On July 12, 2004, I was appointed Assessor for the Muskoka-Parry Sound Health Unit pursuant to Section 82(3) of the Health Protection and Promotion Act, R.S.O. 1997, c.30 Schedule D, s. 11.

The assessment was requested as a result of growing concern with regard to governance and operations of the Muskoka-Parry Sound Health Unit.

The Health Protection and Promotion Act ("HPPA") attempts to create a regime which constitutes a fine balancing act between the role of the government in establishing a comprehensive public health program for the province, while at the same time devolving the funding requirements and program delivery to the municipalities.

Accountability for the discharge of these crucial public services is divided among :

• the provincial government which determines mandatory programs and services which must be delivered by every local public health unit;
• the Chief Medical Officer of Health for Ontario;
• the Medical Officer of Health for each health unit who has extensive statutory powers and responsibilities quite independently of any reporting relationship with the local Board of Health and who is required under s. 67 to report directly to the Board on issues relating to public health concerns and to public health programs and services under the HPPA and all other provincial statutes; and
• the local Boards of Health

The key to the success of this relationship lies in the effectiveness of the Board of Health. The municipally dominated Board must recognize that they are responsible for the quality and success of the mandatory health programs and in the execution of these duties they are largely reliant on their Medical Officer of Health ("MOH"). The MOH is responsible to the Board for both medical and administrative matters under the HPPA (Section 67). The MOH position is both demanding and pivotal in the provincial-municipal interface. The MOH must ensure the development of a budget that is sufficient to meet the public health needs while administering a health unit that is efficient, and cost effective. This leadership by the MOH and the policy and approval oversight by the Board should provide the local municipalities and their residents with assurance that the public health is protected and that their public health programs are delivered at a reasonable cost to their taxpayers.

Like all balancing acts, there must be both a reasonable measure of respect and understanding between the parties particularly the relationship between the MOH and the Board.

Executive Summary continued >>

The full report is available for download in PDF format, below :

EXECUTIVE SUMMARY Operation Health Protection : An Action Plan to Prevent Threats to our Health and to Promote a Healthy Ontario 10 pages | 58 K | PDF format

FULL REPORT Assessors Report on the Muskoka-Parry Sound Health Unit 32 pages | 266 K | PDF format

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October 20, 2004