Financier quits LHIN over slow pace of
TORONTO – A
leading member of Canada’s banking and investment community has resigned
from the Toronto Central Local Health Integration Network (LHIN) in a
protest over the slow pace of computerization in the healthcare system.
Tony Fell (pictured), chairman of RBC Capital
Markets, left the LHIN board in early April, and submitted a resignation
letter which accented the lack of funding to modernize the current
A copy of the single-spaced, four-page letter was obtained by the
Toronto Star, which reported on the high-profile departure.
Fell said in the letter that he was “extremely disappointed” with the
low priority that had been accorded to computerization, or e-health, by
both the Toronto Central LHIN and the ministry of health.
“I was disappointed because I clearly stated when I joined the board
that the only way out of Canada’s health-care morass was through a major
upfront investment in e-health,” said Fell.
He added: “An advanced e-health system could save many billions of
dollars annually while, at the same time, providing vastly improved
service and care to our citizens and a major reduction in medical
Fell goes on to say the health-care sector is “at least” 25 years behind
the Canadian banking and financial services sector in computer systems
and technology infrastructure.
“The reason for this,” he continues, “is that over the past 30 years no
federal or provincial government of any political party has had the
vision or been prepared to make the upfront initial investment in
systems and technology which is required. This is why Canada’s
healthcare industry is so vastly inefficient.”
Fell is not just a financier but also a man with plenty of experience in
the healthcare field as past chair of the board of the University Health
Network, which encompasses Toronto General, Toronto Western and Princess
While he is a Conservative, Fell was appointed to the board of the
Toronto Central LHIN by the Liberal government, which is trying to
decentralize the healthcare system by devolving power from Queen’s Park
to these regional authorities.
Barry Monaghan, CEO of the Toronto Central LHIN, told the Toronto Star
that he was sorry to lose Fell, whom he described as “a very experienced
and capable individual.” But Monaghan took issue with Fell’s stated
reason for quitting the board. “E-health is definitely a top priority
(for the Toronto Central LHIN),” said Monaghan.
In his letter, Fell notes that e-health is just one of nine priorities
for the LHIN, “which means it is not a priority at all.”
The other eight priorities identified by the Toronto Central LHIN are:
mental health and addictions, rehabilitation, seniors, health human
resources, education and research, energy and environment, back office
integration, and provincial ministry priorities.
Furthermore, the LHIN’s e-health strategy is “not a plan but rather an
overview document,” writes Fell. “There is no budget, there is no
timeline, there is no indication whether we will have a single patient
identifier number or whether we will have a drug card like the province
of British Columbia, or what will happen to our currently outdated OHIP
cards. Will all doctors’ prescriptions be entered on computer? Will
citizens be able to access their e-health records on the Internet? These
are all major issues which must be addressed before we decide what
system to build.
“Unless we know what the end game e-health system will look like, there
is no way we can put together a plan, a budget, and timeline to get
Fell also expresses disappointment that the recent provincial budget did
not “clearly establish” e-health as the top government priority. In an
interview with the Star, Fell, who was a major fundraiser for the
Conservatives when Mike Harris was premier, also criticized Harris’s
government for inaction on the e-health file.
Fell said the Harris government received an excellent report on the
subject in 1998. “But the report disappeared and never saw the light of
Health Minister George Smitherman said Fell was “off the mark” in his
criticisms, perhaps because he was not privy to everything that is
happening with e-health.
He said the government has been putting in place the “building blocks”
to achieve a fully computerized system, including legislation to protect
patient privacy, creation of a “unique patient identifier” for every
individual, and a “very, very substantial” investment in the underlying
computer infrastructure (over $600 million, according to his staff).