Publications

Ministry Plans

Business Plan 2000-2001


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Message from the Minister

Ensuring that everyone in Ontario has access to quality health care is the government's top priority which is why we want to have 80 per cent of eligible family doctors working in primary care networks by 2004. These networks will provide access to comprehensive care 24 hours a day, seven days a week.

The ministry's Business Plan reflects our goal and how it will be achieved. It details how we are implementing changes to Ontario's health system and what we have accomplished so far. It also outlines our strategies and commitments for creating a better system for today, and tomorrow.

Ontario's strong economy is enabling the government to pay for health care and to continue to move forward with essential health system reforms. These reforms are necessary to build and sustain a modern health care system.

The Ontario government's commitment to increase health care spending will reach a new high of $22 billion in 2000-2001. This investment is needed to meet the demands of a growing and aging population.

While the Ontario government has kept its commitment to providing permanent funding to the health care system, the federal government has cut funding to Ontario. We continue to encourage the federal government to provide adequate, sustainable, long-term health care funding to help Ontario create an innovative restructured health care system.

With a growing and aging population, the job of preparing health services for the future is well underway. I am very pleased at the progress the Ministry of Health and Long-Term Care has made, but there is still more to do and I am confident that we will achieve our goal.

The Honourable Elizabeth Witmer
Minister of Health and Long-Term Care



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Ministry Vision

Our vision is clear :   an accessible health system that promotes wellness and improves people's health at every stage of their lives and as close to their homes as possible.

In support of its vision, the ministry has developed a health action plan. This plan moves resources from the old infrastructure to fund new programs, health services and facilities that will help :

  • keep people well,
  • detect illness sooner,
  • expand community health services,
  • build on the strengths of our system, and
  • improve quality of life for seniors.

The Ministry of Health and Long-Term Care is committed to ensuring that all Ontarians have access to modern technologies and treatments. Our vision also encourages all health care professionals and institutions to work together to ensure accountability to the patient and the system.

The ministry is modernizing Ontario's health system through restructuring and investing, increasing health promotion and prevention, and enhancing the role of community-based services.

Ontario's strong economy is enabling the government to pay for health care and to continue to move forward with essential health system reforms. These reforms are necessary to build and sustain a modern health care system.


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Core Businesses

The Ontario Ministry of Health and Long-Term Care has four core businesses - Community Services, Professional Services, Institutional Services, and Policy and Planning - that work together to support the province's health system and implement our health action plan.

Community Services

Community Services aims to preserve the health and independence of people by preventing illness and injury and by promoting healthy lifestyles while keeping people close to their homes and families.

This core business includes disease prevention and health promotion programs for public health, diabetes and AIDS; long-term care; community health centres; community mental health; drugs/assistive devices/home oxygen; substance abuse and problem gambling programs; laboratory services; emergency health services; integrated services for children, and OHIP registration and claims.

Ontario's 43 Community Care Access Centres (CCACs) are vital to community health services. Located across the province to co-ordinate home care and placement in long-term care centres, CCACs provide one-stop access to a wide range of services. In addition, the ministry funds about 1,000 agencies that provide community support programs, such as Meals on Wheels and supportive housing.

Nurses are an essential and valued part of community services and Ontario's health system. Knowledgeable and skilled professionals, they provide quality care to patients in virtually every health care setting.

Professional Services

Professional Services ensures that doctors, nurses and other health professionals are available throughout Ontario. It improves access to health services with programs for under-serviced areas. Education funding for resident training at medical schools and training for health providers, such as nurse practitioners, radiation therapists and midwives, help ensure the continued availability of health professionals.

This core business encourages health professionals, agencies and facilities to work together for better patient services. It is piloting a team approach to health care through its primary care reform program. It also monitors OHIP billings to prevent, detect and deter fraud.

Institutional Services

Institutional Services ensures that hospitals and long-term care centres respond to changing needs with appropriate services and technology. Hospitals include community hospitals, specialty hospitals, such as psychiatric hospitals, and university-based health science centres. Long-term care centres include homes for the aged and nursing homes.

The ministry does not directly manage institutions. They are independent corporations run by independent boards. The ministry regulates and funds hospitals and long-term care centres and operates nine psychiatric hospitals in Ontario. Five specialty hospitals and 61 general hospitals also provide psychiatric services in the province.

