Ontario’s McGuinty Government Rewards Bureaucrats It Hides Behind For Unpopular Hospital Service Plans By Exempting Them From Scrutiny

By Doug Draper

While many residents across the Niagara region continue to express worry and concern over the future of hospital services here, at least one bureaucratic body Ontario’s Liberal government has set up to oversee changes to our hospitals has recently been given less reason to worry.

The Local Health Integration Network (LHIN) for the Niagara and Hamilton areas, along with several other high-priced, appointed bodies of bureaucrats like it across the province – is being granted immunity from legislative review by Premier Dalton McGuinty and his government so it can go on doing the government’s dirty work of reducing services at smaller hospitals across the region.

Members of the opposition Conservative and NDP parties discovered late this March, while taking some infra-red light to the fine print of the budget papers the McGuinty government dumped on us that a legislative review of the four-year-old LHIN bureaucrats for our area and others – a review that is in no small part about checking out their performance and spending practices for public accountability purposes, by the way – has been brushed forward from happening now – meaning the end of this March or  sometime in the future, or maybe never, for all we know.

(Click on ‘keep reading’ at the end of this sentence for more news and commentary on this topic.)

There was plenty of debate about this in the provincial legislature in the dying days of this March, and Niagara At Large is posting transcripts of some of it below. It should also be noted that at least one Liberal MPP, Kim Craitor of Niagara Falls, showed the courage to confront this issue on behalf of his constituents in the Niagara Falls and Fort Erie who continue to wrestle with the loss of hospital services in their communities.

This April 1, Craitor was quoted in the Niagara Falls Review newspaper saying he has no problem “with the LHINs being reviewed now. But it’s also time for us to review the Niagara Health System,” he added of the NHS body set up a decade ago to manage most of the hospital sites across the region. “I believe in transparency.”

“Unfortunately, here in my riding the LHIN has been tarnished by what’s transpired over at the Niagara Health System.” Craitor said.

Unfortunate or not, the LHIN Craitor is talking about is also the same non-elected body that had to practically have its head smashed in two summers ago to hold public consultation planson the NHS’s so-called “hospital improvement plan.” It is also the same LHIN that went along with the ‘Alice In Wonderland’ madness that you can have a comprehensive review of that plan without entering the NHS’s decision to locate the only new hospital we are likely to get in this region in the wrong location – a corner of traffic and retail clogged west St. Catharines – into the discussion at all. The LHIN went along with the NHS in placing this ludicrous restriction on a discussion of the future of hospital services here and yet Premier Dalton McGuinty, with St. Catharines Liberal MPP and cabinet minister Jim Bradley, went along with McGuinty declaring that these faceless LHIN bureaucrats are “champions” for our community.

Niagara At Large includes below some of the transcript on this matter from the provincial legislature and below that there are comment boxes where you can offer your opinions.

From NDP Welland Riding MPP Peter Kormos, in legislature this March 31.

Mr. Peter Kormos: Speaker, I stand here to tell you that while Dalton McGuinty, the Premier of Ontario, wants to scrap the review process of LHINs, I say let’s just cut to the chase and scrap the LHINs. They do no one any good other than create a firewall for this government from the anger in community after community where emergency rooms are being shut down, where core hospital services are being devastated and where hospitals are disappearing.

We had some of the Yellow Shirt Brigade here at Queen’s Park this morning, the brigadistas, people like Fiona McMurran and Merilyn Athoe.

While they’re joining the Yellow Shirt Brigade from Niagara that’s been fighting tooth and nail to keep hospitals open, like the emergency rooms of Fort Erie and Port Colborne, they’re going to be here on April 7, along with the Ontario Health Coalition, making sure that Minister Deb Matthews—when she’s speaking down at the posh Royal York Hotel to the Canadian Club of all places about health care, they’re going to be out there demonstrating and picketing and letting the Minister of Health know that there are folks across this province who don’t believe this government for a minute—not for a second—when this government says it’s doing anything to sustain health care, never mind improve it.

I’m encouraging folks down in Niagara to be at the Fort Erie Leisureplex at 8 a.m. on Wednesday, April 7, to get a bus to Toronto; be at the Welland Market at 8:30 a.m. and get on a bus and come on up to Toronto; be at the St. Catharines Pen Centre at 9 a.m. and get on a bus and come up to Toronto, and let them know what you really mean.

