As merger talks swirl, Haldimand-Norfolk Health Unit plans for an uncertain future

Armed with hard-won lessons from the COVID-19 pandemic, the Haldimand-Norfolk Health Unit is ready to face the future — assuming the organization has one.

The board of health in the two rural counties must soon decide how to respond to a provincial call for voluntary merger proposals from Ontario’s 34 health units.

The Ford government wants rural health units interested in joining forces to submit proposals this month, and behind closed doors, Haldimand-Norfolk’s board of health has been mulling the merits of various voluntary merger scenarios.

In the meantime, the health unit has crafted a strategic plan to guide its decision-making over the next four years, with a focus on better communication to rebuild public trust and helping residents stay healthy through early intervention.

The plan sets out core values but is “intentionally light” on details “because we’re engaged in merger discussions and there’s a lot going on,” said Sarah Page, general manager of health and social services.

Even if the health unit does not end up folding into a new entity, Ontario’s public health standards are currently under review by the health ministry, and there could be changes coming to what health units do, Page noted.

“So we didn’t want to get too specific into the services that are being provided,” Page told The Spectator.

The strategic plan, which cost taxpayers $20,000, was crafted with consultants Platinum Leadership Inc., who sought input from Haldimand-Norfolk’s health and social services advisory committee, Haldimand and Norfolk councils, and health unit staff.

The process produced four priority areas — ensuring health equity for all residents, fostering relationships with the community and health-care partners, promoting the well-being of public health employees, and managing change.

“This plan will be our key document when making big decisions” such as which programs to fund, Sarah Titmus, the health unit’s infectious disease program manager, told the board of health at an April 3 meeting.

The strategic plan incorporates the results of a 2022 community survey designed to identify gaps in health-care services in the two counties. That survey found more residents are mistrustful or even fearful of public health than before the pandemic, a change blamed on poor communication amid the often fractious debates over vaccinations and gathering restrictions.

Page, Norfolk’s former chief paramedic, led the COVID-19 vaccine rollout and saw firsthand the importance of clear and open communication with residents.

That approach may not always win people over, she said, but they will be better informed.

“I think what we really learned is the more information the public is privy to, and the more transparent you’re willing to be, it helps in the learning process and the understanding process,” Page said.

“It’s important for us to ensure the public knows what we’re doing, why we’re doing it, why it makes sense, and what difference it’s going to make.”

The health unit will focus on the “vital” need to collaborate with other heath-care and social service agencies to provide the best care for residents — especially those currently “falling through the safety nets” — and make the system more efficient by removing duplication of effort, Page said.

Reaching “priority populations” such as Low German Mennonites, seasonal farm workers, young families and new immigrants moving to the region, and Mississaugas of the Credit band members may involve providing services in multiple languages and bringing health care to people unable to get to a clinic or health centre.

Health units exist in part to respond to public health emergencies like disease outbreaks. But Page said the strategic plan emphasizes preventive medicine through educating residents about health risks and intervening before issues become costly and complicated to solve.

That intervention can take the form of encouraging healthier lifestyle choices to head off diabetes, launching a new community drug and alcohol strategy, inviting residents to enrol in smoking cessation programs before they develop serious respiratory problems, or something as simple as promoting vaccinations and handwashing.

“Instead of looking at the end result of the homeless individual who’s fighting addiction without any access to resources, we’re backing that up to say how could we have prevented that in the first place?” Page said.

The health unit cannot solve chronic health and social problems itself, but it can advocate for funding to address issues like rising food insecurity and the need for more addictions counselling, Page added.

Titmus said the health unit’s next step is to craft an action plan to put the four core principles into practice, while waiting to hear what the future holds.

“If changes occur, we can be flexible enough to meet community needs,” she said.

J.P. Antonacci, Local Journalism Initiative Reporter, The Hamilton Spectator