There is a strong case to be made for a three-way merger between Hastings Prince Edward Public Health and its counterparts in Kingston and Brockville.

Medical Officer of Health Dr. Ethan Toumishey was at Shire Hall last week to describe the work of a Tri-Board Voluntary Committee. Representatives from HPEPH, Kingston, Frontenac, Lennox & Addington Public Health and Leeds, Grenville and Lanark District Health are working together to merge the three health units. 

That amalgamation continues work initiated by the Government of Ontario before the pandemic to create ten larger public health organizations out of 35 regional bodies. That previous process was involuntary.

The province has returned to restructuring, but this time has suggested that individual Health Units examine a merger — and create a business case for such a move. It has also incentivized the process: newly formed health units will retain any cost savings.

Dr. Toumishey explained that this time around, the voluntary and provincially funded process is not about cost savings or reducing per capita services, but about ensuring a critical mass for services. He mentioned an uptick in measles and Mpox cases correlated with health units of varying degrees of size, skill roles and surge capacities.

The goal is to have new health units with a catchment area of no fewer than 500,000 residents.

“The end goal is to have a public health system where all public health agencies have a critical mass capacity and can meet unexpected surges in demand, have the skill competencies that can fully deliver all core public health services, and a cohesive public health system that better aligns with community and system partners to support progress on improving population health outcomes while reducing health inequities,” said Dr. Toumishey.

Councillor Bill Roberts noted, “this is a really big deal.” A merger would affect every resident in the HPEPH catchment area, considering the breadth and depth of the services HPEPH delivers. 

PUBLIC HEALTH

Units are responsible for immunizations, infectious and communicable disease control, harm control, tobacco, sexual health, food and drinking water testing, environmental health as well as health promotion, including promoting healthy lifestyles, oral health, avoidance of chronic disease and injury, and reproductive health.

Councillor Roberts wondered exactly how voluntary the current process was, and about the consequences for those health units that don’t go along.

Dr. Toumishey explained that prior to the pandemic, HPEPH was notified they would merge with the Durham Region Health Department. At that time, there was desire from the field for a voluntary process, to allow for locally developed solutions to build capacity and skill sets and deliver better results for the community without amalgamation.

He added the voluntary exercise has been undertaken by a number of Health Units with varied uptake. For instance, Peterborough and Haliburton-Kawartha-Pine Ridge region chose to go ahead with a merger, while Sudbury and Sault Ste. Marie decided not to go forward.

The Tri-Board committee is completing the feasibility process. Dr. Toumishey said it should have the business case template submitted by the April 2 deadline.