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

Lyons, Joseph

The annual growth of the levy that the City of London pays to the MLHU and the MLHU' s total cost-shared program funding growth were compared with the annual growth of the City of London' s approved operating expenditures. The same comparisons were done for HPHS and the City of Hamilton. (Although municipal budgets consist of both operating and capital expenditures, approved operating expenditures were used, because this is the category that health unit expenditures fall under.) These within case differences were also compared across cases. Most of the time period covered by this study was supposed to be a time of growth for public health spending. The province increased funding during this period with the hopes of increasing the capacity of all public health units, not reducing the amount contributed by municipalities. Both the minister of Health and Long-Term Care and the chief MOH made this clear (see, for example, City of Hamilton 2004). However, because of the cost-shared nature of public health, any corresponding decreases in municipal funding would offset some of these gains.