County must be at the table

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Ontario is the only province in Canada with an independent, voluntary governance model for hospitals.

As mandated by the Public Hospital Act, a board of directors must oversee individual hospitals.

These boards serve in a governance role and have a fiduciary responsibility to the hospital when fulfilling their primary duties, which include financial oversight and developing a mission, vision, and strategic plan for the hospital.

Further, the Excellent Care For All Act, passed in 2010, strengthened the responsibility of boards, regarding oversight for the quality of care delivered within hospitals.

The Haliburton Highlands Health Services (HHHS) has traditionally struggled to get enough people to put their names forward for the board. We’ve heard from some applicants, seemingly good ones, who never got a call back.

Historically, the boards have tended to give much of their power to the president and CAO of the day. With all due respect to current and past members, in recent years, It has not been a particularly strong board.

That is partially why the closure of the Minden emergency department in June has garnered so much criticism. While the board has closed ranks to insist it was involved in every stage of the decision, it has opened itself to rebuke. If the job is to provide financial oversight, for example, why was HHHS allowed to amass a $4 million debt? Why did it allow the closure of a hospital ED with only six weeks’ notice?
For this very reason, County council is perfectly within its rights to demand two seats at the board table as a condition of giving HHHS $1 million to put towards a CT scanner and CT mammography unit.

The argument for not having a council rep in the past was fear of political interference. Yet, one or two members are not going to swing a vote on what is now a 12-member board.

The Ross Memorial Hospital board in Lindsay has a council appointee, ward 5 coun. Eric Smeaton, who is an ex-officio voting director. So, there is very close precedent for what the County of Haliburton is seeking.

Further, the County has financial skin in the game so should be there. It pays for a physician recruitment coordinator and leases homes in Minden and Haliburton to place doctors for the family health teams and HHHS.

Warden Liz Danielsen alluded to HHHS perhaps being amenable to having County representation but that it might have to wait until the 2024 annual general meeting.

Acting CAO Veronica Nelson wouldn’t comment on that when The Highlander asked the question.

However, with $1m dangling in the wind, we expect Nelson and the board to turn this around much quicker than next year’s AGM. Bylaws can be revisited and changed anytime. We encourage HHHS to do its due diligence, get a legal opinion if it must, but move quickly on appointing at least one member of County council to its board as soon as possible.