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

Lyons, Joseph

In sum, the City of Hamilton was able to exert much greater control over HPHS' s levy than the City of London was over the MLHU' s levy. The City of Hamilton' s behaviour aligns with the hypothesis stated above, because it used the increase in provincial funding to reduce the impact of public health spending on the property tax base. As explained by the interviewees from Hamilton, and as indicated in Table 2 , the City quickly moved to reduce its contribution to public health spending as the province' s increased. HPHS staff who were interviewed would have liked to see less of a reduction in the municipal contribution, but explained that the "team mentality" of being a municipal department prevented them from making a more forceful case. Nonetheless, cost-shared program funding for HPHS still increased over this period fairly consistently. In fact, average annual cost-shared budget increases are basically the same as the average annual increase for municipal expenditures. Even with increases to provincial funding, the City of Hamilton was able to quickly get HPHS' s budget increases under control.