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Speeches

Canadian Club of Toronto Broad Vision For Health Care

Remarks By The Honourable David Caplan Minister of Health and Long-Term Care
November 18, 2008

Good afternoon ladies and gentlemen.

It's an honour to be here today.

The Canadian Club has facilitated some of the key public policy debates of our times.

And, I am privileged to engage today's discussion on the future of health care in Ontario.

But before I begin, let me start by thanking Helen for her kind introduction.

Like so many of you here today, Helen has committed much of her energies to public service….

…as Chair of the Ontario Trillium Foundation and as President of this club.

And for that, we owe her a debt of gratitude. Thank you, Helen.

…and thanks also to Allan O'Dette, a past president of this club, who's with us today representing Glaxo-Smith-Kline.
I have quite a bit of ground to cover and I want to make sure I leave enough time for Qs and As, so let's get started.

Today's theme is: A Broad Vision for Healthcare.

But before I get into the broad vision, I'd like to start with something more specific…

…the emergency rooms of our hospitals.

Our ERs have become a metaphor for what ails our health care system.

Our ERs have become the default doorway through which too many Ontarians enter and leave the health care system.

A person with a sprained finger is coming through the same door as someone having a heart attack.

Our ERs see 5 million patients every year.

But more than half of those visits are not medical emergencies.

Think about what that means…

…backlogs….inefficiency….and frustration…

…for patients…for medical professionals…and for policymakers.

That's why many of my priorities as Health Minister will relate in one way or another to the ER.

It's the biggest and most urgent challenge facing the entire system.

Since we took office five years ago, we've made enormous progress in rebuilding and refocusing our health care system.

As a government, we've set two overarching priorities in health care…

…Reducing wait times, especially in the ER…

…And improving access to family health care.

We have increased annual health care sector spending by $11.1 billion…

…that's a dramatic 37 per cent increase.

We are seeing results from these investments.

We've increased the number of front-line medical workers…

…funded 8,000 new nursing jobs and 7,000 jobs in long-term care.

We've undertaken the biggest expansion of community health centres in the province's history…

…benefitting 103 communities.

We've reduced wait times for key surgeries…

…$1 billion alone for this initiative.

Many of our hospitals have sprouted construction cranes…

…All part of the single largest expansion of health capital in a generation.

We've created 150 family health teams…

…630,000 more Ontarians now have access to a family doctor.

We've increased community input through Local Health Integration Networks.

But, as always … there is much more work to be done.

Indeed, I've spent the past few months planning and strategizing for 2009 – which I expect will be a very busy year in health care.

We must continue to focus on realizing our vision…

…Of a modern, accessible and sustainable health care system that delivers the highest quality care available in the world.

That is no easy feat.

But we owe it to ourselves and future generations to do no less.

When I assumed this responsibility as Health Minister, I sought the advice of a former Ontario Health Minister, who shall remain anonymous.

“Son”…she said.

There are literally thousands of urgent issues to be addressed in health care.

But if you try to fix them all, you'll accomplish very little.

Be strategic.

Don't get overwhelmed by daily crises.

Rather, choose a number of key priorities that matter to you…

…priorities that will have long-term impacts…and that will benefit the greatest number of people.

My focus will be on three important areas.

First, chronic disease management…starting with diabetes.

Earlier this summer, we launched a comprehensive diabetes strategy to help the almost 1 million Ontarians living with the disease.

The $741 million investment will sustain a four-year strategy to prevent, manage and treat diabetes.

We're starting with increasing access to insulin pumps and will be launching a diabetes registry in the spring.

Better management of chronic diseases will help ease ER wait times by diverting patients into more appropriate settings.

Second, e-Health.

By 2015, every Ontarian will have an electronic health .

Frankly, we haven't moved nearly as quickly as I'd like on this.
 
We need to redouble our efforts to make up for lost time.

I'm confident that under the leadership of Dr. Alan Hudson, Chair of e-Health Ontario…

…and Sarah Kramer, President and CEO…both here today…we will modernize this critical aspect of the system.

But leadership won't be enough.

We need partnerships....With health stakeholders…With technology providers….

…I see today's sponsors Francois Cote, President of Emergis, and his colleague Dave Cunningham agreeing…

…all working together.

e-Health involves enormous costs…but will produce equally large savings…and most importantly, it will lead to innovations in quality.

It has the potential to transform the system and support many other health-related strategies…

…like our diabetes registry….new models of care…an enhanced ability to track patients…and monitor incidences of diseases and illnesses…

…which will all help to ease the ER crunch.

And, third, mental health and addiction.

It directly affects one in four of us.

And, it's an issue that touches all of us.

The mentally ill represent among the most vulnerable in our society.

The way we deal with the issue is in many ways a measure of us as a compassionate society.

And, this too will help divert patients from the ER to alternative settings for care and treatment.

By focusing on these three key areas, we will be addressing the most pressing challenge we face in ER.

By giving patients the option to access the health care system through more appropriate entry points…

…and, by giving Ontarians the opportunity to avoid entering the health care system altogether…

We will solve the ER challenge.

But the problem of ERs cannot be solved by government alone.

Nor by hospitals working in isolation.

It will require all of our efforts - through coalitions…partnerships…and teamwork.

