It's Time To End Feudalism In Healthcare

“Getting any change made requires getting some moral authority that we have to do things together. The problem with ORNGE is that everyone in this room and everyone out there in the health sector is going to say, ‘That $25 million, that is the money I needed to run my program.’ ”

Moral authority doesn’t come from without – it comes from within.  Communication doesn’t start with the other party – it starts with you.

Ontario’s healthcare sector has an historic opportunity to do the right thing – collaborate on building an integrated healthcare system.  Starting with “but I need to fund my program” is the wrong approach.  There are countless programs out there that overlap, duplicating services for some demographic groups, leaving others in the lurch entirely.  The same applies to business supports, social services, educational services.

It’s time for public service providers to get out of their feudal mentality – Ontario is not a series of publicly funded fiefdoms, we’re a society.  We, as a people, are integrated – we need our services to be integrated as well.

The way of the future is specialized services offered in coordination.  I can think of several groups of healthcare stakeholders I have spoken to that want to develop shared service models; the consolidation of back-office functions, IT, etc was being discussed by multiple players long before the Drummond Report came out.  The biggest challenge they faced wasn’t will or connectivity, but follow-through.  “We aren’t mandated to integrate” isn’t good enough when there are people falling through the cracks. 

If government isn’t giving you its blessing to open a dialogue with partners, you do it anyway.  Boards of Directors can do this on their own time, without eating into existing budgets.  If you are in the business to serve your stakeholders with the best service possible, that means you support whatever model makes that happen, whether you’re the provider or not.  There’s lots of work to be done, everyone will have a chance to specialize – when they work together.

Besides – if the hammer is eventually going to fall, does it not make sense to proactively plan your own future rather than reactively implement someone else’s plan that perhaps doesn’t accurately reflect your ground-level reality? 

A couple of easy starting points:

- Greater accountability for financial resources – how many dollars get spent in funding envelopes because, well, it’s money, in that envelope?  If it doesn’t have to be spent in one area, reallocate within an institution or even cross-sector to where the need is.

- Shared service models for related services serving overlapping demographics

- A digital map of services to lay out what we have, who it serves and how the pieces interact

-       Look outside the box – much of reactive healthcare could be superfluous if we instead invested in proactive health and mental health promotional services.  Same applies to justice and broader social services.  Because we don’t take the time to plan and act proactively, we spend much more at the back-end. 

Some examples of this? 

     *  “mental ergonomics” in the workplace

     *  staff transition strategies

     *  Social Emotional Learning in schools (included in Full Day Kindergarten, by the way)

      * regular staff team-building exercises.

There’s a real appetite for leadership out there – all we need are people willing to lead.