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Kathy O'Brien: a passionate advocate for health-sector clients

Toronto health lawyer Kathy O’Brien is passionate about governance, as well as facilitating restructuring and integration within the health-care sector.

“Anytime these organizations get creative and think of ways to do things more effectively and efficiently – that’s going to save money and resources in the system, I love to facilitate that,” she tells “It’s very rewarding for me and there is a lot of that going on right now.”

O’Brien, partner with DDO Health Law, says publicly-funded organizations are looking around these days for collaborations in an effort to become more efficient. 

“There’s always a concern in an era of limited resources that those organizations that are operating as silos and not collaborating with others will be the first on the chopping block,” she says. “So everybody is looking for a partner. There is strength in numbers and they want to be part of a bigger system.”

Most of her clients are publicly-funded organizations in the health-care sector across the province — with many of them located in rural and northern areas.

O’Brien helps formalize integration agreements that have to go through a regulatory approvals process. She assists organizations through the approvals process and facilitates a strategy for their smooth integration. 

“There are collaboration agreements, alliance agreements, merger agreements — there are also government approvals, depending on the types of entities involved, that I help facilitate,” she says. 

In almost all cases, clients are under the jurisdiction of the Local Health Integration Network (LHIN), of which there are 14 throughout Ontario. The LHIN has the authority to approve or reject integrations among various players in the health sector that are publicly funded, O'Brien explains.

“So we facilitate getting the approval of the LHIN, and the approval of the Ministry of Health is often needed as well,” she says. “Very often our clients are charities so there is a body in Ontario called the Public Guardian and Trustee and it has to approve certain changes as well.”

O’Brien provides guidance to health boards through the process of making such changes.

“There is often a required stakeholder engagement process if organizations are making a significant change — and I can help guide them through that,” she says. “I can help them understand the process they are undertaking so they feel comfortable and confident about it.”

O’Brien also works with health organizations on governance issues. She notes that health boards are composed mainly of volunteers who are working hard to make the health system better. 

“The health-care system is very complex and knowing what the obligations of the boards are can be daunting,” she says. “So one of the things I love doing is helping to make directors and members of boards feel more confident about what they have to do, explaining to them their responsibilities and giving them an orientation.”

O’Brien helps boards with legal processes and strategy issues when they are dealing with challenges. 

“I help them to engage in the best way to get a productive outcome,” she says. “I like helping them do their jobs better.”

O’Brien started out practising corporate law at a large Bay St. full-service firm. While there, she became involved in the legal work that came out of the government’s Health Services Restructuring Commission, which was mandated to improve hospital services in Ontario through integrations.

“I loved the people I worked with in the health sector,” she says. “It’s not about the bottom line for them. It’s about really contributing to a better publicly funded health-care system. I felt that my values and priorities were much more aligned with those clients.

"Once I started doing those types of files, it really directed my career. I soon realized I wanted to work with public-sector clients, health-sector clients.”

O’Brien says health is an exciting area because it is something that everyone can relate to in some way.

“Even though it is very complex, it is very relatable to us,” she says. “Our health-care system is a Canadian icon."

Wanting to help clients through capacity building is also a value at DDO Health Law, O’Brien says. 

“We want our clients to walk away with a better understanding of what they need to do so that they can go off and do it themselves,” she says. “We want to set our clients up for success.”

Prior to joining DDO Health Law, O’Brien was a partner and co-chair of the National Health Law Group at Osler, Hoskin & Harcourt LLP. She worked in private practice since 1994, focusing specifically on the health sector since 1999.

She graduated from the University of Toronto Faculty of Law and was called to the Ontario Bar in 1994. She was an editor of the Ontario Bar Association's Health Matters newsletter from 2001 to 2010.

O’Brien has been recognized by Best Lawyers® Canada 2008-2017 in the field of Health Care Law.

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