Province mulls offering 'one-time funding' for Toronto Public Health amid debate over financial impact of cuts
TPH estimates $1B shortfall over a decade, province expects city to contribute more
Premier Doug Ford's government is considering providing one-time funding to Toronto to help "mitigate" the impact of cuts to Toronto Public Health despite ongoing debate between the city and province over the true financial toll, CBC Toronto has learned.
The new detail comes in a letter sent from the ministry of health to Dr. Eileen De Villa, Toronto's medical officer of health, and other city officials on Friday.
In the letter, obtained by CBC Toronto, the province's chief medical officer of health Dr. David Williams suggests the city has the population size and density to deliver public health with "greater administrative efficiency" and pick up a bigger share of the costs — but that the province will also consider "providing one-time funding to help mitigate some of the financial impacts" of the recent funding changes.
"We are looking forward to discussing these details in collaboration with the city through technical working groups," a spokesperson for the ministry of health said in a statement to CBC Toronto on Monday when asked about the potential funding injection.
In his letter, Williams also said the province believes the impact on TPH this year will be around $25 million, a figure substantially below the roughly $65 million reduction estimated by TPH itself.
"Their math is done quite differently... ours reflects the real impact on the city of Toronto," Mayor John Tory fired back on Monday.
The city's calculation of a $1 billion impact over the next decade is based on the overall funding change for TPH which is directed to different programs, including student nutrition services, dental programs and restaurant inspections, Tory explained.
TPH's figures have been used and backed up by other prominent city officials as well, including city manager Chris Murray, and board of health chair Joe Cressy.
Cressy, in particular, has recently been the target of accusations from Ford, who said the councillor was possibly "lying," and Health Minister Christine Elliott, who suggested he was "misleading" the public about the true financial toll of the province's changes.
Tory denounced those accusations as "deeply regrettable" rhetoric, and said the city had "no evidence whatsoever" of the province's calculations on the financial impact until the letter on Friday.
"This is not partnership. This is not collaboration. This is not working together," he said.
"And then, for anybody to use expressions like that someone is 'lying,' I just think is very, very unfortunate and doesn't address what is a very serious issue."
Here’s another fact: Joe Cressy and his NDP friends either don’t understand Public Health funding or are intentionally lying to the people. His back of the napkin math is flat-out wrong. Public Health will continue to be funded in Ontario. <a href="https://twitter.com/hashtag/onpoli?src=hash&ref_src=twsrc%5Etfw">#onpoli</a>
—@fordnationBudget chief: Finding broader savings 'not possible'
Tory is also calling on the province to reconsider its decision to change the cost-sharing structure.
On Monday, his office sent letters to each PC party MPP across Toronto, highlighting the TPH programs provided in each riding and asking each member to speak to Elliott about reversing the decision in order to "restore funding to vital, front-line public health services."
The province's changes mean as of April 1 this year, TPH programs that were either three-quarters or fully-funded by the province will now be a 60-40 split between the province and the city.
Next year, that split continues for what Williams referred to as a "proposed Toronto Regional Public Health Entity," then in 2021, it shifts to 50-50.
According to Williams' letter, it's clear the province expects the city to increase its share of the pie — something budget chief Gary Crawford recently expressed would not be possible.
This year, the province estimates that the city's contribution for public health will increase by approximately $33 million to a total of approximately $75 million, Williams noted.
Under the 50-50 model two years later, he said the estimated share will increase to around $84 million which represents a $42 million increase over the city's current share.
In other words, the province is suggesting the city should "go looking for savings" across Toronto's broader budget more than a month after it was passed, Crawford noted in a statement on Friday.
"This is simply not possible," he added, because the city can't make adjustments mid-year "on the fly."
'They are clearly scrambling'
The city's 2019 budget included $43 million for public health to match the expected contribution approved by the provincial government in 2018, according to TPH.
The unit's numbers also show the city would need to increase its contribution by $25 million — or nearly 60 per cent — to maintain this year's existing budget based on the funding formula change.
On Monday, Cressy questioned the benefit of a potential one-time funding injection from the province.
"They are clearly scrambling," he said. "My advice to them, and my request of them, is to do the right thing and reverse these cuts."
There's also a growing outcry against the cuts, with Toronto's public and Catholic school boards gearing up to mail out letters about the potential impact to parents, and outside advocacy groups preparing campaigns in protest, according to Cressy.
At next week's board of health meeting, TPH officials are also highlighting the financial impact of the cuts.
De Villa has a separate motion recommending the board and council ask the province to match any increased city investment in student nutrition programs, coupled with a request for the federal government to provide funds as well.
"In all corners of this city, and increasingly in this province, people are speaking out," Cressy said.
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