From a debate involving Premier Dalton McGuinty, Conservative Opposition Leader Tim Hudak and Hudak’s health critic Christine Elliott this March 29.

LOCAL HEALTH
INTEGRATION NETWORKS

Mr. Tim Hudak: My question is to the Premier. On Thursday, Ontario families learned that your budget is on track to doubling the provincial debt by 2012, basically mortgaging the future of our children and grandchildren. A good place to start in controlling your spending is at those unaccountable, anonymous bureaucracies that you call the local health integration networks, the LHINs.

Under the Local Health System Integration Act, 2006, these LHINs were to be publicly reviewed by March 28, 2010. Today is March 29; no review is in sight. Premier, you’re breaking your own law. What makes you above the law in the province of Ontario?

Hon. Dalton McGuinty: I’m pleased to take the question and pleased to have an opportunity to speak about our budget. My colleague makes reference to a particular aspect to be found within the budget bill itself, but I would want him, of course, to take into account what we do at a higher level in terms of the budget.
A number of important things-fundamentally, the budget is about jobs and growth. In that budget, we are not only protecting, but enhancing public services for our families, which they are very concerned about. We continue to invest in a strong economy, and as part of that particular plan, we are balancing our budget in a prudent, thoughtful and responsible way. We’re taking the appropriate amount of time; no more time than is necessary, but not so quickly that we compromise public services or dampen our economic recovery.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Tim Hudak: It’s sad how arrogant the Premier has become after six years in office. I asked a very simple, straightforward question about his legislation that would cause a review of these bloated regional health bureaucracies, the LHINs, by March 28, 2010. But buried deep within his own budget, on page 164, it says the McGuinty Liberals are going to arrogantly rewrite their own law and block the Legislature from holding that review, which should have begun as of yesterday.
Premier, I’m going to ask you again. What has happened to you after six years in office? Have you become so arrogant that you believe you’re above the law in the province of Ontario? Why are you breaking your own legislation?

Hon. Dalton McGuinty: I’m pleased to speak more directly to my honourable colleague’s question this time around. It is quite true that we had originally anticipated that we could and should conduct a review of our local health integration networks by the end of this month. But as it turns out, all of the responsibilities that we wanted the LHINs to take on, they have yet to take on. In particular, a big part of their new responsibilities would be long-term care. Our local health integration networks have not yet done that.
But there are a number of things that we have been doing with a view to ensuring that we are reviewing the operations of our LHINs on an ongoing basis. We asked KPMG to conduct a review for us. They put forward 27 separate recommendations. All of those either have been implemented or are under way. We have an annual review of our accountability agreements to address new issues as LHINs take on additional responsibilities. We think the responsible thing to do is to allow them to take on the responsibilities.

The Speaker (Hon. Steve Peters): Final supplementary.

Mr. Tim Hudak: The Premier uses the term “originally anticipated.” I remind you, Premier, that this is your own law. This is a law written by your health minister, passed by your own members, which called for that review to take place by March 28, 2010. You didn’t have the courage to make any kind of announcement; you didn’t meet with the opposition parties to look for a delay. You buried it in page 164 of your budget bill.
Sadly, this fits a pattern. When the Premier first received a draft report from the Ombudsman on the problems at his LHINs, what was the Premier’s response? Well, he’s trying to defang the Ombudsman by threatening to take his job away.
We take a different view altogether, Premier. What exactly are you trying to hide at your runaway regional bureaucracies, these so-called LHINs?

Hon. Dalton McGuinty: Again, I know my honourable colleague would want to be accurate in terms of his presentation of the facts here. There will be a comprehensive review. We have deferred that for two years. We think the appropriate thing to do before we conduct a fulsome review is to allow the LHINs to take on their fulsome responsibilities, including long-term care. There have been a number of reviews conducted along the way. We take advantage of the results of those reviews and put into place the recommendations.
Before we had LHINs, there were seven regional offices and 16 district health councils. I gather my honourable colleague would prefer that we eliminate the LHINs and bring back seven regional offices and 16 district health councils. We have a fundamental difference of opinion. We believe that we can have confidence in the people in their communities when it comes to local decision-making; hence the LHINs.

