50 LEXPERT MAGAZINE
|
SEPTEMBER 2016
| HEALTH LAW |
Legal uncertainty in the health care
industry is rife, in other words — and ex-
pressions of frustration all too common
— but for organizations that actively keep
themselves apprised of looming issues, the
mounting needs of patients will eventually
present opportunities.
CENTRALIZATION, GOVERNANCE
As baby boomers age, a major issue in Ca-
nadian health care involves sorting out the
logistics of treating more patients at home
or in clinics, rather than admitting them to
hospitals. e reorganization of the home-
care industry is becoming an urgent prior-
ity, especially in Ontario.
In early June, Ontario tabled proposed
legislation, the Patients First Act, also
known as Bill 210. e Act would disband
the Community Care Access Centres
(CCACs) currently responsible for primary
health and community care and transfer
these responsibilities instead to the prov-
ince's 14 Local Health Integration Net-
works (LHINs) — bodies that have a much
broader mandate to plan and fund health
care within specific regions. If enacted,
full implementation of these measures will
likely come into effect next year.
"What they're trying to do is to stream-
line the bureaucracy within the health sys-
tem itself," says Noam Goodman, a partner
at DLA Piper in Toronto. "is Act basi-
cally reorganizes CCACs and has them
taken over by LHINs — it gets patients
treated by teams from one organization, as
opposed to shuffling them from the doctor
to a home-care facility to a nurse adminis-
trator or care coordinator."
e objective is to keep as many people
as possible out of hospitals in order to cut
down on the associated high costs. Good-
delivered, if they don't pro-
vide more funding and more
hours of home care, patients
will still find they're not be-
ing treated properly."
One potentially controversial change
represented by the legislation is a grinding
away of the position of physicians as lead-
ers in the health-care delivery system, says
Lynne Golding in Toronto, who leads the
national health group at Fasken Martineau
DuMoulin LLP. "It gives LHINs a right to
obtain a lot more information from physi-
cians that are a deep dive into their prac-
tices — their comings and goings, when
they're going on holidays, for example. It's
showing a change in the hierarchy — just
man, however, suggests that, while govern-
ment looks to cut hospital costs, it needs to
remain cognizant of the urgent need for in-
creased investment in home care and clin-
ics. Having sat on the board of a CCAC,
Goodman questions whether the govern-
ment's move will have any tangible impact
on patients.
"e government tried to find a bogey-
man, and the auditor general found the
CCACs were not being run efficiently," he
says. "e government seized upon that to
deflect attention away from the fact they
haven't been investing in the amount of
home care that needs to be provided.
"In my opinion, regardless of the govern-
ment's attempts to restructure how care is
PHOTO:
SHUTTERSTOCK
PENNY WASHINGTON
>
BULL, HOUSSER & TUPPER LLP
"Health care functions in many ways like a business,
but is overlaid with a highly regulated environment. It requires
deep knowledge of the industry and its approaches. Many
pieces of legislation apply to the critical work being done."
