The top public-health official in Simcoe County and Muskoka says he has concerns about chopping the local health unit in half and sending the pieces in opposite directions.
The Simcoe Muskoka District Health Unit will be disbanded next year and merged with neighbours to the north and south as part of a provincial consolidation into larger public-health units. The local health unit, as it now exists, will cease to operate April 1, 2020.
The Simcoe County portion will be merged with York Region operations, while the Muskoka component will be folded into an area covering a vast geographic region in the northeastern area of Ontario.
"What has definitely caught us off guard is the idea that we would be split into two pieces and going in different directions," Dr. Charles Gardner, medical officer of health for the Simcoe Muskoka District Health Unit, said. "We didn't anticipate that."
As outlined in the provincial budget, the Ford government's plan is to have 10 health units overseeing Ontario, down from 35.
"That is what we've been told, although other contacts with the province did say that (they) would be open to feedback on what's been proposed," Gardner said. "They didn't give specifics."
Gardner said he has "some concern" about creating new entities to oversee large geographical areas.
"It would be very large indeed," he said. "It would extend all the way to James Bay. It would be one of two extremely large regional public-health entities covering, between the two of them, all of northern Ontario."
Gardner said that brings up some logistical issues and challenges.
"This is something we need to go over with our board tomorrow, but I would say right off the bat that it becomes logistically far more complex to not just merge with one or more health units, but to also split up while we merge," he said.
The Simcoe Muskoka District Health Unit's current coverage area goes from Bradford to north of Huntsville, and from Haliburton over to Georgian Bay.
While Simcoe County is being aligned with York Region, the District Municipality of Muskoka joins with North Bay, Parry Sound, Sudbury, Algoma, Temiskaming, Porcupine and the northern portion of Renfrew.
The health unit administers a number of services and programs, including alerts and recalls, inspections, immunization, advocacy, and various classes.
With the District Municipality of Muskoka being folded into other health units, Gardner said that will also raise concerns around program delivery by being part of a much larger territory.
"If they had stayed with Simcoe and become part of York, would there be a negative impact potentially on their program delivery? I think that's a very important question for our board to consider," he said.
The doctor says there are still many questions to be answered.
"We have to go through a very complex process of aligning and changing our programs to merge with theirs," said Gardner, adding new boards of health will also have to be created to oversee the new entities.
That includes legislative changes, merging of finances, modifications to the organizational and leadership structures, staffing, collective agreements, property leases, etc.
"It's a very complex enterprise to go from where we are now to that end state of those new entities," Gardner said.
The local board of health, which oversees the health unit, is expected to review the announcement and other related matters on Wednesday.
"Out of that, I suspect we'll have a position from them that they'll want to express," Gardner said. "We shall see."
Locally, the health unit has also been heavily involved with the Simcoe Muskoka Opioid Strategy (SMOS) and applying to the province to bring a supervised consumption site to Barrie.
Gardner said that work will continue.
"We are fully committed to fulfilling our entire mandate as the Simcoe Muskoka District Health Unit right up until the point we became part of these other entities," he said. "So, between now and then, we'll be fully behind the work happening (around) the Simcoe Muskoka Opioid Strategy, including the work in Barrie.
"After that point, priorities of public health would then be under the governance of the new boards of health for those entities," Gardner added. "So they would have to decide what their priorities are and what they would be doing."