The community engagement process used by Hamilton Health Sciences, and accepted by our LHIN's appointed board of directors as sufficient for their decision to approve the HHS Access to Best Care Plan, needs a significant overhaul.

It is recognized that the LHIN structure is relatively new, and that LHIN boards will more fully understand their role to represent the community, much like corporate boards represent the stakeholders, as they gain experience.

However, the Ontario government's decision to let them operate without training wheels has placed these boards in an overmatched and under-informed position when faced with the communications resources available to our larger hospital organizations. The result is the tail wagging the dog.

Community engagement in a normal public planning process, where the healthcare experts propose a plan and then leave sufficient time to engage the public in an effort to improve their proposal, was not followed. The process as structured by our provincial government does not allow for any recourse for the public to have their concerns taken seriously. Community presentations are not permitted to the LHIN board.

Cynically, one could interpret this structure as deliberate by our government, as it allows for no one to be responsible for decisions taken. The buck, in fact, stops nowhere. However, let's take the high road.

The current public engagement process needs an external professional review immediately. Decisions made by the LHIN will have long term impacts on our communities, and it should be important to all of us that we take the time to get these decisons right. Leaving this to physicians, most of whom having no training in organization structural issues, needs to be re-examined. Ignoring any wisdom that can be gained from the public is a mistake.

To paraphrase HHS, it is not the time it takes to get to the decision that is important, but it is the shape of the decision once you get there that counts. The public does not want the fastest decision, just the best decision.

Rob Payne

Hamilton