Ontario has embarked on a major expansion of long-term care centres to meet the needs of a growing and aging population. These facilities provide health services for people who can no longer live independently in their own homes and who need nursing and personal care. People who would once have gone to a hospital can now live in long-term care centres and enjoy a more comfortable, home-like atmosphere.

Policy and Planning

Policy and Planning creates health care policies to meet the needs of a growing, changing and aging population. Sixteen District Health Councils, working with local communities and stakeholders throughout the province, are part of the ministry's planning activities.

Policy and Planning develops legislation, standards and programs. It also measures the performance of Ontario's health system and co-ordinates policy with the federal government and other provinces and territories.

The government funds research to improve the delivery of health services, and the ministry, along with 21 professional regulatory bodies, ensures professional standards and patient safety.

Policy and Planning also develops educational programs for the health professions and provides support to four regulatory boards.


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Annual Report on Key Achievements for 1999-2000

The government continues to make considerable progress in reforming and modernizing our health system to ensure its sustainability for the future.

In 1999-2000, hospital restructuring continued and more health dollars were invested into front-line patient care and services including $27.4 million in cardiac care, $48 million in cancer services and $31.3 million in dialysis. Seven primary care pilot projects were introduced to provide more accessible, co-ordinated services.

To improve patient services, provide care closer to home, and reduce waiting lists in hospitals, we invested $18.6 million in MRI services, $5.6 million in new cardiac centres, $155 million in new and expanded radiation treatment facilities, and provided $375 million in funding for 12,000 more nurses, including 106 new nurse practitioners. We've also introduced a new emergency room service standard for patients to be assessed 15 minutes after registering. Mothers can remain in hospital for 60 hours after childbirth and every new mother will receive a phone call and offer of a home visit within 48 hours of discharge.

The government has worked to ensure that rural and remote communities have better access to health services and specialists by providing alternate funding agreements. And we've strengthened community-based mental health services with more mental health beds, facility improvements, training and by implementing the mental health homeless initiative. We've also renewed the Aboriginal Healing and Wellness Strategy to improve the health of Aboriginal people and promote family healing.

For seniors, we've speeded up the expansion of long-term care beds, expanded community services, such as Meals on Wheels and home care, and added more nurses to long-term care facilities and in the community.

Shifting our focus from sickness to wellness and to encourage good health habits, we've continued to support a variety of prevention programs including Healthy Babies-Healthy Children, Ontario Heart Health, the Ontario Tobacco Strategy and the breast screening program.

Planning for enough health professionals is a priority. The ministry responded immediately to the McKendry report on Physicians for Ontario by providing $11 million in funding for immediate needs and by appointing a panel of experts to recommend long-term strategies that ensure doctors and other health professionals meet the future needs of communities. And the ministry is working to implement the recommendations of the Nursing Task Force report.


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Key Commitments and Strategies for 2000-2001

Ontario's spending on health programs and services for 2000-2001 will reach a record high of $22 billion. This is an increase of $1.4 billion over last year and the highest level of provincial health spending in the history of the government of Ontario.

This investment in health care will provide funds for :

  • public hospitals and their critical programs such as dialysis and treatments for heart disease and cancer patients;
  • long-term care and community care programs including 43 Community Care Access Centres and the 200 agencies that provide in-home nursing, therapy and homemaking services;
  • more than 20,000 doctors, optometrists, chiropractors, physiotherapists and other health practitioners; and
  • drugs for two million people.

Our strategies for 2000-2001 reflect the ministry's commitment to health and to health reform by :

  • improving access to medical services;
  • implementing better care practices;
  • preventing illness; and
  • supporting health research.

We will continue to work with other provinces to convince the federal government to become a full funding partner in the health care system.

We will anticipate the needs of a growing and aging population.
The ministry will help ensure appropriate services and technology so everyone in Ontario will have access to quality health care at every stage of their lives. In 2000-2001, we will focus on research, organ donation programs, neonatal units and rehabilitation services. We will continue with our expansion of long-term care beds, increase our investment in modernizing hospitals and bringing health services closer to home.