Mr. Tim Hudak: Back to the Premier: So the Premier is breaking his own law. He is trying to silence the Ombudsman, who has been looking into the problems with your regional health bureaucracies, and I think we have a good understanding of exactly what Premier McGuinty is trying to hide. This time last year, we brought forward revelations of runaway spending and sweetheart untendered contracts through his eHealth boondoggle. After months of denying and deflecting and stonewalling, the Premier was forced to finally end this frenzy for consultants through his untendered contracts.
Premier, on June 17, you said it had come to an end. Why did the central LHIN, within one week of your making that announcement, hand out an untendered contract to Beth Snyder Coaching and Consulting-one week after you said this would come to an end?

Hon. Dalton McGuinty: To the Minister of Health.
Hon. Deborah Matthews: Our government believes in the value of LHINs; we believe in the importance of integrating our health care system. As we move forward, improving the value for money in our health care system, we’re going to need the LHINs to do their work. We have put in place tough new rules around tendering for contracts. As we moved to those new rules, there were some contracts that needed a bit more time to complete their job. So the contracts that the member opposite is referring to were all extensions of existing contracts. We thought the right thing to do was to let that work continue rather than starting over from scratch.

The Speaker (Hon. Steve Peters): Supplementary?

Mr. Tim Hudak: So let’s make sure we have the facts here. The Premier made an announcement on June 17, and then, a week later, your central LHIN gave out a sweetheart untendered contract.
You’d think the Premier or the health minister would show some anger. You’d think they would get to the bottom of this. You’d think there would be a price to pay for breaking the promise that the Premier made. But all we see is a shrug, and again, pass the buck.
Let’s be clear: $42,000 in a sweetheart contract was given out one week after the Premier promised there would be no more. So I ask the health minister, are you not in charge of your own government, or did you simply give a wink and a nod to the LHINs to let the sweetheart deals keep rolling?
Hon. Deborah Matthews: Quite the contrary. We have put in place tough new rules. What we inherited in 2003 was not what we needed to do today. We put in place tough new rules-no more sole-source contracts, regardless of dollar value; and consultants will not be paid for hospitality, food or incidental expenses-and we are mandating that the LHINs report to us quarterly on how they are complying with these tough new rules.
I have every confidence that they have embraced the new rules. Let me give you one example: The Waterloo-Wellington LHIN did extend a contract after the new rules came into place. This is a contract to complete a rural health study-I’m sure the member opposite thinks we should make sure that rural health needs are fulfilled in the Waterloo-Wellington region, and I’m sure he would expect us to.

The Speaker (Hon. Steve Peters): Thank you. Final supplementary.

Mr. Tim Hudak: Quite frankly, Minister, tough new rules don’t matter a whit if you don’t have the backbone to stand up and enforce them and make sure the job gets done: $42,000 handed out in a sweetheart deal after Dalton McGuinty said they would end; we found the LHINs have given out some $7 million in untendered contracts. Just like we saw at the eHealth boondoggle, your LHINs, the sons of eHealth, are following the same procedure: sweetheart deals to well-connected consultants and then giving out money for contracts for little work or before the contract is even signed.
I ask the health minister: Surely you must be aware of this abuse. Surely you will do something about it. Can you stand in your place in the assembly and say this is the only exception to breaking the rules that you say are so-called tough?

Hon. Deborah Matthews: I can assure you that we are very serious about making sure the tough new rules are in fact adhered to. That is why we’re mandating quarterly reports from the LHINs. We are doing random audits to ensure that these new rules are being adhered to.
The contract you’re referring to-I believe you might want to double.

Mrs. Christine Elliott: My question is for the Premier. As the eHealth scandal was breaking, the Premier made a big show about taking charge. On June 17, he issued a media release and said “From now on, the government and all its agencies will no longer allow sole-sourced contracts for consulting services.” But according to freedom-of-information records, the Waterloo-Wellington LHIN handed out three untendered contracts between July 29 and November 9, 2009. Premier, why didn’t you just say the new rules don’t apply to the LHINs and the consultants to which they’re handing out this sweetheart deal?

