Updates

In 2019, after 13 years of experience with a unique form of “regionalization”, the Ontario government announced its plans to dissolve the LHINs as part of a broader system reform. In 2006, Ontario became the last province to regionalize health services with the implementation of 14 regional LIHNs. The aims were to contain health care costs, increase efficiency, and enhance system responsiveness. Unlike other provinces that established regional planning bodies, Ontario maintained a three-tier system: LHINs, health care boards, and the ministry. Policymakers framed regionalization as the solution to systemic problems, however the LHINs arguably added another level of bureaucracy, decreased transparency and diminished provincial accountability. In 2015, the Auditor General of Ontario found widespread underperformance and concluded that the LHINs had failed in their mandate. This failure may be due to the exclusion of physicians and primary care from LHIN responsibility, and health care board overlap.