“How can anyone consider supporting (London Health Sciences Centre)?” a former board member asks in a scathing letter calling out the current board of directors and announcing plans to cease his $1-million legacy pledge to the hospital foundation upon his death.
Ronald Breen, a chartered accountant who was at one point chair of the London, Ont., hospital network’s finance committee and even served on the board of directors, says the current board “does not have a governance regime” and has “lost its way.”
“If it had a governance regime,” he told Global News on Tuesday, “we would not have had a situation in terms of having four acting, interim or appointed CEOs in the last six years.”
The letter is the latest blow to the organization, which — in concert with repeated CEO turnover — has faced increasing financial scrutiny in recent years that Breen suggests has eroded public trust in LHSC.
Recently appointed interim president and CEO David Musyj, however, says change is coming.
‘Executive leadership turmoil’
In the letter dated July 16, Breen writes that the “effectiveness of LHSC governance has been significantly impaired for several years” and that the board should be “held accountable for the executive leadership turmoil.”
The revolving door of CEOs began with Dr. Paul Woods, taking over from Murray Glendinning, who retired in 2018. Woods faced challenges with morale among front-line staff during the second wave of the COVID-19 pandemic in late 2020, with one nurse arguing that the administration failed to properly prepare and then tried to shift blame to front-line workers once cases among staff ballooned.
Woods weathered that storm but was ousted in January 2021 following controversy over his stateside trips amid the height of the COVID-19 pandemic. That prompted a wrongful termination lawsuit, as well as the resignation of the then-chair of the board of directors and the departure of two executive vice-presidents. The lawsuit was resolved in spring 2023 before it was set to go to trial.
Dr. Jackie Schleifer Taylor filled the role on an interim basis before being appointed president and CEO in November 2021. Two years later, she took a leave of absence “due to a health matter.” However, the announcement came two weeks after the London Free Press reported that the Ministry of Health had launched an investigation into two international trips for executives and one planned trip that was then scrapped, totalling $470,000.
Dr. Kevin Chan, corporate medical executive, was then appointed acting president and CEO of LHSC until Windsor Regional Hospital’s CEO David Musyj was brought in this May.
Hannah Jensen, spokesperson with the Ministry of Health, complimented Musyj’s leadership skills and said the province is “confident in his ability to bring those same skills to London Health Sciences Centre.”
“Questions related to internal human resource matters and donor relationships should be directed to the hospital itself,” she added.
In addition to the instability at the top, Breen also expresses frustration over “key partnerships with other healthcare providers” being “ripped apart at the expense of bad relationships and incremental operational costs.”
While not specifically referenced, a notable example involves plans to sever a partnership with St. Joseph’s Health Care London, the other hospital network in the city. The London Free Press reported in June 2023 that the hospital was scrapping a formal collaboration agreement, with sources saying LHSC was driving the split.
Later that month, LHSC and St. Joseph’s posted a joint letter to the community stating that “our health care system is under pressure to deliver care in new ways that meet the needs of our growing and aging population” but they are “continuing to establish formal and informal agreements based on patient and health system needs.”
‘Banking on a government bailout’
“I have keenly observed, in horror, a financial disaster in the making,” Breen wrote in the letter.
He says that seven years ago the organization had over $200 million in working capital, which is calculated as a measure of current assets minus current liabilities. Now, LHSC has projected an “unprecedented” $150-million operating deficit for 2025 on top of deficits in 2023 and 2024.
“Over the last three years, you’ve got to an unimaginable amount of $275 million worth of deficit,” he said Tuesday.
The $150 million estimate for 2025 may be overstated as Musyj has only just stepped into the role and may not have “his hands around the situation just yet,” Breen acknowledged. Regardless, though, the situation is “probably heading in that direction, which is beyond disappointing.”
Breen also suggests that “simply banking on a Government bailout(s) is difficult to justify” when he alleges LHSC has the “highest cost per case in Ontario according to provincial funding formula.”
The Ontario Case Costing Initiative dataset is restricted and will not be made available, a government website says. Data from the Canadian Institute for Health Information for 2021-22 showed the cost of a standard hospital stay at LHSC was less than average, though it noted that the results should be interpreted in the context of the COVID-19 pandemic.
Overall, Breen’s letter concludes that “LHSC’s state of affairs is purely a function of numerous bad decisions” and “bloated executive payroll – now approaching $40 million” with no “strategy toward stability.”
“The bizarre and costly organizational structure approved by the Board and implemented without a risk/cost analysis is parallel to borderline dereliction of the Board’s obligation to the public,” his letter reads.
Schleifer Taylor was the third highest paid in the hospitals and boards of public health category on Ontario’s Sunshine List in 2023 with a salary of $786,003. She followed Ronald Cohn, president and CEO of the Hospital for Sick Children, at $851,414 and Kevin Smith, president and CEO of University Health Network (Canada’s largest academic health sciences centre), at $844,992.
Of the 10 individuals with the highest salaries at their respective hospitals in 2023, nine had “executive” in their title at LHSC, the CEO was the only executive in the top 10 at SickKids (eight were radiologists or neuroradiologists and one was the chief of research) and six were executives or vice-presidents at UHN (three were laboratory physicians).
Musyj, meanwhile, made a salary of $433,027 as president and CEO of Windsor Regional Hospital.
Breen would like to see the board replaced and whittled down to a core group of “experienced leaders, people that understand accountability, can set goals and will demand achievement and compliance with those items.”
Musyj, meanwhile, provided a statement welcoming “direct conversations with members of our community, who can reach me at 519-870-2999.” He said LHSC is “actively taking steps” to address its financial situation and that the results of a management organizational structure review and benchmarking exercise will take “approximately three to four months to complete.”
“LHSC is not unique in experiencing the numerous financial pressures many hospitals across Ontario are contending with,” Musyj wrote.
“We’re committed to the work ahead to return the organization to a balanced financial state while not compromising on the delivery of quality care.”
Breen says the decision to take steps towards pulling his $1-million legacy donation was very difficult because he was so proud of his years of volunteer work with the hospital and the direction the hospital was headed in when he made the decision to set up the legacy gift in 2011.
But now, he argues it’s “inconceivable” that the foundation and the hospital can ask for donations given “no control of fiscal responsibilities” and that “the governance regime is broken down.”