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Amid surgical backlogs, increasing privatization, a health care staffing shortage, emergency room closures and changes to the Ontario Health Insurance Plan (OHIP), Ontarians overwhelmingly recognize that their health care system is in crisis.
While many discussions about the causes of this crisis focus on the actions taken (or not taken) by the federal and provincial governments, there is another largely overlooked tier of power in our healthcare system: Hospital and foundation boards.
Hospital board members occupy roles that fall somewhere between elected politicians and medical providers. They have the power to decide what health care research is funded, what equipment hospitals can purchase, which specialized patient care programs get off the ground, and more.
Unlike medical doctors, hospital board members don’t take a hippocratic oath — based on the pledge to do no harm — but their decisions nonetheless affect everyone's health care experience.
Who are the people sitting on hospital boards, and what are their connections and expertise?
In an analysis of over 27 hospital and foundation boards in Toronto, which included a total of 668 positions, we found:
169 donors to the governing Progressive Conservative Party, compared to 52 Ontario Liberal donors and 18 Ontario NDP donors.
110 donors to former Toronto mayor John Tory (from 2018 to2022) compared to just five donors to progressive challengers during that same time period.
36.7 per cent of the board members with voting rights come from executive finance positions, compared to just 11.9 per cent who have backgrounds in health care.
244 work in finance, 47 hail from the legal sector and 41 come from real estate and development backgrounds.
While there are exceptions (we found a former teacher, one artist and an urbanist), these board members are disproportionately wealthy and Conservative.
Hospitals and foundations literally do life-saving work. They serve us in all of our diverse backgrounds and health conditions. But currently they must also work within a framework of top-down bureaucratic board structures that seem to be mostly reserved for the elite and well-connected.
The research we have pulled together paints a concerning picture of people whose roles in public health care do not necessarily align with their business, personal and political interests. And with the door swung open by Premier Doug Ford for further privatization, we’re facing even less transparency in the sector.
Is this the future of health care?
In a series of follow up articles, we’ll share more insights that our research uncovered and look more closely at the political affiliations, business interests and philanthropic activities of these board members.