Hon. Dalton McGuinty: To the Minister of Health.

Hon. Deborah Matthews: Make no mistake about it: These new rules do apply to the LHINs. The LHINs know it and are complying with it. There were some contracts that needed extensions after the new rules came in place, and that was the right thing to do. It would have been irresponsible to halt those contracts in the midst of their work. Did they continue to study rural health in Waterloo-Wellington? Yes, they did. Should they have done that? Absolutely, yes.

The Speaker (Hon. Steve Peters): Supplementary?
Mrs. Christine Elliott: This scandalous abuse of taxpayers and their money proves why the public’s review of the LHINs simply can’t wait; it needs to happen now. The Waterloo-Wellington LHIN handed out almost $97,000 after the Premier led Ontario families to believe your rules wouldn’t apply and put an end to the sweetheart deals. The untendered contract of November 9 shows that not even the resignation of the former health minister on October 6 slowed down the Premier from using this money as a personal slush fund.
Will Premier McGuinty stand in his place now and ensure Ontario families that no other untendered contracts were handed out after you told Ontario families that they had stopped?
Hon. Deborah Matthews: The party opposite has made it very clear that their position is to shut down the LHINs and bring all of that power and decision-making ability back to Queen’s Park. We have seen what has happened when that power is all here at Queen’s Park.
I actually believe in the power of local decision-making. I believe that if we want to move forward to improve health care, we need to do it at the local level and the LHINs are the right organizations to be driving that integration.
Let me give you an example of what happened in Waterloo-Wellington that would not have happened without the LHINs. First Link is a program that provides recently diagnosed individuals with dementia and their caregivers with comprehensive and coordinated supports. They strengthen the linkages between the physicians, the specialists and the caregivers.

Mrs. Christine Elliott: My question is for the Premier. Last year, you made a big show of telling Ontario families that you changed the rules to put an end to the untendered contract feeding frenzy that saw eHealth hand out sweetheart deals to Courtyard and other Liberal-friendly consultants. But according to freedom-of-information records, the Erie St. Clair LHIN handed out two untendered contracts months after you said your new rules put an end to these sweetheart deals.
Will you finally admit that your LHIN bureaucracies are diverting health care dollars from patients and front-line care with no value in return?

Hon. Dalton McGuinty: To the Minister of Health.

Hon. Deborah Matthews: The LHINs are providing tremendous value. They have embraced their new responsibility to integrate services with the patient in mind. The future of health care demands that we do everything we can to integrate health care. Patients know that. This morning, I spoke at a patients summit here in Toronto. They know that integration is the key to the future, and it is the LHINs that are best positioned to do that integration. That is very, very good work that they are performing.

The Speaker (Hon. Steve Peters): Supplementary?

Mrs. Christine Elliott: A year ago, the Premier said he put an end to these untendered contracts. Two weeks ago, the spokesperson at the Erie St. Clair LHIN said that the LHIN “no longer has untendered contracts and will continue to comply with all provincial procurement directives.” She must have been referring to a different set of rules because your unelected, unaccountable appointees handed out $73,000 in untendered contracts that we know of.
The untendered contracts binge at eHealth cost you a minister, a deputy minister and the chair and CEO of eHealth. Who will be held accountable for the untendered contracts binge at the LHINs, Premier?

Hon. Deborah Matthews: I know that the member opposite is looking for a story here, but I’m afraid there isn’t one. The LHINs are doing very good work on the ground, they are adhering to the new rules that are in place, they are reporting quarterly on their adherence to the rules, and we are ensuring that that is in fact happening.
Let me tell you a little bit about something that the Erie St. Clair LHIN has done that I don’t think could have been accomplished from here at Queen’s Park. In December 2009, the Erie St. Clair LHIN had the lowest ALC days to discharge in the province, at 22 days. What that means is that people who are in hospitals are getting home or into the care they need more quickly than any other place in the province. They’ve improved wait times, they’ve got the best wait times in cancer, cataract, hip and CTs. This is good work.

