From the largest cities to the smallest municipalities — and now, nearly everything in between — the Doug Ford government is facing unprecedented blowback to its plan to slash funding for public health.

Resistance to the unexpected scheme to restructure public health, including a reduction in provincial funding and cutting the total number of public health boards from 35 to 10, now transcends Ontario’s urban-rural political divide, extending deep into the heart of bedrock conservative areas of the province.

In briefing notes obtained by the Star over the weekend, the Mayors And Regional Chairs of Ontario (MARCO) joined the opposition to the proposed cuts, calling on the Ford government to halt plans that “will have a significant negative impact on the health, safety and general well-being of the residents of Ontario.”

The three-page MARCO document warns that in its plan to separate public health units from municipalities and replace the 35 existing bodies with 10 regional health boards, the province runs the risk creating a layer of “large, arm’s length unaccountable boards” that will wield the power to levy costs on municipalities with limited local input.

“Money invested into public health is money well-spent, with an excellent return on investment — and is critical to the province’s stated goal of ending hallway medicine,” the MARCO memo concludes.

“In contrast, the planned cuts to public health are short-sighted and, over the long-term, are almost certain to result in higher overall health-care system costs.”

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Toronto Councillor Joe Cressy, who chairs the city’s Board of Health, on Sunday described the groundswell of resistance to public health cuts as unlike anything the Ford government has faced in its nine months in power. Having retreated previously in the face of more limited resistance to issues of autism funding and greenbelt development, Cressy says he sees no way for the province to implement its public health overhaul.

“Of all the 100 cuts they’ve made and are making, this is clearly one that will not stand. It is not resonating well,” Cressy told the Star.

Ford government officials offered reassurances late Sunday upon reading a copy of the MARCO objections provided by the Star, insisting that “almost all of the public health units that service MARCO regions and municipalities, as well as small, rural and northern municipalities across Ontario” would be “protected from major cost increases.

“Our government has every expectation that public health units will continue to be properly funded as we empower municipalities to have a stronger role in the delivery of public health,” Hayley Chazan, spokesperson for Health Minister Christine Elliott, said.

Cressy on Monday will host two fellow health board chairs — Denis Doyle of Kingston, Frontenac, Lennox & Addington and Kerri Davies, vice-chair of the Peterborough Board of Health — to detail objections to the planned cuts, which are projected to cost the City of Toronto $1 billion over the next 10 years.

A by-the-numbers fact sheet distributed by Cressy staff over the weekend showed the scale of the province-wide resistance to the public health cuts, including all 28 mayors of Ontario’s large cities, 12 boards of health ranging from Windsor to Muskoka, Haliburton, the Kawarthas to Ottawa and Thunder Bay and the Northwestern Ontario Municipal Association.

“In that list of mayors, we see two former Progressive Conservative party leaders now opposed to these cuts. When you have MARCO — the mayors and regional chairs — together with LUMCO — representing the 28 largest cities — these are groups that most Ontarians have never heard of because they only rarely take strong advocacy positions,” said Cressy.

“What it adds up to is a controversy that not only spans the province but spans political leanings, all in opposition to these cuts,” he said.

“It will send shock waves in certain quarters. But it also reflects the broad understanding that there is no left or right way to keep water safe to drink and to prevent diabetes — there’s only a good way, which is to prevent the harm in the first place.”

The Ford government’s public health cuts are hardly unique. In an op-ed article published last week in the Toronto Sun, former Ontario chief medical officer Dr. David Mowat noted that such preventive work is often taken for granted and may even be “invisible in that, when they succeed, nothing happens. You don’t see headlines such as ‘Child does not die of meningitis.’ ”

But the scientific evidence — and Ontario’s own experiences with the water-quality crisis at Walkerton and the SARS scare — said Mowat, show that reduced public health investment provides short-term gain at the cost of long-term pain.

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Among the key details of the province’s public health restructuring that remain unclear, Ontario stakeholders say, none matters more than knowing which of the 35 public health units are to be targeted for shutdown.

“The funding cuts are one thing,” said Cressy. “But the cutting of the number of public health units from 35 to 10 is the other. The biggest concern we are hearing from northern Ontario is, ‘What is this going to mean for the delivery of health care in rural settings, when it becomes further centralized and consolidated?’

“What I take away from that: If you think this is controversial now, just wait until they announce which 25 units are going to be closed down. Those are the details that will take the blowback to a new level.”

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