We will expand health promotion and illness prevention activities.
To help people stay healthy, we will promote flu shots and "stop smoking" programs. We will implement one of the most comprehensive strategies in North America to prevent stroke and to rehabilitate stroke victims. Investing in child health and development, we will expand our eating disorder programs, implement a new infant hearing screening program, and extend the pre-school speech and language program. We will also develop plans for asthma prevention, education and treatment. The ministry's Statement of Environmental Values outlines our commitment and support of environmental issues in all our policy decision-making.

We will plan for enough health professionals throughout Ontario.
We will continue to work closely with the Northern Academic Health Sciences Centre and the Professional Association of Interns and Residents of Ontario. We will increase the number of spaces for medical students and offer free tuition for medical students willing to relocate and practise in under-serviced areas and specialties. We will continue to implement the recommendations of the Nursing Task Force and hire more nurses for hospitals, long-term care facilities and in the communities. Our support for research, state-of-the-art surgical techniques, and high-technology equipment, such as MRI machines, will help draw and retain the most talented specialists.

We will strengthen the health care system.
To provide better care for patients and improve access to services, we will expand and enhance our community-based health care, home care, and psychiatric services. Keeping up with advances in technology is essential to meet people's health needs in the 21st century. We will expand our primary care health network and Telehealth, a toll-free telephone advisory health service.

We will integrate health reforms to improve access.
We will fund innovative, locally developed and sponsored projects to better link health services for people in their own communities. For special need students, we will extend ministry funded health services to students in all schools.

We will enhance customer service and increase accountability.
We will introduce a Patients' Bill of Rights, hospital report cards and patient satisfaction surveys. To support a safe blood-supply system, we will fund blood conservation projects and bloodless surgery techniques. In keeping with the government's zero tolerance for fraud and to ensure the future sustainability of our health care system, we will be strengthening our detection, investigation and prosecution of people defrauding the system.

We will respond to changing needs and technology.
We will continue to be flexible in allocating resources and funds to hospitals and priority programs. For recent immigrants and others, not covered by OHIP, we will fund services to diagnose and treat TB.


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Key Performance Measures

The ministry monitors its goals for an improved health care system continually. By linking the effectiveness of services to performance measures, the ministry can see how its reforms are working. Performance measures also help the ministry plan for the future sustainability of the health care system.



Community Services
Preserving and Protecting the Health of Citizens in Their Communities


Goals/Outcomes Measures Targets/Standards 2000-2001 Commitments
Ontarians will be among the healthiest people in Canada and the world Percentage of people rating their health as "excellent" Highest self-rated health in the country.

In 1998/99, 27% of Ontarians, aged 12 and over, reported their health as excellent. 90% reported their health as good or better. In other provinces, the results for those reporting their health as excellent were :

Que - 27% Nfld. - 27%
Alta - 27% B.C. - 24%
Man. - 23% PEI - 22%
N.S. - 21% N.B. - 18%
Sask. - 18%
Encourage healthy public policies.

90% of Ontarians will rate their health as good or better.

  Life expectancy at birth (in years)
Country Male Female
Canada 75.3 81.3
France 73.9 81.9
Germany 73.0 79.5
Italy 74.4 80.8
Japan 76.4 82.8
Sweden 76.2 81.5
UK 74.3 79.7
USA 72.5 79.2
OECD Health Data, 1995.
Life expectancy at birth (in years) will be the longest in Canada.

In 1996, Ontario women had the fourth longest life expectancy at birth of any province or territory in Canada



Province Male Female
Ontario 76.1 81.4
Alberta 76.0 81.3
B.C. 76.1 81.8
Manitoba 75.4 80.7
N.B. 75.2 81.2
NWT 69.8 75.5
Nfld. 74.9 80.5
Nova Scotia 74.9 80.8
P.E.I. 73.9 80.8
Quebec 75.1 81.5
Sask. 75.3 81.5
Yukon 70.9 84.4
 
Canada 75.7 81.4
Statistics Canada 1999.
Evaluate Heart Health program.

Ensure that all 37 boards of health in Ontario have alcohol risk management policies.

Evaluate diabetes foot care program in northern Ontario.

Coordinate adult and pediatric diabetes care/education.

