im- plement some of the re- commendations of the task force since it has nothin! else with which to work," said the East Gwillimbury mayor. “The (Mustard) Report it- self is rather disappointing in that there are very few new ideas being proposed and many of the recommen- dations are a re-statement of other task force findings. Basically, the report comes Mrs. Rollings consulted a group of York Region health officials and experts before writing her recent state- ment. She also has long ex- perience through involve- ment in health and social servlces as a municipally elected representative, ROLLING’S STATEMENT Her statement, in part, is as follows: 0 That upon receipt of these reports and conside- ration of them, the munici- pal liason committee and the province formulate posi- tions to be considered at a provincial-municipal liason committee meeting. BY HAL BLAINE ' PROHIBITIVE COSTS 4' “The (Mustard) Report ap- pears to come out in favor nf a de-centralization of health services from a hos- pital central focus to what appear to be community health clinics. In this report the task force appears to be agreeing with the concept proposed by “Prof. Hastings in a federal task force report of 1% years ago. The Hast- ings Report at that time stated a new unit of health care delivery facility should be established apart from hospitals, but providing many of the diagnostic and mi 11 o 1' treatment services now provided by hospitals. _The government at first embraced this idea as the :panacea it was seeking, but has since backed away be- cause of the cost implica- itions such duplication would 'entail. I “Essentially the Mustard 1 task force appears to recom- . mend the establishment of a ‘separate management board ‘(Area Health Services Ma- nagement Board) which {would be responsible for lthe actual management of lservices and facilities. (In 1addition there would be) a ‘zDistrict Health Council res- Iponsible for planning and imaking recommendations as . to scope of service. The Dis- itrict Health Council would report direct to the Ministry on planning matters with respect to emphasis, scope of service and type of faci- lity to be offered in the area coming under the coun- cil’s control. The Ministry would react to this advice and give appropriate direc- tion to the Area Health Services Management Board on implementation. '1 REGIONS ARE OUT 1 "It is important to note Ithe Mustard Report has come out directly in opposi- tion to either of these two loriginal functions coming under regional government. ‘They haven't clearly stated whether or not they are ;opposed to this type of con- 1trol in principle, but have Erather taken the less criti- cal approach of saying regio- nal councils are too new to ‘be saddled with the sophis- l:ticated responsibility of ad- ! ministering a health care de- livery system which, in it- self. would be in a state of . evolution. "The respective roles of: the District Health Councils and the Area Health Serv- ices Management Board will: have to be clearly Stated-I The Mustard task force has! already found some difficuH ty in the respect, saying. ‘with respect to on-going operational matters the re- “It is a well-known maxim that delegated authority and responsibility must involve fiscal accountability. But the Mustard Report appears to have avoided this maxim since there's no recommen- dation regarding how the new system will be cost- shared. Indeed, in the pro« posed composition of the health council there is no definition of a municipality. Does it mean area municipa- lity or regional . . . the answ- er to this question makes a vast difference. One must also question whether the establishment of regional di- rectorships might not also be merely the institution of an- other bureaucratic level. DIRECTOR OVER BOARD “From a critical point of view. there is no doubt the board outlines of the (Mus. Lard) task force recommen- dations could be implemen- ted and would be useful in terms of closer integration of health services and avoid- ance of duplication of facili- ties. Howaver, there are several areas of concern, since this control is to be clearly retained by the Mi- nistry and not delegated. The actual effect of having priorities set up at the local level may well intensify demands for additional funds and broader services. “The comments with res- pect to primary and secon- dary care (the Mustard Re- port’s proposed categories for local medical service groups) aren’t very helpful since there seems to be a great deal of overlapping. The point made for the sepa- ration of these two (catego- ries of local health service) isn't very meaningful since, in many respects, those lis- ted as responsible for secon- dary care would also be res- ponsible for the primary care as defined in the re- port. role of council. the district health gional