Ontario is moving to scrap the controversial Community Care Access Centres in an overhaul of the health-care bureaucracy aimed at streamlining the way elderly and recovering patients receive care in their homes.

Minister of Health and Long-Term Care Eric Hoskins announced the release of a discussion paper and proposal at a news conference on Thursday.

"We want to make it easier for patients to find a primary care provider when they need one, to see that person quickly when they are sick and to find what they need closer to home," he said.

The province's CCACs include 14 centres in which home-care workers, nursing staff and co-ordinators serve more than 700,000 patients a year at a cost of $2.5-billion.

The discussion paper, entitled “Patients First: A Proposal to Strengthen Patient-Centred Health Care,” outlines a plan in which the province's Community Care Access Centres would be scrapped and their governing boards “dissolved” in favour of expanded Local Health Integration Networks. LHINs are directly accountable to the health ministry.

"We see this as not only reducing levels of bureaucracy, but also integrating more effectively with resources we have so we can then channel more frontline resources to front-line care," Hoskins said.

There will have to be changes in legislation to implement the reorganization, which Hoskins expects will be tabled early in the new year.

Linda Haslam-Stroud, president of the 74,000 strong Ontario Nurses' Association (ONA), greeted the announcement with guarded optimism.

"If the demise of the CCACs actually cuts some of the bureaucratic excess that is presently there with the CCACs, and that money is reinvested in patient care, I think it'll be a positive step forward in making the best use of health-care dollars," she said.

Haslam-Stroud said that if this is just another layer of bureaucracy under a different name, then the proposal will just create more problems. She also said she's skeptical that all the LHINs are up to the organizational job they'll be asked to do.

"They are a separate entity that has really had nothing to do with the majority of health-care workers in Ontario," she said. "So this is going to be a new chapter in their work. ... We're going to have to sit down and figure out how ONA is going to work with the 14 CEOs of these LHINs because they're now going to be the employer of our members."

She said that after the reorganization is in place, there will be more work to do as far as patient care is concerned.

The auditor general's 2015 annual report found "long-standing" problems with the CCACs in which clients on wait-lists "have to face long wait times to obtain personal support services, and clients with the same assessed needs still receive different levels of services depending on where they live in in Ontario."

The problem, according to the AG, is that "home-care funding to each CCAC is predominantly based on what each received in prior years rather than on actual client needs and priorities." Furthermore, each CCAC can exercise its own discretion on the types and levels of services it provides, "thereby contributing to significant differences in admission criteria and service levels between CCACs."

When asked about the AG's criticisms within the context of Thursday's announcement, Hoskins praised the front-line health-care staff.

"However, part of the challenge was that it was isolated from the rest of the health-care system, or not as integrated as it might be," he said. "And that's part of the reason for moving into the LHIN, so there's that single point of accountability rather than having separate governance and a separate structure."

A statement from the Registered Nurses' Association of Ontario (RNAO) applauded "the bold changes" being proposed.

"We are delighted to see many of the ideas discussed in RNAO's Enhancing Community Care for Ontarians (ECCO) report reflected in the proposed government changes," it said. "These changes will enable health system integration by aligning whole system planning, funding allocation, and accountability."

NDP Leader Andrea Horwath said the minister's announcement will do little to ease concerns that the health-care system is under attack.

"Cutting health care is not the kind of transformation that Ontarians need to see, but that’s exactly what the Liberals continue to deliver. Today’s long-overdue discussion paper won’t fix the problems in our health-care system unless the Liberals stop cutting hospital services and laying-off front-line health-care workers." she said.

Proposed health overhaul would scrap CCACs to ‘ease’ patient access to home care

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