In the current environment it is increasingly important for health system providers to integrate operations, services and activities and in some cases entities. We have been involved in facilitating and implementing integration for many years including voluntary amalgamations many years prior to the work of the Health Service Restructuring Commission.  We were heavily involved in amalgamating hospitals from 1996 through to the present including the three most recent hospital amalgamations in 2011-12.

Integration is much more than just mergers and amalgamations and includes: program transfers, shared service arrangements, alliances and networks, and partnering in the delivery of services and programs.

These are complex transactions that involve not only legal expertise but an understanding of some of the implementation issues that may arise "post integration." We are sensitive to professional staff and other human resource implications as well as the impact of these transactions on the community at large, fundraising initiates, volunteers and foundations.  Our work has often gone beyond drafting agreements and due diligence to developing work plans that consider all aspects of the integration.  We also understand the regulatory requirements and expectations of the Ministry of Health and Long Term Care and the Public Guardian and Trustee.

We help prepare presentations for directors to assist them in understanding their role in integration activities.

We have also been involved in integration and collaboration between cross sector institutions where our understanding of the regulatory framework for different health service providers has been a valuable addition to our legal expertise.

Publications & Presentations

Representative Work

  • Numerous hospital amalgamations including multi-site amalgamations, asset transfers, statutory amalgamations and implementation of Special Act amalgamations.
  • Amalgamation of Foundations and Volunteers/Auxiliaries.
  • Transfer of special service program between hospitals.
  • Creation of not for profit shared service corporations for supply chain management, procurement and diagnostic imaging services.
  • Transfer of hospital "sites" form one hospital to another.
  • Laboratory service partnership between a hospital and a private sector partner.
  • Creation of an alliance framework between 2 hospitals to create a structure for program and service integration and collaboration.
  • Establishing health service networks.