The early winter light was already fading when I arrived at the Grey Bruce Health Unit’s administrative building in Owen Sound. Inside, a handful of concerned citizens huddled in small groups, speaking in hushed tones about the latest twist in a governance saga that has divided this typically collaborative community.
“We’re just trying to understand what’s happening to our health board,” explained Eleanor Manson, a retired nurse who’s lived in the region for over 40 years. “This isn’t just bureaucratic reshuffling—it’s about who gets to make decisions about our health services.”
The controversy began when Grey Bruce Health Unit board chair Brian O’Leary made a startling claim: that Dr. Kieran Moore, Ontario’s Chief Medical Officer of Health, had personally instructed him to remove municipal representatives from the health board. This alleged directive has sparked intense debate about local autonomy, provincial oversight, and the changing landscape of public health governance across Ontario.
According to O’Leary, the conversation with Dr. Moore occurred during a meeting in Toronto on November 2nd. “He told me that I should get rid of the municipal members,” O’Leary told local media. “But we’re functioning well with them. I don’t know why we would want to get rid of them.”
When reached for comment, the Ministry of Health presented a different perspective. Ministry spokesperson Hannah Jensen stated that while discussions about board composition have been ongoing as part of provincial public health modernization efforts, Dr. Moore “has not directed any boards of health to remove municipal representatives.”
The contradiction has left many in the community wondering what really happened in that Toronto meeting and what it means for local health governance.
Grey Bruce’s health board currently includes five provincial appointees and eight municipal representatives—a structure that reflects both provincial oversight and local accountability. This balance is something many residents value deeply.
“Having municipal representatives means having people who understand our unique challenges,” explained Gordon Thornton, a former town councillor from Hanover. “Our region deals with everything from agricultural health concerns to tourism-related public health needs. That local perspective matters.”
The possibility of removing municipal voices comes amidst broader provincial changes to public health. Ontario has been working toward consolidating its 34 public health units into 10 regional entities—a plan that has faced significant pushback from rural and northern communities concerned about losing their distinct voice in health decisions.
Dr. Ian Arra, Grey Bruce’s Medical Officer of Health, finds himself caught in the middle of this tension. When approached for this story, he acknowledged the importance of both provincial direction and local input. “Effective public health requires balancing standardized approaches with community-specific solutions,” he said. “The board structure should reflect that balance.”
The controversy has deeper implications for democratic representation in public health governance. Municipal board members are accountable to their local communities in ways that provincial appointees may not be, argues Melissa Hayden, a political science professor at Georgian College who studies rural governance.
“When health boards lose local representation, there’s a risk that decisions become more centralized and less responsive to community needs,” Hayden explained. “There’s also the question of transparency—municipal representatives regularly report back to their councils in public meetings. That creates an important accountability mechanism.”
The Grey Bruce debate reflects a pattern seen across Ontario and other provinces, where tension between local autonomy and provincial standardization has intensified during and after the COVID-19 pandemic.
The Federation of Canadian Municipalities has documented similar concerns about diminishing local input in health governance decisions across multiple provinces. Their 2022 report, “Local Voices in Public Health,” noted that municipalities often bear responsibility for implementing public health measures while having decreasing input into their development.
At the recent Grey Bruce Health Unit board meeting, community members voiced their concerns during the public comment period. Sarah Johnston, a small business owner from Markdale, expressed what many were feeling: “We’re not opposed to provincial guidance or standards. We just want to make sure our specific needs aren’t overlooked.”
The Ministry of Health maintains that ongoing public health modernization aims to “strengthen public health delivery” while “ensuring value for taxpayer dollars.” However, critics argue that removing local voices may ultimately prove counterproductive to these goals.
As I left the health unit building and stepped into the cold evening air, I noticed O’Leary standing alone in the parking lot, looking troubled. When asked about next steps, he sighed. “We need clarity from the province about their expectations and the reasoning behind them. And we need to make sure our community understands whatever changes might be coming.”
For now, the board remains intact, but the controversy has opened important questions about who should have a seat at the table when it comes to public health decisions. In Grey Bruce, as in many rural communities across Canada, the answer to that question will shape not just governance structures, but the health outcomes of residents for years to come.
