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Speeches

Ontario Hospital Association Health Achieve Conference

Remarks By The Honourable Deb Matthews Minister of Health and Long-Term Care and Tom Closson, President & CEO of the Ontario Hospital Association

November 18, 2009

Thanks very much for that kind introduction, Kevin. It is such a pleasure to be here.

As you probably know, I am something of a newcomer to the Health and Long-Term Care portfolio. It’s an enormous honour, and one I embrace with enthusiasm and with enormous respect for the responsibility invested in me.

I come to the job at an interesting time – global pandemic – challenges at eHealth – global recession.  Other than that, it’s been pretty quiet.

I’ve had to come up to speed pretty quickly on some issues – I can tell you that, six weeks ago, I had absolutely no idea how to say “unadjuvanted”, let alone know what it meant!

But for the most part, I am spending my time learning as much as I can, as quickly as I can.  I’m asking questions, getting some answers, asking more questions.  Listening.  Learning.

I have been aided in my work my many, many people.  Both within the ministry and outside the ministry. 

There is one person to whom I owe special thanks, and that is my Deputy Minister, Ron Sapsford. 

A new minister could not ask for a finer Deputy, and I will be eternally grateful to him for his professionalism and his generosity of spirit through what has been a very trying chapter.

Thank you, Ron, not just for what you have done for me personally, but for all you have done over your many years of service to make Ontario’s health care system stronger.

I’m getting to know the extraordinarily gifted people who make our system work.

People like you.

I have to say — I am tremendously grateful for your support, your encouragement and for all your good wishes. And your advice. 

One thing I’ve learned is that everyone involved in health care has one thing in common: you are all incredibly passionate about health care.

You’re motivated to always, always look for ways to do things better.

After all, that’s what HealthAchieve is all about — coming together to talk about how we can improve health care.

We’re here today to talk about how to get health care right.

For patients.

Not for me.  Not for my government.

Not for you. Not for hospitals or doctors or nurses. Or pharmacists or drug companies.

For patients. Period.

And that includes their families, their loved ones.

The other people in their lives who are part of the circle of care around them.

Doing better for our patients is really the only thing that matters. 

It’s about making sure that someone like Rick — from Lindsay — gets the life-saving quadruple by-pass surgery he needs within days of being diagnosed.

It’s about helping three-month-old Sophia find a family doctor in Ottawa so she can get a healthy start to life.

And it’s about giving Gordon — from Huntsville — the supports he needs to live independently at home and avoid visits to hospital.

I could keep going…

Because there are 13 million people just like Rick and Sophia and Gordon in this province.

And we need to be there for them.

We need to get it right. For them.

And we’re going to have to work together to do it.
Over the past six years, health care spending in Ontario has increased by 45 percent.

We’re seeing great results from this investment.

Take wait times.

The collaboration between our government and this province’s hospitals on wait times is one of our great successes.

I could list off the numbers….

…we’ve reduced wait times for cataract surgery by more than 200 days

…knee surgery by more than 190 days.

…the list goes on.

These are very impressive results.  But, more impressive than these statistics is what they mean for individual Ontarians.

Shortly after I was elected in 2003, before we started our wait time strategy, an elderly couple came to my constituency office.

The wife desperately needed a new hip. She was in tremendous pain. 

She was taking pain medication but that was causing her stomach problems so she couldn’t eat. She was on medication for that, too.

The stress of caring for his beloved wife was taking a real toll on her husband’s health.

So when I think of our wait time successes, I think of that couple. 

That if she’d needed her surgery today, she would have had it nearly a year earlier than she did in 2003.

…I think about the extra time that she and her husband could have spent enjoying life together…seeing their grandkids…working in their garden.

Those are tangible results. Those are meaningful results.

When we first announced our wait time strategy, there were those who feared that there would be adverse impacts on other surgeries…

…They thought that, because hospitals would be so focused on reducing wait times in the 5 key areas we identified — like hip surgery—  that wait times for other surgeries would go up. 

But that hasn’t happened. 

In fact, our hospitals have done a terrific job managing their wait lists. 

Our substantial investments have paid off — across the board — and we’re now meeting all our surgical targets. 

I’m pleased to tell you that, moving forward, we’re going to share these results with the public.

Starting in the new year, we’ll be expanding the public reporting of wait times even further, to cover all surgeries in Ontario.

It’s just another way we’re being transparent and accountable.

