A primer on Ontario’s health care system for primary health care boards of directors

Last year, Healthy Debate published a primer on Ontario health care system for the boards of directors of hospitals. We’re very happy to now release a primer on the health care system specifically designed for the boards of directors of community governed primary health care organizations.

Ontario’s health care boards

I have served on several health care boards in both Alberta and Ontario.

I have been impressed by the dedication of the board members, and the depth and breadth of expertise they provide.

I am also convinced that having many board members who are not health care insiders provides an exceptionally important external view and critical eye that makes the system better.

However, the health care system is so complex that getting up to speed can be a daunting challenge for new board members, especially those with no health care background. Even those of us who have worked within the system for many years are not aware of many important nuances – although I started medical school way back in 1976, there hasn’t been a single Healthy Debate story I’ve worked on in which I didn’t learned something.

Ideally, organizations within health care would provide their boards with an orientation to their organization, the board’s responsibilities and an understanding of how their organization fits into the broader health care system. Recognizing that not every organization is able to do this, Ayodele Odutayo, with help from Jeremy Petch and the Association of Ontario Health Centres, has produced a primer for boards of directors of community governed primary health care organizations. We hope it will be useful for board members in Ontario, and will complement the excellent material already available to them.  In 15 pages it covers some “basics” that we think are important for primary health care board members, with links to various Healthy Debate articles and opinion pieces that explore some issues in more depth.

We are committed to keep this material up to date, and will be reviewing the document every 6 months to add new material and delete material that is no longer current.

I hope this primer is of use to board members and others, and I am eager for your feedback.

My thanks to Ayo and Jeremy for a terrific job, as well as the team at the Association of Ontario Health Centres for their careful review and important contributions which were essential to the document.

To view and/or download the document, click here. We’ve developed the primer as a PDF that is optimized for online viewing on your computer or tablet (it contains many hyperlinks to helpful resources). You can also print the document to review offline.

Primer for primary care boards copy

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1 Comment
  • Graham Scott says:

    Andreas, I think your primer is excellent and are certainly enhanced by the links.
    I was delighted to see the attached piece on DorvalMedical. In the years of governance work I have done with hospitals and provider boards the biggest problem facing them is their accountability for quality (and it took a while to understand the need for board accountability in overseeing quality) and their complete lack of guidance as to how to measure the quality of performance within their institution. This problem is most acute as it relates to physician performance. All hospitals have this problem measuring physician performance generally compounded by a lack of focus in some cases to outright opposition in others. Some teaching hospitals are generally slightly better than community hospitals due to the teaching/research environment but generally the problem is very deep.
    I believe that the number one requirement for HQO and MOHLTC is to get good performance indicators into the hands of hospital and PFMOs as sooon as possible. It will in my opinion not only speak to better quality it will lay the ground work to move the payment system to encourage teamwork performance rather than the existing reliance on FFS and shadow billing even in capitation.


Andreas Laupacis

Editor-in-chief Emeritus

Andreas founded Healthy Debate in 2011. He is currently the editor-in-chief of the Canadian Medical Association Journal (CMAJ)

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