Monitor/enforce/review standards for chronic disease prevention, early detection of cancer injury prevention and substance abuse prevention programs.
  Low birth-weight rate. Lowest rate of low-birth weight babies in Canada.

In 1997, the low-birth weight rate in Ontario was 5.9%, slightly above the national average of 5.8%In 1996, Newfoundland and Alberta had the highest number of low-birth weight babies, 6.1%.

Finland, with 4.1% in 1995, is a model internationally.
Meet or exceed the national average of 5.8% for the rate of low-birth weight babies in Canada.

Integrate Best Start program into the Healthy Babies, Healthy Children Program.

Expand Healthy Babies, Healthy Children screening to include prenatal families.
Reduce premature deaths. Potential years of life lost to cancer and heart disease. Fewest potential years of life lost in Canada.

Values for 1997 for all causes of death in Ontario are lower than national.

Ontario/Canada
Total 32.3 36.2
Males 41.9 47.0
Females 22.9 25.41
Maintain fewest potential years of life lost in Canada. Complete implementation of tobacco control initiatives.

Increase by 25% the number of women being screened in the breast screening program. Increase the number of women screened for cervical cancer.

Improve outcomes for children through prevention and early intervention Percentage of families receiving Healthy Babies, Healthy Children services and/or linked with other community services. 100% of newborns screened for developmental risk factors.
100% of mothers will receive a telephone call within 48 hours of hospital discharge and offered a home visit.
100% of high risk families will be offered home visiting services and/or be linked with other community services.(Long-term targets).
Screen 100% of live births for risk factors related to child development.
Call 70% of mothers within 48 hours of discharge and offer a home visit by a public health nurse.
Offer 9,000 (100%) high risk families home visiting services and/or other community services.
Ontarians can choose from an increasing range of health services that let them remain in their homes and communities. Number of long-term care community services used. Maintain the % of people over 75 living in the community.

In 1996, 86% of Ontarians over 75 lived in the community. Increase use of LTC community services.

86% of Ontarians over 75 will live in the community.

Report on the number of clients who received long-term care services in 1999/2000.

Increase use of long-term care community services by an additional 11,500 clients.
Reduce premature deaths. Infant mortality rate. Lowest rate of infant mortality in Canada.

In 1996, the infant mortality rate (deaths per 1,000 births) in Ontario was 5.7, slightly above the national average of 5.6.

The NWT has the highest rate at 12.2 in Canada. Japan, with a rate of 3.8, is the international model.
Maintain lowest rate of infant mortality in Canada.

Review and revise standards and requirements for reproductive health.

Increase the number of boards of health to 37 that are able to deliver the mandatory reproductive health program.
Provide affordable supportive housing in the community to homeless people with mental illness. The number of supportive housing units made available for emergency hostel users. 1,000 housing units in Toronto, Hamilton and Ottawa. Establish 800 supportive units in Toronto, 100 units in Hamilton and 100 units in Ottawa.


Professional Services
Providing Access to Primary and Specialist Care


Goals/Outcomes Measures Targets/Standards 2000-2001 Commitments
Enhanced access to primary care through continued implementation of primary care reform. Number of primary care sites where reform is implemented.

Percentage of targeted patient enrolment rate achieved.

Number of primary care physicians joining primary care reform.
Increase number of primary care reform pilot sites to seven.

Average patient enrolment in each primary care network, 75% of target enrolment.

Number of physicians moving to primary care reform at seven sites, target of 275 physicians.
Implementation of primary care reform at seven pilot sites.

Achieve an average of 75% enrolment at four sites, average 25% enrolment at three remaining sites.

Complete conversion of 125 physicians at four sites. Complete 75% of conversion at three remaining sites.
Regional access to professional services in communities across the province. Availability of general practice doctors and specialists province-wide and in under-serviced areas. Increase the number of doctors and specialists practising in areas with fewer doctors per population than the provincial average. Report on the availability in under-serviced areas.

Maintain effective working relationships with provider associations to address service delivery and expenditure management issues.

