Legislation
The Excellent Care for All Act, 2010
Questions and Answers
- What is the Excellent Care for All Act?
- I’ve heard stories in the media about patient-based payments and executive compensation. Is this part of a larger strategy?
- Why is the government proposing this bill now?
- Does this focus on quality mean that the government did not feel that Ontarians received quality health care before?
- How will these changes affect me?
- How will it affect the health system?
- When will this happen?
- Does the Strategy mean less funding to health care?
- Will this cost more money to implement than will be realized in savings?
- How does the health care community feel about this?
- Will the public be consulted before these changes are implemented?
What is the Excellent Care for All Act?
The Excellent Care for All Act is proposed legislation that would improve quality, value and promote evidence-based health care. It would ensure that future investments get results and improve health while ensuring that the health care system is there for future generations.
The hospital sector would implement these proposed legislative changes first, and results from hospitals would be assessed before extending the requirements to other health sectors.
The proposed legislation includes requirements for:
- Quality committees, which would report to the hospital board of directors on quality-related issues
- Annual quality improvement plans where each hospital would be required to create and publicly post a plan
- Executive compensation which would be required to be linked to achieving improvements set out in the annual quality improvement plan
- Patient relations process to address patient, client and caregiver relations
- Patient/client/caregiver surveys to assess satisfaction with services
- Staff surveys to assess satisfaction with employment experience and views about the quality of care provided by the health care organization
- Declarations of values that would be developed by health care organizations after public consultation.
Critical incident reporting would also be strengthened through regulatory amendments by requiring critical incidents in hospitals to be reported to the Medical Advisory Committee (MAC) and the hospital administrator, in addition to the affected patient. Action plans would be required for every critical incident.
Regulations would require that the Medical Advisory Committee report, at least annually, a summary of all critical incidents to the quality committee. Regulations would also require the Medical Advisory Committee report to the quality committee regarding clinical and general rules respecting regulated health professionals.
The following persons would not be allowed to be voting members of hospital boards: any member of the medical staff, dental staff, nursing or midwifery staff of the hospital, and any employee of the hospital.
I’ve heard stories in the media about patient-based payments and executive compensation. Is this part of a larger strategy?
We want to create a high-quality, integrated health care system where the needs of the patient come first.
The Strategy is based on the following principles:
- Care is organized around the person to support their health
- Quality and its continuous improvement is a critical goal across the health care system
- Payment, policy and planning support quality and efficient use of resources
- Quality care is supported by the best evidence and standards of care
Quality means better patient outcomes and improved access to care.
The Strategy will ensure the system is there for future generations. Specifically, the Strategy includes:
- Creating clear lines of accountability between health care executives and hospitals for the quality of care that’s delivered in hospitals.
- Introducing new legislation to ensure we have a quality standard. It would help us improve accountability and reward results.
- Ensuring organizations are more patient-focused – Ontarians will get the same high levels of quality care no matter where or when they use the system.
- A transparent and accessible quality rating system for hospitals.
- Moving towards a patient-based payment model that creates a transparent link between hospital funding and the care delivered to patients.
- Enabling an independent, expert advisory body to promote health care that is supported by the best available scientific evidence. It would make recommendations to the Government of Ontario so that future investments get results and improve patient health.
This is a natural step in the evolution of health care in Ontario. This builds on all of the investments and foundation of greater access that we’ve put in place during the past six years. We’re putting a lot more money into the health system. Now, what we want to do is to make sure that every single dollar that we put into health care system is having the desired effect - quality improvements and better patient service.
The goal is better and safer practices right across the system informed by evidence and delivered by health care providers who place the best possible patient outcomes first and foremost.
A quality health system is everyone’s responsibility.
Why is the government proposing this bill now?
Government resources are finite while the demands being placed on the health care system are not.
As demand for health care services continues to increase, adequate resources will not be available to meet these demands.
Just 20 years ago, 32 cents of every dollar spent on government programs were spent on health care. Today, it is 46 cents. In 12 years, it could be 70 cents if appropriate action is not taken.
Does this focus on quality mean that the government did not feel that Ontarians received quality health care before?
The government wants to foster a culture of continuous quality improvement, where the needs of patients come first. That is why the government is proceeding with legislation that would ensure our health care investments get results, and provide high quality care that is patient-focused.
This strategy will build on our investments in the system and on the foundation of greater access that the government has put in place during the past six years. The government has made significant investments in quality improvement (QI) initiatives through key QI stakeholders and will continue to support these groups to build capacity at all levels of the health care system. As part of this strategy, the Ministry will partner with these QI groups to implement evidence-based care initiatives.
How will these changes affect me?
Simply put, it would ensure that you and your loved ones receive the right care, in the right place, at the right time. You can count on consistent high quality care across the province that is based on evidence.
There is room for you to play a larger role in your own health care, allowing you to make the very best health care decisions for yourself while still preserving the system for others.
Patients have a responsibility to be engaged in their care, in order to get the best care possible.
How will it affect the health system?
The goal is better and safer practices right across the system informed by evidence and delivered by health care providers who place the best possible patient outcomes first and foremost.
When will this happen?
There are many components to the proposed legislation and overall strategy that are intended to be implemented at different stages over the next few years.
We’re starting the process by introducing the legislation on May 3rd. If passed, most of the proposed new requirements such as the patient relations process, declaration of values, CEO compensation would come into effect immediately. The requirements that do not come into effect immediately, such as the establishment of quality committees, would come into effect shortly after.
We intend to carry out stakeholder consultations in the coming months to inform implementation of components of the strategy.
With patient-based payment, this will include conducting trials to inform how we introduce some increased form of patient-based payment in the coming year.
Does the Strategy mean less funding to health care?
We are putting a lot more money into the health system. Now, what we want to do is to make sure that every single dollar we put into the health care system is having the desired effect – quality improvements and better patient services.
Will this cost more money to implement than will be realized in savings?
Much of the foundation for this Strategy leverages the existing investments we’ve already made in the system. Just 20 years ago, 32 cents of every dollar spent on government programs were spent on health care. Today, it is 46 cents. In 12 years, it could be 70 cents if appropriate action is not taken. This strategy will ensure that the health care system is there for future generations.
How does the health care community feel about this?
We have consulted broadly with, and will continue to consult with the health care community. This includes stakeholders from areas such as hospitals, nurses, physicians, professional colleges and community providers. Stakeholders will continue to to have their voices heard while the legislation passes through the approval process and as policy is being shaped.
Will the public be consulted before these changes are implemented?
We want to ask Ontarians how we fund the best health care without crowding out all the other priorities we share. We think it’s important that the public have a say in how their tax dollars are being spent which is why we will initiate a dialogue and will engage Ontarians directly in this important conversation. As in any other legislation, the public will have the opportunity to provide input.