And it’s another way we’re going to help hospitals improve quality, because we govern based on the principle that “if you track it, you can improve it.”

I want to thank each of you here for doing your part to make the wait time strategy such a huge success.

 We couldn’t have done it without your commitment to excellence and innovation.

When the great minds in Ontario hospitals start focusing on improving quality for patients, it is amazing what you can accomplish…

…What you have accomplished.

It is also amazing what you have accomplished reducing ER wait times – what we have accomplished working together.

Working together, we are tackling the ALC problem.

With programs like Aging at Home we are freeing up hospital beds to let you do what you do best for the patients who need it most.

With programs like Pay for Results we are, in a very targeted way, helping specific hospitals improve their ER performance.

We’re also reducing the number of people coming to ERs in the first place.

We’ve done this by improving access to care right across the province.

800,000 Ontarians — who didn’t have a family health care provider in 2003 – have one today.

My commitment, my challenge, is to grow that number by another 200,000 over the next two years.
 
More health care providers, delivering better front-line primary care, is a critical component of any Emergency Room strategy.

It means Ontarians are better able to manage chronic diseases like diabetes, which means we see fewer people with diabetes in our ERs.

It means Ontarians with mental health challenges get the care they need without having to visit an emergency room.


All of this cuts down on emergency room traffic in our hospitals.

We have a long way to go, of course, but in the past year alone we have reduced ER wait times by nearly an hour overall.

Our job is to build on this success.

When the Premier appointed me Health Minister, he told me that my job was to forge ahead with the government’s two biggest health care priorities:

And he also asked me to do two other things.

The first: get eHealth back on track.  It’s simply too important to let up on.

The second: restore Ontarians’ trust …show them that we’re building a health care system for the future and that we’re spending their tax dollars wisely.

The people of Ontario expect both a strong health care system, and fiscal responsibility. And it’s our job to provide both.

Especially now, when there is a sense out there that health care dollars – tax dollars – haven’t always been used as well as they should.

One part of restoring that trust is being transparent about how we’re spending and what we’re doing. It’s about showing Ontarians what we’re achieving and being honest about our shortcomings.

I’d been on the job three weeks when Tom Closson wrote me suggesting that Freedom of Information laws be extended to cover hospitals.

He pointed out that recent events should be viewed as a wake-up call for leaders of all public-sector organizations, and hospitals should not be exempt from that.

He showed himself, the OHA and this province’s hospitals, to be transparent and accountable to taxpayers and to patients, and I salute you for that.

With that kind of leadership, we’ll be able to restore the trust and regain the confidence of Ontarians. 

You know, one of the best parts of being an elected person is that, every four years, you get to spend a couple of months going door-to-door, talking to whoever answers the door about whatever is on their mind. 

There’s simply no better education than that. 

Back in the 2003 election I was canvassing in my riding in London.  I was in a modest neighbourhood in northeast London, and knocked on the door of a modest home.

An elderly gentleman answered the door… he was tired and not particularly happy to see me.

He told me that he was a retired school custodian.

He looked at me and said: “Deb, I’m going to vote for you.  I don’t want to hear your promises. And I’m going to ask of you only one thing…

…Every time you spend money, I want you to remember where it comes from, who it comes from.

I want you to remember that it comes from people like me and my wife,

… we worked hard all our lives

…we struggle to make ends meet every month.

… and if you don’t think it would be okay with me to spend that money, don’t spend it”

That stuck with me. I carry that gentleman on my shoulder every day. 

And, when I hear the word “accountability,” I think of him. Because — ultimately — I’m accountable to him.

We all are.
So, my responsibilities to continue to build on the progress we’ve made on wait times and access to family health care, get eHealth back on track and restore confidence in our ability to manage are all on my – on our – to-do list…

…but I wouldn’t be doing my job if I wasn’t looking a little further ahead, and addressing the threats to the sustainability of our precious health care system.
 
I see that we have two different, but related challenges when it comes to the sustainability of our health care system in Ontario.

 And it’s time to turn our attention to how we – working together - are going to meet those challenges. 

 

Because, while building a strong health care system for today is critically important, putting in place the foundation that will keep it strong for our kids and grandkids is every bit as important.

You see, I am a demographer.  And, as David Foot once said, “Demography explains two-thirds of everything.”  And, I think, demography explains 9/10ths of health care.

I understand as well as anyone that we have a demographic tsunami headed our way.  And I define our job not just to deliver the best possible health care today, but it’s also our job to prepare for that tsunami that’s coming as surely as winter follows fall. 

