LHINs (Ontario, Canada) at Five years – What Now? :: Longwoods.com

Power throttled
On paper, the LHINS are exceedingly powerful, with over $20billion of funding authority and the power to issue integration orders compelling healthcare organizations to alter and even merge services to improve healthcare. In spite of these formidable powers, in 2006, I wrote: “Many fear that LHINs will simply be a funding conduit, perpetuating the status quo; or that they will simply do the Ministry’s bidding and add another layer of unnecessary bureaucracy and contribute further to the inefficiency of the “system”. Sadly, this prediction has largely come true, with LHINs largely reverting to traditional planning exercises, throttled by Ministry directives, and acting much like their predecessor District Health Councils, which were broadly viewed within the Ontario healthcare community as ineffectual......So what went wrong?..........
Leaving Critical Functions Outside
“While the role of the new LHINs is massive, at least on paper, there are significant omissions that may limit their effectiveness in truly improving patient care.  Public health, physician services, ambulance services, laboratories and provincial drug programs are all excluded from the mandate of the new organizations.”  I wrote this five years ago and these omissions continue to hamper an effective integration model today.  Primary care is particularly problematic.  Ontario now has an alphabet soup of primary care models, with Family Health Teams holding the most promise, but with none of them being held publicly accountable for service or performance standards.  It is past time to move to truly integrated care.......