In Ontario, hospitals are independent corporations run by a localized board of directors.  

However, they are still part of an interconnected system of healthcare services offered by the government. Hospital boards work a little bit like school boards and municipalities in that they decide on their individual strategic plans, but they use the framework set by Ontario’s Ministry of Health and Long Term Care.  

Connecting hospital boards to the Ministry of Health and Long Term Care is a network called Home and Community Care Support Services. 

Ontario is the only province that has enacted legislation of an independent hospital network, of which hospital boards are a key component of governance.  

The board’s role is  policy-making, decision-making, and internal oversight; its responsibilities to higher levels of government are strategic planning, quality of care, financial oversight, board effectiveness, management performance, and self-evaluation. 

Board members organize themselves into sub-committees, and Grand River Hospital board members sit on multiple sub-committees, not the least of which is Governance and Community Engagement.  

Community members can also serve on sub-committees with the board as official community advisors.  

Many boards involve themselves in human resourcing, enforcing standards and skill requirements for nursing staff and physicians hired by their hospitals.  

It’s the board’s job to ensure the highest qualifications of medical professionals and therefore the quality of care patients get at the hospital.  

Individual hospitals are then in competition with each other over salary and compensation, although they are all working within the network and standards set by the Ontario Health Association and the Ministry of Health and Long Term Care. 

The decentralized, interconnected nature of the healthcare system is meant to aid agility and hospitals’ ability to address local needs and best represent the people they directly serve. Local and distributed leadership with the ability to address specific community needs and issues is key to the purpose of hospital boards.  

Hospital board members are from the communities they serve, and the Ontario Hospital Association has set out regulations and skill evaluations to ensure that hospital board members have the appropriate skills and experience.  

Boards also aim to represent a diversity of sectors, including labour, finance, technology, and philanthropy. 

While the Ministry of Health and Long Term Care directs 40 per cent of hospital funding directly to specific kinds of services, like cancer care or childbirth services, another 60 per cent of funding is allocated by the board and is considered “non-targeted.”  

The majority of funding from the government can then be directed by the hospital board toward the needs of that hospital and the patients and community it provides care for.  

Grand River Hospital’s current strategic plan as set by the board centres quality of patient care, team support, and “diversity and inclusion”.  

However, because Ontario public hospitals are corporations, hospitals like Grand River “invest in world class [health care] by increasing non-ministry revenue and operating efficiency through innovation, entrepreneurship and philanthropy.”  

Hospital boards are then tasked with budgeting and fundraising as well as decision-making and other policies.