      Develop solutions for emergency departments through Phase III.
    Increase the number of months of rural and northern medical education taken by doctors in training. Sign up at least 10 medical students for free tuition in exchange for working in under-supplied areas.
  Number of Nursing Task Force Recommend-ations implemented. Implementation of all recommendations over next 5 years. Continue implementation of all recommendations to support nurse training and education, nursing research, retention and recruitment, and nursing leadership in health organizations.


Institutional Services
Providing Acute and Long-Term Institutional Care


Goals/Outcomes Measures Targets/Standards 2000-2001 Commitments
Ontarians receive appropriate institutional care. Percentage of days spent by patients in a hospital when another type of facility would be more appropriate. 1999/2000 target was 8.5% days. Decrease the percentage of days by at least 0.1%.
  Number of beds available in long-term care facilities. A 35% increase (an additional 20,000 beds) in long-term care beds. By March 31, 2001, an additional 1,327 long-term care beds will be in operation. To achieve target of 2,000 beds committed in 1998 funding has been accelerated.


Policy And Planning
Developing Direction for Health Care and Monitoring Quality and Performance


Goals/Outcomes Measures Targets/Standards 2000-2001 Commitments
High level of public satisfaction with government-funded health services. Ontarians' ratings of quality, availability and accessibility of health services. A public survey to provide the basis for establishing targets and quantitative commitments for 2000/2001 is underway.

1998/99's National Population Health Survey identified a 95% positive response in Ontario on availability of services, a 1% increase from 1996/97.

Incorporate questions on public satisfaction with health services in an Ontario survey that compares to other provinces, with statistics available in 2000/2001.
Increase accountability by rooting out waste, fraud and abuse. % of referrals for investigation and to review committees.

Number of fraud investigations undertaken.

For next five years, increase % of referrals, ensuring minimum of 100 referrals annually to Medical Review Committee.

% of referrals to fraud programs for investigation.

Increase awareness of fraud programs by ministry staff and implement communications plan.



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1999-2000 Ministry Spending By Core Business - Interim Actuals *

Ministry of Health and Long-Term Care
Operating** $20,600 million
Capital $1,344 million
One-time Major Operating $286 million
9380 staff
Community Services
Operating $4,846 million
Capital $16 million
2615 staff

Long-Term Care Community Services
Community Mental Health
Community Health Centres
Drug Programs/Assistive Devices/Home Oxygen
Substance Abuse
Registration and Claims
Disease Prevention and Health Promotion
Community Labratory Services
Emergency Health Services
Integrated Services for Children

Professional Services
Operating $5,352 million
150 staff

Physicians
Health Services Organizations/Independent Health Facilities
Midwives
Other Practitioners
Underserviced Area Program
Northern Health Travel Grants
Clinical Educations

Institutional Services
Operating** $10,172 million
Capital $1,328 million
5780 staff

Hospital/Psychiatric Hospitals
Long-Term Care Facilities

Policy and Planning
Operating $78 million
140 staff

Integrated Policy and Planning
District Health Councils
Regulatory Agencies
Research

Internal Administration
Operating $152 million
695 staff

Corporate Services
Information Technology
Other corporate functions
Health Sector Year 2000


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2000-2001 Ministry Approved Allocations By Core Business Plan *

Ministry of Health and Long-Term Care
Operating** $21,988 million
Capital $291 million
5550 staff
Community Services
Operating $5,282 million
Capital $54 million
2255 staff

Long-Term Care Community Services
Community Mental Health
Community Health Centres
Drug Programs/Assistive Devices/Home Oxygen
Substance Abuse
Registration and Claims
Disease Prevention and Health Promotion
Community Labratory Services
Emergency Health Services
Integrated Services for Children

Professional Services
Operating $5,500 million
145 staff

Physicians
Health Services Organizations/Independent Health Facilities
Midwives
Other Practitioners
Underserviced Area Program
Northern Health Travel Grants
Clinical Educations

Institutional Services
Operating** $11,024 million
Capital $237 million
2310 staff

Hospital/Psychiatric Hospitals
Long-Term Care Facilities

Policy and Planning
Operating $90 million
145 staff

Integrated Policy and Planning
District Health Councils
Regulatory Agencies
Research

Internal Administration
Operating** $152 million
695 staff

Corporate Services
Information Technology
Other corporate functions
Health Sector Year 2000


June 2000

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