If we can’t get the health care system right today, I shudder to think about trying to get it right 20 years from now. If we’re struggling to find the right supports for our frail seniors today, just think about what we’ll be dealing with in 20 years.
So building a sustainable health care system – one that will take us through the decades to come – is a high priority for me.

The second big challenge we have when it comes to the sustainability of the system is our ability to pay for it. 

The growth we’ve seen in health care spending in past years is simply not sustainable.  We are going to have to work very, very hard to bring spending on health care in line with our ability to pay for it.

But that doesn’t mean sacrificing quality.  Not by a long shot.  It just means we’re going to have to get smarter about how we spend.  Spend on the right things. At the right time.

 

That’s why our investments in the Diabetes Strategy, in bariatric surgery, are so very smart – not just because they pay tremendous returns in quality of life for people, but because, in the long run, they’ll save us money.  Which will allow us to invest in even better health care.

As you may know, in my previous portfolio, I was the lead on Ontario’s Poverty Reduction Strategy. 

I can tell you that I’m pretty proud of the work that was done on that project. 

And I can also tell you that one of the many things I learned as I worked through the development of the strategy was the inextricable link between poverty and health. 

That we simply aren’t paying enough attention to the social determinants of health. 

And because of that, we’re paying more than we need to for health care.  Not to mention the social costs and costs to other publicly-funded systems, such as social assistance and justice.

And that’s why I am committed to carrying on the work that my predecessor, David Caplan, began on mental health and addictions.

There are so many people, with so many good ideas about the ways we can improve our system…

…and there are so many ways we can make improvements.

We can do more with what we have. We just have to rise to the challenge.

So we will, together.
I salute hospitals for the great work they have done balancing their budgets under often difficult conditions…

…and the ongoing work that they are doing with the LHINs…hammering out Hospital Service Accountability Agreements. 

I also salute the individual hospitals around the province that are making dramatic quality improvements…

…not through increased funding but through better practices.

Hospitals like North York General, where improvements to the process of transferring patients to long-term care dramatically improved the ALC numbers there.

As the Ontario Health Quality Council pointed out in its report, as a result of those improvements…

…ALC days at North York dropped from 39 to 27 between August 2007 and October 2008.

That’s progress. That’s innovation.

 

This year’s OHQC report outlines several cases like these, citing them as reasons for optimism, but of course sounding the warning that we still have a long way to go.

And we do.

I’m determined to help us get there. I want to work with our partners in health care to continue improving our system...

... and to do it in the face of a difficult economy.

And so, while I am urging you today to hear and understand the message that we have to find ways of decoupling quality improvement from increased funding…

…nobody should be under any illusion that this government is suddenly abandoning its investments in health care, and in this province’s hospitals.

Far from it.  We know that our health care system is the one thing that Ontarians identify as the most important job that we, as a government, have. 

We hear that message loud and clear.

And we will continue to respond to it. 


Because our job, as the elected people in this province, is to bring to reality the priorities of the people who put us in office.  We will never lose sight of who put us here and why.

I want you to know that I am excited about this job.

And in large measure, I am excited because of the fact that I get to face the challenges ahead in partnership with Ontario hospitals and all the others who are so committed to health care in this province.

I look at the job you are doing helping us manage the H1N1 situation, and I am enormously impressed and grateful on a personal AND professional level.

I need you to keep up that great work.

Ontarians expect, and more importantly they deserve, a great health care system – one that is focused on, and built around, the needs of patients.

I know that everybody here has the same goal. We all want to give Ontarians accessible, high-quality, sustainable health care.

We’re going to do it by working together and by continuing to innovate.

Innovation: it’s something you’re all doing every day…

…something some of you are doing exceptionally well.

…And something that I’m tremendously proud to honour today.

I’m lucky enough to be here as the last speaker at HealthAchieve, and the first speaker at the Innovations in Health Care Expo…

I’m thrilled about it, because the Expo really exemplifies a lot of what I’ve been talking about in my remarks.

[pause to allow new background to appear]

So…with a little change of scenery, and a slight shift in focus… I’m so very pleased to welcome you all to the Expo.

It brings together more than 200 exhibitors from across the province to promote creative ideas, share knowledge and generate new approaches to improving health care for Ontarians.

To kick things off, we’re going to honour the best of the best by presenting achievement awards in six categories.

