The Independence of Ontario's Public Health Units: Does Governing Structure Matter?

Lyons, Joseph

The inquiry and commission reports that came out in the wake of Walkerton and SARS were critical of the integrated health unit model, arguing that it prevents health units from fulfilling their mandate (Campbell 2004; O'Connor 2002) . For example, the SARS Commission argued that, without full control over administrative and personnel decisions, MOHs are limited in their ability to deliver the required public health services. In plainer language, "basic protection against disease should not have to compete for money with potholes and hockey arenas" (Campbell 2004: 18) . The Capacity Review Commission (CRC), which was tasked by the province with reviewing the organization and capacity of local health units, also advocated for autonomous health units. It recommended that "public health units should be governed by autonomous, locally based boards of health. These boards should focus primarily on the delivery of public health programs and services" (CRC 2006: 30) . In contrast, the Association of Municipalities of Ontario (AMO), a group representing Ontario' s municipalities, argued that as long as municipalities are required to partially fund health units, they should have some governance and financial control (AMO 2006) .