A cautionary tale for new Ontario Health board
On March 5, Dr. Malcolm Moore, the CEO of British Columbia’s Cancer Agency (BCCA) announced his resignation more than a year before his contract expired. Moore was the third CEO at the agency in six years. His two predecessors also resigned long before their contracts were up. This high-level churn is a signal that something is very wrong at the agency that was once recognized internationally for its leadership in cancer clinical care and research.
Prior to 2001, the CEO of the cancer agency reported to the health ministry in B.C. and had responsibility for cancer staffing levels, recruitment and performance across the province.
In 2001, the B.C. health ministry ordained structural changes to B.C. health similar to the health system transformation recently announced in Ontario. This resulted in one provincial super agency called the Provincial Health Services Authority (PHSA), as well as five regional health authorities. The provincial agency took over responsibility for cancer care as well as for children, maternal, mental health and emergency medical care.
In Ontario, the new provincial super agency is called Ontario Health. The new board was announced last week. At the same time, boards of more than 20 agencies were terminated, meaning that the new directors have already taken over responsibility for all 14 current Ontario regional health authorities, as well as all clinical services, measurement of clinical quality and possibly a new supply chain for Ontario health purchases. The breadth of responsibility of the Ontario super agency is far broader than the B.C. authority.
In 2014, Don Carlow, the B.C. cancer CEO prior to 2001, expressed concerns about B.C. cancer care under the new provincial authority. Carlow said the board of the authority was too distant from cancer treatment to provide effective leadership of cancer services. The cancer CEO was now four bureaucratic levels below the ministry of health. This contrasted with the prior situation where the cancer CEO had direct connection to the ministry.
Continuing problems with retaining leadership as well as problems with clinician work load, recruitment of front-line staff and prolonged wait times have been evident since Carlow’s concerns were expressed five years ago.
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