And in the spirit of partnership, I’m going to ask Tom Closson to join me on stage to help me announce the winners…



Thank you, Minister Matthews.

As you likely gathered from Kevin’s opening remarks earlier this morning, the Ontario Hospital Association is a strong supporter of innovation in health care.

That is why we were so happy to partner with you on your Expo and why I am so happy to stand here today and help you celebrate some of the exciting things happening in health care organization across the province.


Let’s begin. In the category: Meeting Community Need through Integrated Care, the finalists were:

St. Michael's Hospital   
My Baby and Me: Infant Passport for Young Pregnant Homeless Women
Toronto Central LHIN

Young Carers Initiative
Powerhouse Project
Hamilton Niagara Haldimand Brant LHIN

Carefirst Seniors, Community Services Association and Scarborough Regional Dialysis Program
Scarborough Kidney Health Initiative (SKHI)
Central East LHIN

For a program that fosters healthy pregnancies by providing pre- and post-natal care to women of no fixed address, the winner isSt. Michael’s Hospital - Congratulations

In the category Improving Quality and Patient Safety, the finalists were:

Espanola Regional Hospital and Health Centre
Natural Bowel Care Program
North East LHIN

Registered Nurses’ Association of Ontario (RNAO)
Strategies to Support Long-Term Care Staff in the Uptake of Best Practices
Provincial/cross-LHIN

Ontario Community Support Association (OCSA)
Effective Front-Line Dementia Education to Improve Safety and Quality of Care
Provincial/cross-LHIN

For an innovative program where expert nurses help long-term care home staff increase the quality of care, the winner is: The RNAO - Congratulations

In the category Improving Efficiency through Process Redesign, the finalists were:

The Hospital for Sick Children
Leveraging Leadership to Execute and Sustain Notable Access to Care
Toronto Central LHIN

Hamilton Health Sciences
DefinePDSA: Incorporating Selected Improvement Tools in Outpatient Clinics
Hamilton Niagara Haldimand Brant LHIN

St. Michael’s Hospital 
Getting Results through Collaboration in Action
Toronto Central LHIN

For creating Action Groups to develop simple, patient-focused solutions that lead to more holistic patient care, the winner is: St. Michael’s Hospital – Congratulations

Under the topic Innovations in Health Promotion, the finalists were:

Northern Diabetes Health Network (NDHN)
Northern Ontario Aboriginal Diabetes Initiative (NOADI)
Provincial/cross-LHIN

VON Canada
Caregiver-Connect.ca: An Innovative Approach to Service for Family Caregivers
Provincial/cross-LHIN

St. Paul's L'Amoreaux Centre
Seniors and Law Enforcement Together (S.A.L.T.)
Central East LHIN

For a program that provides exceptional supports to family caregivers, the winner is:  VON Canada – Congratulations

Under the category Innovations in Health Information Management, the finalists were:

Fig.P Software Incorporated and McMaster University

Registries-Based CDMS for Systematic and Equitable Patient Care Improvement
Hamilton Niagara Haldimand Brant LHIN

Sunnybrook Health Sciences Centre
eSheet - Just What The Doctor Ordered!
Toronto Central LHIN

Mount Sinai Hospital
Innovation in Real-Time Reporting of Utilization and Performance in the Emergency Department
Toronto Central LHIN

For an innovative program that provides complete, accurate and timely emergency room data, the winner is: Mount Sinai Hospital – Congratulations

And finally, in the category of Innovations in Health Human Resources, the finalists were:

St. Michael's Hospital 
Evolution in Practice, Roles and Responsibilities of ACPAC Program
Toronto Central LHIN

Rouge Valley Health System
Neonatal and Paediatric Orientation Program Designed for the New Graduate
Central East LHIN

County of Elgin - Terrace Lodge  
Terrace Lodge Coaches - Mentor Team Program
South West LHIN

For their neonatal and paediatric orientation program for new graduate nurses the winner is:  Rouge Valley – Congratulations

My warm congratulations go to all the entrants, the finalists and the winners.

I’m inspired by your enthusiasm, dedication and professionalism.

Please take the time to look at all the exhibits and please, don’t forget to cast your ballot for the People’s Choice Award which will be announced at the end of the day.

In closing, I want to thank everyone here today for your hard work, your dedication, and for your passion for health care,

Together, we’re going to keep putting patients first.

And, together, we’re going to get health care right for Ontarians.

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