THUNDER BAY — A controversial proposal to merge Northwestern Ontario’s two public health units will be put under the microscope in a third-party review.
The Thunder Bay District board of health voted on Wednesday to engage a consultant to report on the implications of a merger with the Northwestern Health Unit (NWHU).
The board, which oversees the Thunder Bay District Health Unit, appeared to be mostly united around a consensus that a merger would hurt the delivery of public health programs, by stretching them across an area more than 400,000 square kilometres in size.
Simply driving from one end of that area to the other takes over 10 hours, board members noted.
The Ford government announced plans to consolidate Ontario’s 34 health units into 10 in 2019, saying it hoped to find efficiencies. That push, put on pause during the COVID-19 pandemic, drew concerted opposition from Northern Ontario leaders.
The province launched a new process to encourage voluntary mergers earlier this year, looking to “reduce overlap of services and focus resources.”
Board members expressed skepticism cost savings could be achieved in the Northwest, with one speculating wages would need to increase at the TBDHU to achieve parity with the NWHU, for example.
While the move could generate savings for the province, a report from medical officer of health Dr. Janet DeMille warned Thunder Bay District communities could face "significant increased costs for public health" in the case of a merger.
However, directed by the province to consider the possibility, the board voted unanimously to at least examine a merger.
“There are so many concerns with amalgamating,” said board vice-chair and Greenstone Mayor Jamie McPherson. “I’m dead against it, to be quite honest, but I think it’s something we should have a look at — I have no issue with that.”
While the province is not mandating mergers through the current process, DeMille indicated the Ministry of Health favours them.
“It is my strong sense that the ministry would like to see a merger of the Northwestern Ontario health units,” she said.
DeMille said the idea of consolidating health units isn’t new, pointing to a 2006 provincial review that found “huge geographic challenges” in Northern Ontario “might outweigh the benefits” of merging.
Her report suggests the two health units also could pursue ways to pool resources to find efficiencies “without the disadvantages that a merger would bring.”
That report points to some benefits of a merger, such as a greater ability to leverage skilled professionals from the two organizations and the potential to avoid duplication of efforts and services in some areas, while noting savings may be minimal.
One board member suggested a merger would allow consolidation of some senior leadership and administrative roles.
On the other hand, the report warns of serious governance challenges for a merged health unit serving dozens of municipalities and First Nations.
"It is challenging to imagine a board that could equitably represent the interests of all local municipalities," DeMille wrote.
That concern resonates for Manitouwadge Mayor Jim Moffat, who sits on the board of health.
“As it is right now, I'm at the eastern end of the border of the Thunder Bay District Health Unit, and it’s a 400-kilometre drive for me every time there's a meeting," he said.
The motion passed by the board Wednesday will see the health unit “engage a third-party consultant to assess and report on considerations and implications of a merger.”
The board of the NWHU is expected to consider a similar proposal to jointly hire a consultant for the review in the coming days.
DeMille said there is not yet a hard date for when the consultant’s report would be delivered.
The province is looking to initiate voluntary mergers by Jan. 1, 2025, according to a guidance document from Ontario’s chief medical officer of health.
