December 1, 2023
Dr. Kieran Moore,
Chief Medical Officer of Health,
Box 12,
Toronto, ON M7A 1N3
Dear Dr. Moore,
Re: Voluntary Mergers and Boards of Health Leadership
On behalf of the Association of Local Public Health Agencies (alPHa) and its Council of Ontario Medical Officers of Health, Boards of Health Section and Affiliate Associations, we are writing to provide advice on the voluntary mergers component of the Strengthening Public Health initiative that is currently underway.
We agree with your statement that, where it makes sense to do so, voluntary mergers have the potential to address longstanding challenges in the public health system and improve optimization and coordination. We also appreciate the efforts that you have made to share information and discuss the process through meetings with local public health leadership over the past month.
Recognizing the aggressive timelines that have been imposed on this process, we are also cognizant of the fact that engagement opportunities are important for all parties, so it makes sense to use existing channels between your office and the medical leadership (e.g., the Public Health Leadership Table) and meetings with local public health staff via the regional engagement structures to drive the process forward. Our members have, however, identified targeted consultation with boards of health as a gap.
Mergers of this nature are fundamentally a governance issue and must be planned and executed by those with the authority to do so, grounded in the knowledge of the needs of the communities they serve. The final decisions will be made by local boards of health, so it is imperative there is direct and specific ongoing engagement and meaningful dialogue with local boards that includes information, clarity of process, and expectations so that they are properly equipped with the information they need to make decisions on the future of local public health.
Although there are differences in the structures of Ontario’s local boards of health, it is important to acknowledge they will all be affected by the outcomes of this process. There are boards that are considering it, boards that are well into discussions, and boards that will remain as they are but nonetheless be subject to ripple effects of neighbouring mergers. The implications are too numerous to outline here, but there is a wealth of expertise and experience to draw upon from each group, which will be of tremendous benefit to the others.
We are therefore strongly recommending that you consider the development of a comprehensive strategy for direct engagement and dialogue with boards of health, as a whole and individually, that recognizes their primary authority in following through on new partnerships, taps into existing expertise at the local level, and ensures that all of the complexities and consequences of such an undertaking are fully addressed. alPHa would be pleased to work with you in this regard through our Boards of Health Section.
We look forward to working with you and would like to request an opportunity to meet with you and your staff. To schedule a meeting, please have your staff contact Loretta Ryan, Executive Director, alPHa, at loretta@alphaweb.org or 647-325-9594.
Sincerely,
Dr. Charles Gardner, President
Copy: Hon. Sylvia Jones, Minister of Health, Deputy Premier
Elizabeth Walker, Executive Lead, Office of the Chief Medical Officer of Health
Colleen Kiel, Director, Public Health Strategic Policy, Planning & Communications Branch