Changes are coming, but some members of Middlesex County council question whether the Middlesex-London Health Unit can properly respond to those changes.

And council members worry it could mean a significant hit to local taxpayers.

Representatives of the Middlesex-London Health Unit went before council Tuesday afternoon to field questions on what the future might hold.

The session began with Lucan-Biddulph Mayor Cathy Burghardt-Jesson again calling into question the health unit’s decision to enter into a 20-year lease with Citi Plaza in downtown London.

"You know it's something that I think we saw around here that could very well happen."

That 'something' is the elimination of local health units, to be replaced by larger regional public health entities.

The new public health body in Southern Ontario will extend from Woodstock to Windsor.

The fear is that if the regional organization isn't headquartered in London, the newly leased space could end up sitting empty.

Burghardt-Jesson says, "There are significant concerns, financial implications, to this move and to the restructuring that is going to potentially impact Middlesex County and the City of London and we need to keep that forefront in the discussions."

Even before the provincial announcement, Burghardt-Jesson advocated for a decentralized model, using smaller satellite locations. She believes that would make even more sense under the larger regional body.

But Middlesex-London Health Unit CEO Dr. Chris Mackie believes the space will be used and still makes economic sense, allowing the health unit to consolidate operations currently housed in two separate locations at 50 King Street and 201 Queens Avenue in London.

"We knew that to stay in the existing locations would cost significantly more money. So it saved us money and provided a better product."

And there are other cost concerns for the county linked to provincial government decisions.

The health unit says provincial downloading could cost the county $1.8 million a year by 2021.

And Middlesex County CEO Bill Rayburn says severance payments for staff declared redundant under the new regional system will also fall to the county, another concern for Burghardt-Jesson.

“We scrutinize our tax dollars at the municipal level. And if those tax dollars have to be raised to pay severances, I don't think there's anybody that's going to be happy about that.”

Burghardt-Jesson questions where the provincial government fully contemplated the wider impact of their own quest for cost savings.