If I've learned anything in my previous role as Infrastructure Minister, it is the value of teamwork.

Building infrastructure requires the coordinated and concerted efforts of bankers, architects, engineers and a whole host of professional trades…

…all working towards a single goal.

Likewise, solving the ER conundrum will require a combination of leadership and partnership.

Just ask Tom Closson, President and CEO of the Ontario Hospital Association…who is with us today…what partnerships can accomplish.

The OHA has been a strong partner of the Ontario Government.

And, that's one of the reasons we've got so many major hospital projects underway and so many in the procurement pipeline…more than 100 in all.

Or, ask Linda Haslam-Stroud, President of the Ontario Nurses Association, who also came to participate in today's discussion.

She and her members have been absolutely critical in transforming health care.

Thousands of new nurses and thousands more to come…helping us to take on some of the toughest challenge the system faces, …infection control….wait times….the list is endless.

As the largest group of regulated health care providers, nurses are the frontlines of health care and their partnership is crucial to the future of our public health care system.

Or ask Johnathan Guss, CEO of the Ontario Medical Association…also here today.

Last month, we reached a new agreement with the province's doctors that includes a shared commitment to help the 500,000 Ontarians who don't currently have a family physician find one.

That commitment is the driving force behind a new program I'll be launching in the new year called Health Care Connect.

This unprecedented initiative will connect patients with family health care providers in their community who are taking on new patients.

For the first time in Ontario, people struggling to find a family doctor will have a single place to turn to… and find real solutions.

We'll also be working hard in the new year to ensure people are better informed about ER alternatives such as urgent care centres and walk-in clinics.

The Ministry of Health and Long-Term Care…LHINs….Nurses and doctors…Patients…And, hospital administrators.

All working together towards a common goal.

Applying innovative and creative approaches to problem solving over reflexive demands for more funding.

Examples abound.

Let me share one with you.

The Timmins & District Hospital, like so many other hospitals across the province, was experiencing a severe bed shortage.

50 per cent of its acute care beds were being occupied by patients who didn't actually require acute care.

And, 80 per cent of its emergency stretchers were being used by patients who didn't need emergency treatment.

Working with the Northeast LHIN, the hospital accessed a new strategy called Wrap-Around Funding.

As its name implies, the strategy provides support to help get patients out of hospitals and into more appropriate settings.

Nursing care, social services referrals, housekeeping help, personal support, even equipment like wheelchairs and special mattresses are funded.

Within two weeks, the hospital began discharging patients.

And within months, the hospital was able to eliminate wait times for ER beds.

The total amount of funding?

$233,000.

But the impact of that relatively small amount produced exceptional value-for-money…

…for the hospital…and most importantly for patients.

The program has been so successful that the LHIN is recommending the program to hospitals in Sudbury, North Bay and Sault Ste. Marie.

There are lessons in leadership and partnership to be learned from Timmins & District Hospital.

And, lessons in innovative thinking and problem solving.

These approaches are all the more critical as we face tough economic times.

As you heard in last month's Fall Economic Statement, we are entering a belt-tightening period.

When we formed government we inherited a hidden $5.5 billion deficit.

Through hard work, we eliminated it.

So you can imagine how difficult a decision it was for our finance minister, and our government as a whole, to post a $500 million budget deficit this year.

It was a tough decision, but the right decision…

…in order to protect health care and education…two priorities that Ontarians hold dear.

Belt tightening is what Ontario families do when faced with tough financial times. And, it's what we'll do in health.

We will spread out the hiring of 9,000 new nurses over a longer period of time than we'd originally anticipated…

…And we will be slowing the addition of some family health teams.

But let me be clear.

We are moving forward…just not as fast as we'd like to.

We are spending 46 cents of every program dollar spent in Ontario on health…the highest level ever.

We are still hiring thousands of nurses.

We are still adding family health teams.

And, we are still renewing hospital infrastructure.

What we will not do is what the previous government did: borrow money to fund tax cuts, and then make drastic cuts to health care and education to balance the books.

Our choices are clear.

Even in these difficult times we will continue to invest in health care and we will do so in a prudent and responsible manner.

More than ever, we need leadership and partnership.

More than ever, we need the federal government to step up.

Ontario families continue to be short-changed by more than $700 million a year in health transfers alone.

Federal Finance Minister Jim Flaherty's recent equalization announcement fell short of the mark.

If we had a willing and engaged partner in Ottawa, we could do a lot more … and we could do it a lot faster.

As it is, we have a federal government that has been missing in action for too long.

The challenges we face in health care in this province…in these economic uncertain times….are too great for any of us to shirk our responsibilities.

Ladies and gentlemen, I'd like to end my remarks today by borrowing from someone whose intelligence and humanity we would all acknowledge.

Albert Einstein….who said: “We can't solve problems by using the same kind of thinking we used when we created them.”

In that vein, the challenges we face today require us to be bold…to be innovative…to come together.

And together we will navigate through the turbulence and emerge with a strengthened health care system.

There is much that could divide us….But there is more that can unite us.

As leaders and as partners…We need to work together.

There is so much to say on this topic, but at this point I'd like to hear from some of you.

I'll be happy to take some questions.

Thank you.