Search This Blog

CCE in brief

My photo
Recovering backpacker, Cornwallite at heart, political enthusiast, catalyst, writer, husband, father, community volunteer, unabashedly proud Canadian. Every hyperlink connects to something related directly or thematically to that which is highlighted.

Monday, 12 May 2014

Redesigning Public Services in Ontario

The Liberals have a plan - go in and work with service providers to find cost-saving efficiencies.  The Tories have a plan - cut funds and force service providers to find efficiencies.  The NDP - well, the NDP have mantras.

Each of these Parties is trying to solve the wrong problem.

When you cut funds, people don't look to provide better services - they feel desperate themselves and will seek to shore up their own positions.  With drastic cuts count on labour strife, on the one side, but increased opacity of facts on the other as organizations realize they need to sell well rather than do well if they're to make the cut.

When you get in with individual agencies or communities and try to help them fix their financial woes, you're still missing the structural problem.

As a recent example - the Provincial Government recently decided that tackling Type II Diabetes would be a good investment.  Fair enough - it's incredibly costly, healthcare-wise, places a massive burden on families and support networks and leads to a reduced quality of life.  Did I mention the cost?

Diabetes Type II is preventable, by the way - through things like appropriate diet and exercise.

Governments have tried to minimize the uptake of commercial products that exacerbate the likelihood of getting Type II diabetes (things like pop) through bans and the like.

It hasn't gone over very well - companies like Coca Cola have done a magnificent job baiting and switching, presenting the issue as more one of government taking away free choice from the people.

Do you really want government determining what your kids can eat and drink in school?  How totalitarian!  How Dickensian!

No, corporations would much rather government keep its nose out of the consumption of the masses, meaning they're free to sell whatever they want, using whatever persuasive techniques they want.

"Momma, Johnny gets to have Coke for lunch and dinner, why can't I?"

"But honey, Johnny is obese and is going to end up diabetic, having a heart attack and needing knee and hip replacements by the time he's 40."

"Johnny's momma loves him, that's why he gets Coke.  Why don't you love me?"

Coke doesn't care if little Johnny is hospitalized and removed from the workforce by 40 - they're not paying for healthcare.  In a global economy, they don't even need to have anything other than storage facilities in Canada.

But I digress.

Ontario wanted to address Diabetes Type II without going the ban route - instead, they opted for education.  Funding was provided through the Ministry of Health to municipal government agencies, like Toronto Public Health, to develop programming and train community groups to teach their folk about diabetes.  

The training consisted of a three-day course provided to whoever was sent by groups that received money.  Those groups would then be responsible for passing the training along, resulting in the communities most likely to get Diabetes Type II becoming more informed about prevention.

Sounds great, but.

The NFPs that signed up for these classes were by-and-large not focused on health.  In fact, many of them were simply so desperate for operational dollars that they were signing up for whatever program handed out cash and considering themselves clever for doing so.  After all, the way public funding of Not-For-Profits has been going, these folk can't afford to hire organizers, fundraisers or lobbyists able to get them the support they need.

Their work is important, even vital - but nobody's selling it well and nobody's funding that work.  So they're championing Diabetes Type II instead.  They send people to the training with little-to-no understanding of what their mandate is.  They get some information and a couple of toys over three days, and then are sent off into their communities to train their peers.

There was no evaluation of the knowledge absorbed.  No evaluation of the efficacy of the program.  

There are no metrics to ensure consistency of training, absorption or behaviour changes by communities and the most important stats of all, changes in Diabetes Type II rates by community.  Without these metrics, there's no telling if the process worked, who's got best practices, what approaches work best in individual communities, etc. 

The entire program was a waste of dollars, essentially serving as a band-aid to keep completely unrelated services afloat because sustainability has been leached out of the system.

This was a Liberal program.  Under the Tories, it would be gone.  Score one for efficient use of public dollars!  Yet the problem would remain - in fact, it would get worse.

The same holds true for any program cut, any regulation decrease or policy shift that places more emphasis on individual, corporate success at the expense of the structural whole.  

Think the duplication, gaps and overlaps we have now are bad?  Just imagine what they'd be like with no process in place at all.

Again, across the board we're trying to solve the wrong problem - it's not more money or less money or more regulation or less regulation attempting to nudge individual behaviours that's required - real efficiencies are found through better structure from top to bottom.

Last I heard, there were efforts underway - finally - to at least map out services provided to youth in Ontario.  I argued that, to be effective, that map should look like a flow-chart; what money tagged for what purposes was being sent to where, between and across Ministries.  

It's like doing a leak-test on a house; if we don't know how the money is being distributed on the front line, we can't know where the holes are or where individual sectors have simply gotten better at demanding more.

When it's all about individual success, after all, it's he who manipulates best who comes out on top.  

Just ask Coca Cola.

The options on the table seem to be: we can collectively subject ourselves to the whims of government, through regulations, or we can put ourselves at the mercy of well-funded private sector interests with all the latest science on how to manipulate our "free" choices so that they win.

Of course, there is an alternative - one that would see a restructured government doing a better job coordinating its efforts, working with private sector and not-for-profit sector partners under the supervision of an engaged public.

It is time for a change in Ontario, and across the board, but it's not one we can demand of others unless we're willing to step up ourselves.

We can have an Open Government, but not without active participation on our part.

The only catch is this - the only way to have ownership over your future is to be a responsible member of society. 

No comments:

Post a Comment