Proposed merger for H-N, Brantford-Brant Health Units

By Amy Martin

In response to a call from the Province of Ontario, the Haldimand-Norfolk Health Unit (HNHU) has taken significant steps towards a potential, voluntary merger with the Brantford-Brant Health Unit. This initiative aligns with the province’s encouragement for health units to consider voluntary mergers and offers to cover 100% of associated costs. A merger could result in a more integrated, efficient health unit that would strengthen public health resources for both regions.

This journey toward a potential merger has been anything but simple. Over the past months, officials, staff, and provincial appointees from Haldimand-Norfolk and Brant have been rigorously assessing the potential benefits and logistics. While an initial, broader proposal suggested a three-way consolidation that included South West Public Health in Oxford County, a thorough investigation revealed that a two-unit merger with Brant was a more manageable and focused solution, ensuring control and community-minded programs and services are prioritized. The two-way option offers a balanced path toward an improved public health structure without overwhelming resources or diluting service delivery.

The process, led by Sarah Page, General Manager of HNHU, and Brent Richardson, CEO of Brant Public Health, has involved extensive information gathering and multiple governance committee meetings, each attended by both board chairs, municipal staff, consultants, and provincial ministry supports. Compatibility between Haldimand-Norfolk and Brantford-Brant was a critical consideration, and officials undertook a comprehensive review process - including legal, financial, and operational assessments - to ensure a well-informed decision.

Norfolk County has led the HNHU as a single, council-based board, with the Norfolk County mayor serving as the chair. This political board, responsible for health and social services, has brought its own unique challenges. Since the de-amalgamation of Haldimand and Norfolk in 2001, the health unit’s governance structure has placed Norfolk councillors at the helm of health decisions, leaving Haldimand with no direct representation despite its responsibility to cover 40% of health-related costs. This structure differs significantly from typical health boards, which often include provincial appointees and subject matter experts, providing a broader perspective on health decisions - similar to what the proposed merged board of health will also seek.

The unusual governance structure has presented challenges in terms of representation, decision-making, and resource allocation. The potential merger would offer an opportunity to address these longstanding structural issues, bringing Norfolk’s health board closer to the norm while also enhancing collaboration with Brant.

For those interested in the history and challenges surrounding Haldimand and Norfolk’s governance split, my podcast, Folklore, recently covered these issues in a two-part series featuring former Haldimand Councillor Bernie Corbett and current Norfolk Councillor Linda Vandendriessche. Both speakers discussed their roles in the de-amalgamation of Haldimand and Norfolk in 2001, which left Norfolk solely responsible for health unit oversight. This unique arrangement resulted in HNHU being embedded within Norfolk’s municipal operations, a rare scenario in Ontario’s public health system.

The lack of direct Haldimand representation on the board has made health governance a complicated issue. A voluntary merger with Brant could be the solution needed to strengthen regional public health governance and improve service delivery for both communities.

The primary goal of the merger is to foster efficiencies and synergies, enhancing the overall quality of public health services in the Haldimand-Norfolk and Brantford-Brant regions. By consolidating resources, we expect to streamline operations and expand our capacity to respond to community health needs. This has been observed in other regions, such as Southwest Public Health, which recently completed a similar merger. Their experience demonstrated that consolidation could bolster public health resources and create a more resilient framework for service delivery.

For HNHU and Brant Public Health, the merger offers unique advantages, particularly in terms of resource allocation. The province has committed to providing greater financial support to health units that opt for a voluntary merger, meaning our new entity will receive a funding increase to help sustain and enhance services. This is a benefit that non-participating health units would not receive, making the merger an attractive and strategic option for strengthening public health.

The expanded unit would also bring together diverse expertise and resources from both Norfolk and Brant, allowing us to achieve a more robust public health system capable of addressing complex and evolving health challenges.

While there is significant promise in the proposed merger, the process is far from complete. Merging two distinct health units requires careful planning and ongoing collaboration. Transitioning HNHU’s governance structure away from Norfolk County’s council oversight will require adjustments and open conversations with both the public and government representatives. It will also mean ensuring a smooth integration of operations and services across the regions, keeping in mind the needs and expectations of both Haldimand-Norfolk and Brantford-Brant residents.

Haldimand-Norfolk and Brantford-Brant’s leadership remain committed to continuing their due diligence as they work through the remaining challenges. Every step taken thus far - from legal and financial assessments to community consultations - has been essential in building a solid foundation for the proposed merger. While no final decision has been reached, the collaborative effort by Norfolk and Brant health unit teams and boards speaks to a shared vision of improving public health service delivery for both communities.

The potential new health unit represents a thoughtful and proactive response to the province’s call for regional consolidation. By working together, our two communities can address longstanding governance issues, strengthen public health resources, and build a more effective and sustainable health system.

Through continued transparency and community engagement, Norfolk County will remain committed to representing the best interests of our residents and achieving the ultimate goal of improved public health. As the process moves forward, we will keep our residents informed, ensuring that their voices are part of this significant transition in local health governance. This merger has the potential to be a transformative step, paving the way for a healthier future.