A serious threat

During the year, the Commissioner learned that it had been determined that health service providers were not subject to the third-party regulation because of their particular relationship with the Local Health Integration Networks (LHINs). Boiled down to its simplest form, the argument goes as follows: though funded by the government, health service providers have agreements with the LHINs. Since the LHINs have no responsibility for service delivery as such, they cannot “delegate” that responsibility to health service providers; therefore, they do not provide services “on behalf of” the government, which means, in their view, that the regulation does not apply.

Obviously, the Commissioner does not share that opinion. In fact, he even maintains that these legal gymnastics are contrary to the lawmakers’ intent. After all, don’t the laws refer to “public health services”?

This is a major stumbling block, since the health sector, because of its nature and size, has the largest number of third parties. (The health sector includes hospitals, psychiatric facilities, long-term care facilities, home care, community health centres, addiction centres and so on.)

In short, the third-party regulation, though still useful, supposedly does not cover the majority of the government-funded service providers.

It was a pill that the Commissioner simply could not swallow, and he immediately expressed his grave concerns to the most senior authorities of government who seemed sympathetic to his argument. At the time this report was written, the negotiations were relatively promising, suggesting the possibility of new regulations that would explicitly target certain health care providers and define their French-language service responsibilities in black and white. However, these piecemeal initiatives will take time, resources and effort that may ultimately prove fruitless.

Once bitten, twice shy, and there is, for the moment, too little movement in regulatory clarification of health care providers’ obligations for the Commissioner to be happy about it. Just the opposite. But all he can do for now is to congratulate those government agencies that have understood the message conveyed by the third-party regulation and to keep a close eye on the evaders.