director and staff will deal directly with the Area Health Services Manage- ment Boards. They will as- sist the boards in carrying out their resposibilities with- in the established guidelines. The boards, however. will be fully accountable to the Mi- nistry through the regional director for the use of funds provided. The District Health Council won't be in- volved in the detailed insti- tutional operations'. “0f major concern also is the allocation of areas for health regions and dis- tricts. They are stated as having been drawn up with consideration for fac- tors such as population, transportation patterns. distribution and referral patterns or health and other related services. To give an example, an ex- amination of the York. Simcoe and Muskoka dis- trict can hardly be des- cribed as meeting the test of this criteria. In fact, the grouping of the Region of York. County of Sim- coe,. and District, of Mus- koka appear to meet none of these criteria. “This proposed health dis- trict has a population of some 372,000 persons com- pared to Durham with 215,- 000, Peel with 265,000, Hal- ton with 191,000 and Water- loo with 253,00. Since it is well over 200 miles from the southern part of York to the northern section of Mus- koka, the cost of transporta- tion and communication to inter-relate services would be fantastic. Considering the problems of communication during the recent mail strike and some Bell Canada prob- lems we have been having in this area, some poor soul in Lake of Bays could well be dead and buried before authorization could be ob- tained from the proper au- thority to transport and ad-‘ mit him to the hospital which can best meet his needs. DISTANCES T00 GREAT “All three municipalities have separate boards of health and planning bodies. I am sure residents of Hunts- ville have no identification with Markham, nor are they much interested in Newmarâ€" ket or Barrie. The same is true in the reverse. Durham. Pell,, Halton, Niagara, Wa- terloo and other compact areas are recommended in- dividually to be health dis- tricts and these may be ac- ceptable to their councils. However, I am sure other areas in Ontario will be concerned about the health districts proposed for them. “In consideration of what the report expectszof the proposed regional di- rector, he surely must pos- sess a combination of the strength of Samson. the courage of David. the wis- dom of Solomon and the patience of Job. Having given him all these attri- butes. the report then pro- ceeds to protect him with a veritable army of a staff, an army that could well discourage anyone with twice the presistence of Delilah from trying to break through to him. Should this regional direc- tor be appointed, some mechanism must be work- ed out to make him more aware, through personal knowledge of the health needs of the various areas under his control and more accessible to those who need his direction and assistance. “From the point of view of the medical association, the plea for 24-hours-a-day, seven - days - a - week service with a continuing relation- ship between receiver and provider, indicates idealism rather than practicality. (The proposal for) nurse practitioners also appears to be illogical in the face of an excess of medical practi- tioners in this province. DOCTORS’ POSITION “Most areas now have a variety of group practices, partnerships, associations and sole practitibners. But there is coverage available in off times so there cannot be a "no system' classifica- tion. It appears from studies that group practices of over five doctors with ancillary facilities are economic. Thus in order to provide the serv- ice recommended ln the reâ€" port, human rights must be considered. Can society ex- pect or demand a level of service that will limit the privacy of may individuals doctors)?" “In conclusion I would point out that the March 80 edition of “Mediscope” in- dicates Britons are turning back to a private medical system because the waiting period for service is unbear- able under the British Natio- nal Health Services system, also because the service is reported to be deteriorating rapidly. Thus it appears the Ontario Government should tread slowly before getting into any similar health deli- very system," says East Gwillimbury Mayor and York Region Councillor Mrs. Rolling in her state- ment on proposed provin- cial health system re-organ- ization." AURORA: Town council has decided to appeal York Re- gion's rejection of its pro- posed 30 mile speed limit on north Yonge Street to the Aurora boundary. The re- gion's engineering commit- tee reported there was not enough development along the roadway to warrant a 30 mile speed and enforcement would be difficult. THE LIBERAL, Richmond Hill, Ontario, Wednesday, July 24. 1974 Wgamwhxmamfi ~ m»; wow‘ Estimates call 884-8945 FACIA Free FOR