The following is a media release on this matter from the opposition Conservatives

TODAY IN THE LEGISLATURE: MARCH 29, 2010
 
 McGuinty Liberals Quietly Rewrite Accountability Rules
 To Block Scrutiny of Latest Contracting Scandal at the LHINs
  
Buried deep in the 2010 Budget Papers, the McGuinty Liberals quietly, and deliberately, cancelled a legislative review of the Local Health Integration Network (LHIN) bureaucracies.  This review would have shed light on the spending and contracting practices of the unelected, unaccountable and anonymous appointees who run these regional health bureaucracies.
 
Under the Local Health Systems Integration Act, 2006, the McGuinty Government is legally required to subject the LHINs to a full public legislative review by March 28, 2010.  Rather than be forced to subject the LHINs to public scrutiny, the McGuinty Liberals have instead buried a provision on page 164 of the Budget that would eliminate the obligation to hold this review.
 
The decision to remove accountability provisions from the LHINs legislation is just the latest example of how far Dalton McGuinty is prepared to go in order to hide his government’s dirty secrets.  Previously, the McGuinty Liberals acted quickly to block the reappointment of Ontario Ombudsman André Marin after they obtained a confidential draft report of his own LHIN investigation.
 
Despite this elaborate secrecy, the Ontario PC Caucus has nonetheless obtained evidence  confirming that Dalton McGuinty’s LHIN bureaucracies have handed out at least $7 million in untendered contracts, involving many of the same players who got rich off of the Liberal eHealth scandal.   Most shocking of all is the fact that at least a half-dozen of these untendered consulting contracts were handed out well after Dalton McGuinty’s much-publicized ‘ban’ of untendered consulting contracts throughout government.
 
Quotes
 
“There is no excuse for using the 2010 Budget to undermine accountability rules.  This has nothing to do with Ontario’s finances and everything to do with hiding the Liberals’ latest dirty secrets from the public.”
— Ontario PC Leader Tim Hudak
 
“Dalton McGuinty promised he would ban untendered contracts, but his own appointees at the LHINs kept on handing them out.  Not only is Dalton McGuinty refusing to enforce his own rules, he is now deliberately trying to help the LHINs cover-up the truth.  It is clear that this is not the same Dalton McGuinty people thought they were voting for in 2003.”
— Ontario PC Leader Tim Hudak
 
Quick Facts
 
On the cover-up
 
·        Ontario’s LHIN bureaucracies were created by a standalone piece legislation which created the Local Health Integration Networks in the “Local Health Systems Act 2006”.   This legislation received Royal Assent on March 28, 2006.
 
·        The “Local Health Systems Act 2006” calls for a public Legislative Committee review of the LHINs to begin no later than four years after the act receives Royal Assent (March 28, 2010). 
 
·        On page 164 of the 2010 Budget, the McGuinty Liberals propose rewriting the Act to remove this requirement and replace it with a vague commitment to conduct their own “thorough review of the Act and the powers available to Local Health Integration Networks”.  There is no deadline for this internal review nor is there any guarantee that it will be made public.
 
On the scandal
 
·        The Ontario PC Caucus has used Ontario’s Freedom of Information Laws to reveal that Dalton McGuinty’s LHIN bureaucracies were engaged in the same binge of untendered contracts that were behind the Liberal eHealth scandal.
 
·        To date over $7 million worth of untendered contracts have been discovered at the LHINs, including untendered contracts for the eHealth-linked Liberal-friendly Courtyard Group.
 
·        On June 17, 2009, Dalton McGuinty issued an edict supposedly banning untendered contracts throughout the Ontario government. 
 
·        Despite this edict, the pattern of handing out untendered contracts continued at the LHINS where, on at least a half-dozen separate occasions, McGuinty’s own LHINs appointees ignored this edict and continued the practice.
 
·        On June 25, 2009 – only eight days after the McGuinty edict – the Central LHIN handed out an untendered contract.
 
·        On October 1, 2009, the Waterloo – Wellington LHIN handed out an untendered contract.
 
·        On July 20, 2009, the Erie – St. Clair LHIN handed out an untendered contract.
 
·        On July 27, 2009, the Erie – St. Clair LHIN handed out a second untendered contract.
 
·        On July 29, 2009, the Waterloo – Wellington LHIN handed out an untendered contract extension.
 
·        On November 9, 2009, the Waterloo – Wellington LHIN handed out a second untendered contract extension.

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