Legislation
The Excellent Care for All Act, 2010
Questions and Answers
- Has the Excellent Care for All Act passed Third Reading?
- Was Bill 46 reviewed by a committee?
- What happens during a Standing Committee hearing?
- What were the changes?
- When will CEO salaries begin to be tied to quality measures?
- How will the government ensure hospitals actually comply with the legislation?
- When will the changes take effect?
- What will happen next?
Has the Excellent Care for All Act passed Third Reading?
Ontario is putting patients first by improving the quality and accountability of the province’s health care system.
The Excellent Care for All Act completed Third Reading today, June 3rd and upon Royal Assent, will make health care providers and executives accountable for improving patient care. The legislation requires health care organizations, beginning hospitals to:
- Create quality committees to report to each organization on quality related issues
- Develop and make public annual quality improvement plans
- Link executive compensation to quality plan performance improvements
- Conduct patient and employee satisfaction surveys
- Develop patient declaration of values
- Establish a transparent patient relations process that reflects the declaration of values
Upon Royal Assent, the legislation will also expand the mandate of the Ontario Health Quality Council to recommend evidence-based delivery of health care based on clinical practice guidelines and protocols. The council will also make recommendations on possible changes to the way health care is covered and paid for to ensure that it is consistent with the evidence.
Today’s announcement is part of the government’s Open Ontario Plan to provide more access to health care services while improving quality and accountability for patients.
Was Bill 46 reviewed by a committee?
Yes, the Bill was ordered to the Standing Committee on Justice Policy. Public hearings were held mid-May. People and stakeholders that were interested in making an oral presentation were asked to submit their name for consideration. Written submissions were also accepted by the Committee Clerk.
What happens during a Standing Committee hearing?
The purpose is to comment on, ask questions about and/or propose amendments to various sections of the Bill. The committee may invite individuals, groups and Ministry officials to comment on the Bill in writing or in person. Following public submissions, the Bill is considered clause by clause. Each clause of the Bill may be considered, amended or deleted, and new clauses may be added. The Bill is reported back to House after completion of clause-by-clause consideration, if amendments have been made, the Bill is reprinted. The Bill is then ordered for Third Reading
What were the changes?
The bill was amended at committee as follows:
- Surveys: Upon Royal Assent, amend so all health care organizations carry out surveys every two fiscal years (instead of once a year) when surveying employees of the health care organization and persons providing services within the health care organization.
- Patient declaration of values: Upon Royal Assent, amend so that only the health care organizations that do not already have a publicly available patient declaration of values produced after consultation with the public are required to produce one.
- Ontario Health Quality Council (OHQC) Membership: Upon Royal Assent, the provisions in the bill relating to appointments to the OHQC will be amended so that, in addition to what is already in the bill, regard should be had to the desirability of appointing to the Council:
- persons with interest or experience in clinical service evaluation;
- persons with expertise in quality improvement including expertise in the measurement of quality indicators; and
- persons with expertise in the creation of a safe, quality and healthy work environment
- Regulations made by the Minister: Upon Royal Assent, a subsection was added requiring that, before making a regulation, the minister must consult with the public in accordance with the relevant policies of the Government of Ontario concerning public consultation in the making of regulations.
- Public Hospitals Act: Upon Royal Assent, the Hearings section of the Public Hospitals Act will be amended by adding a subsection stating that no member of a board shall be disqualified from participating as a member of the board in a hearing held regarding an appointment or a reappointment to any group of the medical staff of a hospital or for a change in hospital privileges by virtue of the information contained in a report written by the medical advisory secretary regarding the quality of medical diagnosis, care and treatment provided to the patients of the hospital
When will CEO salaries begin to be tied to quality measures?
If passed, upon Royal Assent of the Excellent Care for All Act, CEOs will be expected to focus immediately on quality. The linkage of salaries to quality targets can be fully implemented once the annual quality improvement plans are developed. The specific performance measures on which salaries are based would be identified in these plans and posted publicly.
How will the government ensure hospitals actually comply with the legislation?
If passed, upon Royal Assent of the Excellent Care for All Act, compliance would occur through the requirement to publicly post annual quality improvement plans, and the targets contained within those plans. The public posting would ensure accountability and transparency. In addition, upon request of the Local Health Integration Network (LHIN), hospitals would submit their annual quality improvement plans to them for review.
When will the changes take effect?
Most of the contents of the Bill will come into force on Royal Assent although some sections will require proclamation from the Lieutenant Governor to come into effect.
What will happen next?
The government will be working with stakeholders to support this legislation.
