The province has released the Health Governance Advisory Council Report and introduced legislation to create an arms length governing body to be called Health PEI.

The Council was asked to make recommendations regarding the governance of the health care system in response to the observations made in the Corpus Sanchez International (CSI) Report in which concerns were raised regarding governance structure. The only specific directive was that the process needed to engage a cross-section of Islanders and recommendations needed to support the vision of One Island Health System.

“The recommendations made in this report were not made lightly. We were mindful of the many reorganizations of the health care system over the last fifteen years, and the need for a stable governance model that will enable the Island health care system to focus on the need for sustainable care for Islanders,” said Dr. Rosemary Henderson, Co-Chair, Health Governance Advisory Committee.

The report recommends the establishment of an arms length governing entity with a global budget and authority to deliver services in accordance with Department of Health policy, plans and overall direction. Government has accepted the broad direction as set out in the Council’s report and will carefully consider all individual recommendations moving forward.

Governance issues go beyond structure; governance is also a process that engages staff and the Island community. The sustainability of the health care system very much depends upon the support of the community it serves. “We strongly recommended that the future Board of Health PEI identify a process to determine the values of Islanders and of Government and use these principles to guide the future direction of the system,” said Ron Maynard, Co-Chair, Health Governance Advisory Committee.

The legislation around the creation of Health PEI, tabled this afternoon, is just another step towards implementing Government’s vision of “One Island Health System.” Unlike many past changes in governance of the health care system, there will be minimal impact on staff and there will be no job losses as a result of these improvements. As well, staff transfers to Health PEI are not anticipated to occur prior to January, 2011, allowing Government sufficient time to engage in effective consultation with physicians, staff and unions. The legislation is designed to enable an inclusive, considered process to implement the report’s recommendations.

“I would like to thank the Committee and the Co-Chairs for their dedication to this review. We were fortunate to have an outstanding committee advising Government on this matter. Good governance systems are not as visible to Islanders as the day-to-day health services that mean so much to them, but they are absolutely vital to the quality and sustainability of those services,” said Doug Currie, Minister of Health. “I wish to assure staff the changes they will see will be for the better. Operating decisions will get made more quickly and resources will be managed more flexibly to meet the needs of the situations staff face day in and day out.”

The Council was comprised of individuals from across the Island, representing various stakeholder perspectives on the Island health system including those of the aboriginal community, health administrators, academic, professional and front-line operations people.

The process included direct invitations to approximately 40 community organizations, as well as newspaper advertisements with open invitations to the public and requests for written submissions. This outreach resulted in nine focus groups involving over 60 people from across the Island, as well as written submissions.

The detailed recommendations of the Council are set out in the report available on-line at www.gov.pe.ca/go/advisoryreport.

BACKGROUND INFORMATION

Health Governance Advisory Council Report

In its April 4th, 2008 Speech from the Throne, the Provincial Government declared the health care system a strategic priority:

“Together with Islanders, we will build a sustainable, integrated health care system, one that shifts emphasis and culture toward wellness and primary [health] care, placing patients, the community as a whole and sustainability above all considerations.” Prince Edward Island, Speech from the Throne, 2008.

The Department of Health engaged Corpus Sanchez International (CSI) to undertake a province-wide review of the health system to make observations on the system. In its final report, CSI identified a variety of opportunities for improvement and in November 2008 Government released the CSI report.

CSI recommended numerous steps required to curtail the growth in healthcare costs and to ultimately provide safer, quality care to all Islanders. In November of 2008, seven of the recommendations were adopted as policy:

• Investment of $1.5 in home care

• Long-term care modernization

• Explore new models of care

• Changes to emergency services

• Community health centre role changes

• Re-alignment of hospital services

• New health governance model (this recommendation led to the dissolution of existing five hospital boards)

While the CSI report made recommendations on front line operations, it also noted challenges to leadership and governance, and made strong recommendations in this area, noting that governance infrastructure was a key factor in leading the changes needed in the operational model.

The CSI report recommended that the Province re-establish an arms length governing entity with a global budget and authority to deliver services in accordance with Department of Health policy, plans and overall direction.

They noted that the current governance model is unique in Canada in that there is no overall governance entity that provides direction to the system, while still providing the typically required arms-length framework between the government (including the Department of Health), and those who provide health care. This has led to a degree of bureaucracy that impedes the system, resulting in a lack of clear lines of authority and accountability.

The PEI Health Governance Advisory Council was established to research, consult and recommend a new governance model for the PEI health system – a model that supports the Government adopted direction of “One Island Health System.”

As had the CSI report before it, after a thorough and evidence-based process, the Council also recommended that the PEI health system be operated by a operating entity that is at arms length to government.

The Council’s report contains background, a concise overview of governance theory and the key concepts being recommended.