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It's not surprising that a poll commissioned by the health unions found that 82 per cent of Ontarians know little or nothing about LHINs. The astonishing thing is that 18 per cent claim to know what the fuss is all about. Rest assured that few of these people work in the Queen's Park press gallery. The Health Minister says Bill 36 recognizes that ministry bureaucrats in Toronto cannot run the sprawling health system efficiently or ensure equal treatment across the province. The LHINs, he adds, will be able to provide "seamless" delivery of health care by the appropriate institution. Mr. Smitherman is, however, a politician who believes that eggs have to be broken to make an omelette, and he loves confronting his critics. He argues that the status quo, where expensive hospitals provide an extraordinary range of services, is no longer the best way to go. (He said that he had his wisdom teeth extracted 25 years ago in hospital and sniffed "there are those among the status−quo set who still believe this is the place to do that kind of thing.") One problem he faces is that LHINs are not like school boards or city councils, in that their members will be appointed by the government and not elected locally. The other is the powers of oversight that Bill 36 gives to a minister. Together, they lead critics to believe that the "integration" of services that Mr. Smitherman talks about is, in fact, a cover for a wholesale restructuring. The bill's wording offers little guidance about who's right. A minister could dissolve or amalgamate any health−service provider on the advice of a LHIN, but Mr. Smitherman says this would all be done in the open. "There is no nefarious power here," he said. On the other hand, an analysis by lawyers at Cassels Brock found the bill gives the minister "far greater powers" than earlier legislation to restructure the health system without cabinet approval. We won't know who's right until the regulations accompanying the bill come down and the "strategic plan" required by the legislation is divulged in about a year. Meanwhile, the unions, which already launched a $1−million ad campaign, plan to keep up the pressure with protests and town hall meetings, and pledge to punish the Liberals in the election if their fears are realized. The rest of us, meanwhile, can go back to sleep. mcampbell@globeandmail.com ADDED SEARCH TERMS: GEOGRAPHIC NAME: Ontario SUBJECT TERM:legislation; health care; reform PERSONAL NAME: George Smitherman

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