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Was creating a separate ministry of Long Term Care a mistake?

Was creating a separate ministry of Long Term Care a mistake?

The decision to hive off the Long-term-care Ministry from the Ministry of Health was seen as a contributing factor in the deadly spread of the COVID virus through the LTC system last spring. That was the gist of questioning and testimony before the Ontario Long Term Care COVID Commission last week. The Commission has a mandate to investigate how and why COVID-19 spread in long-term care homes, what was done to prevent the spread, and the impact of key elements of the existing system on the spread. Testimony last week provided a peek behind the curtain of a vast health care bureaucracy that appeared to be at times cumbersome and siloed.

Ontario Hospital Association said LTC needs were not met

Commission Counsel John Callaghan was questioning Health Minister Christine Elliott and her Deputy Minister Helen Angus about the early delay in getting a handle on the outbreak in LTC homes as deaths piled up. He quoted the testimony of Anthony Dale of the Ontario Hospital Association who had earlier testified “I think that (Long-Term Care’s) separation from the Ministry of Health has created systemic kind of silos and barriers to integrated thinking. After we realized that long-term care was, not — the needs of long-term care and the need for speed and substantive planning and preparation for the pandemic response, once we realized that those were not being met, we chose to act and undertake some actions to address that.”

Deputy Health Minister Helen Angus

Deputy Minister Helen Angus replied, “I am  aware of the view of some stakeholders…about whether  the carving out of the Ministry of Long-Term Care  from the Ministry of Health was a good idea, given, you know, the idea of sort of connecting all parts  of the health care system to work more functionally  together through things like Ontario Health teams,  which are an important part of how we want health  care providers to work together going forward.”

She added that the system corrected itself after the hospitals started to move into Long Term Care Homes to battle the pandemic. “it  wasn’t long after that — that the hospital sector  stepped up to support long-term care in exceptional  ways.”

Still it wasn’t until last Fall that the command table structure was changed to add the Ministry of Long Term Care  but the Ministers—Elliott and Fullarton only attended “on occasion.”

Unorganized lab testing system

Discussion turned to the slow start Ontario got on COVID testing, both in terms of the number of tests being administered and the delays in getting results back from the labs. Minister Elliott Admitted that in comparison to Alberta, Ontario’s lab system was disorganized. “We didn’t have a connected system,  such as they do have in Alberta, that would have  allowed us to ramp up our lab capacity  significantly, and this is something that we worked  on.  And fortunately, due to the work that was done by Matt Anderson, by the Deputy Minister  and by others, we were able to put together a  system that was able to increase the ability to  process tests considerably within quite a short  period of time.”

The NDP have been calling for the head of Long Term Care Minister Merrilee Fullarton, but the testimony is suggesting there were bureaucratic and systemic issues that were a factor in the slow response of the Ministry. The commission is set to issue its report by the end of April

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