Weekend Interview With Pat Mandy
Hamilton Spectator, Feb 16, 2008
When Pat Mandy was hired to set up a new organization, she learned quickly it wasn't a desk job. For the first several months she travelled to meet people and hear their stories.
Mandy is chief executive officer of the Local Health Integration Network (LHIN) of Hamilton Niagara Haldimand Brant and one of 13 people from across Ontario responsible for introducing a new regional health system.
It's not an easy job given the complexity of health-care problems, such as wait times and doctor shortages.
But Mandy felt qualified. From 1978 to 1997, she'd held various management positions with the Hamilton Civic Hospitals.
She also served as vice-president of patient services at Hamilton Health Sciences, where she worked from 1997 to 2005.
She is currently on the Faculty of Health Sciences (Nursing) at McMaster University and is past chair of the Hamilton-Wentworth District Health Council.
Q: In the simplest terms, what is the role of the LHIN?
A: Our goal is to ensure people have access to the kind of care they need when they need it and that it's done in a way that's effective. What we try to do is work with the community to find out what they have identified as their needs.
Q: Did you meet with people in focus groups?
A: For the first year and a half, the LHIN board chair and I travelled all around the area to find out the issues. We had open houses for the public, not necessarily to find out what a LHIN is about but to find out from them what was going on.
Q: What was your biggest challenge in setting up the LHIN?
A: We started from scratch so I started working out of the car. We didn't have an office for months so it was a slow start-up.
I think expectations were high because people knew the LHINs were coming and that we were going to be looking at better access, better co-ordination, better flow through the system.
Q: How does your role differ from the district health councils?
A: This is much broader. The LHINs actually have funding authority. The district health councils sent their plans to Toronto. The LHIN boards can actually fund projects and we will hold accountability agreements with all of our providers.
Q: What are the biggest health-care challenges facing us today?
A: Certainly the whole issue of alternate level of care is an issue, whether it's the hospitals or home care delivery and so I think it really is key. It's really crucial to look at some of the things we can put in place to help people stay in their homes.
Q: So is it a big part of your job trying to make that happen?
A: We rely a lot on the expertise of people who work in the health-care system. What we're trying to do is look at, for example, what are the policy issues that might be standing in the way of that. For example, the cap on the number of hours that home-care providers can provide.
We can then work with the ministry to make change so people would be able to stay at home longer.
One of the things that's been most gratifying to me is to see people across the LHINs sharing ideas and picking up on them.
Q: That's the gratifying part. What about when you read stories about people waiting for care? Do you take that home with you?
A: We probably all do because we all have families who are waiting, too. I have a 98-year-old aunt right now who we're trying to support her staying in her apartment. So we all have compassion for what's going on.
Q: In the big scheme of things, what's the one piece of the puzzle that will be most key to turning things around? A: I wish I had the magic pill.
Q: Are you optimistic? A: I am. I really am. Some of it, I think, is just changing the culture and it is changing. In the past, hospitals, or any community agencies were just looking at responsibility for their agency and not seeing it as a part of the community. It's not a quick bullet …
Q: You talk about the change in culture among agencies. Do we also need a change in culture among the general public and their view toward health care?
A: I think it will come if they have access to services. Right now, not everyone has a family doctor. Once they do, they won't be going to emergency wards.
Q: What are the top three health- care issues right now in Ontario?
A: I would say access to emergency care and chronic disease management, like asthma and diabetes. Plus, are we doing all we can in health promotions? Are we eating and exercising and all those things?
Q: On a personal level, is this something you strive for?
A: I try. I go to Curves three or four times a week at 6:30 in the morning. I was doing it for my health and I feel better when I get there; and I've been losing a little bit of weight.
Q: What would you like to see the LHIN achieve in the next five years.
A: I guess it's just everyone working toward the same end. We need a system that works where people can find the right care at the right place at the right time.