November 9, 2011
Thank you, Tom [Closson], for that very kind introduction.
And thank you for the work you’ve done. You are a tremendous system leader and government partner.
I have been so lucky to have worked with you for the last two years. We all have.
It’s great to be here again this year. For so many reasons.
And what a year it has been! Much has happened in Ontario since the last time I stood at this podium.
Most importantly, my daughter had a baby! Her first child, my fourth grandchild.
He’s perfect. I have photos, if you’re interested.
We’ve also had an election…
Or as I like to think of it, a four-week job performance evaluation. With 13 million people on the evaluation committee.
I spent most of my time knocking on thousands of doors in my riding of London North Centre.
I love knocking on doors. Because people don’t hesitate to tell you what’s on their mind….
…What we need to do better….
…How they’ve been impacted by decisions we, in government, have made.
I listen carefully. Very carefully….
…After all, they’re my boss.
I heard dozens and dozens of stories about health care.
Often people started those stories off with “I know you only hear about the things that go wrong, but let me tell you …”
And then they would tell me about something that went right…
…about the wonderful care they — or someone they loved — received.
…about how a doctor or a nurse went above and beyond the call of duty.
…about how their child was saved by the miracles of modern medicine.
….about how grateful they are to live in Canada, where they got care they couldn’t possibly have paid for.
Often, they would say ‘thank you’ to me.
But I know they weren’t really saying ‘thank you’ to me – they were saying thank you to YOU…
…For going the extra mile, for listening to your patients, for providing excellent care.
And so, to you, from my constituents, and from people right across this great province, I want to say THANK YOU for doing such an extraordinary job for the people we serve.
Now, I don’t want you to get the impression that I heard only positive stories about health care.
Indeed, I heard lots of stories where the patient experience could have been — and should have been — better.
And I wanted to hear those stories, too. Because they reminded me we still have lots to do.
And they made me eager to get back to work.
Because there’s so much more we can do together.
That’s why I was so pleased — and honoured — that Ontarians re-elected our government…
…That they put their trust in us once again…
….and tasked the Ontario Liberal Party with the challenge of making sure our health care system can thrive for generations to come.
I’m so very thankful to Premier McGuinty for the opportunity to continue working with all of you as Ontario’s Health Minister.
Because, although it is a very challenging role, it is also a role that allows me to make a real and lasting difference for the people of Ontario.
Before I go on, I want to tell you a little something about your Premier.
You see, I have a front row seat. I get to watch him in caucus, in cabinet.
I get to see how he makes decisions, what he cares about, what his values are and how his values drive his decision-making.
And he’s tough. Really tough. He demands results.
Which is why he’s someone Ontarians can rely on to make sure they get a fair deal when we negotiate a new 10-year health accord with the federal government.
Put simply, the Premier is there for Ontarians.
I know that’s why, for the third time in a row, Ontarians chose him, and our Liberal team, to keep this province moving forward together.
Yes….we’re back with a minority. But I don’t think that changes our task.
We have a clear mandate. And work to do.
It means we have to collaborate with the other two parties in order to give Ontarians the good government they want.
But that’s exactly what any government should do, regardless of the number of seats it has.
And it’s precisely what we’re going to do.
Because, Ontarians made some things very clear on October 6th.
They made it clear that they want a government that will protect and strengthen their health care system…
…and make the tough decisions that must be made — and put patients first.
And they also made it clear what’s top of mind for them:
It’s jobs. And it’s the economy.
The stories I heard on the campaign trail brought to life the statistics that are regularly reported.
Stories about young university graduates with big student loans who are having trouble finding a job that reflects their skills.…
Stories about people in their 50s, laid off from manufacturing jobs they’d had since they were 17, with few prospects...
The economy is about a whole lot more than numbers, it’s about people’s lives…
…About their hopes and their dreams…their ability to care for their kids.
The economy has been through a few extremely turbulent years, not only here in Ontario, but around the world.
Indeed, Ontario’s problems pale in comparison to challenges faced by other jurisdictions.
But, we’re not out of the woods yet.
The people of this province know that and they want a government that is prepared to lead them through the storm.
They want a government that can make the right choices as we work our way through this economic reality…
….That can find the right balance between being fiscally responsible and providing services people need.
As you may know, the highly respected economist Don Drummond is currently leading a commission that will provide advice to our government on how to do exactly that…
…without — and this is important — without increasing taxes or doing anything that would lead to the privatization of health care or education.
Just last week, we heard that Mr. Drummond is going to recommend that we hold government increases in spending to one per cent a year for each of the years between now and 2017/18.
One percent. That’s our new reality, as a government.
So we need to significantly slow down increases in health care spending.
Notice I didn’t say cut spending.
I said slow down increases in spending.
Some other sectors in government might not be so privileged.
Our government has made the decision to protect healthcare, even in the face of significant fiscal challenges.
Health care spending, overall, will continue to increase….
…Not at previous rates, but spending will increase.
That doesn’t mean that every line of the healthcare budget will increase. They won’t.
We will need to shift spending from one part of the system to another.
Because there are areas where we’re not getting best value.
And other areas where new investments will generate savings elsewhere or improve quality of care.
Now there was a time, not so long ago, where the economy in this province, and around the world, was booming.
It allowed us to invest in health care like never before.
In Ontario we took advantage of that booming economy, and, together with you, we rebuilt a broken system.
We invested in infrastructure to modernize our hospitals…
We trained more doctors and hired more nurses to improve access to care…
We drove down wait times…We’ve gone from the worst wait times in Canada to first in Canada.
We began to measure and improve quality of care.
We created LHINs to bring decision making from Bay Street to Thunder Bay…and to drive integration.
We invested in electronic health...
And we introduced a comprehensive mental health and addictions strategy that was long overdue.
Together with you, we laid a strong foundation for this system.
It took teamwork.
And it took leadership.
And we’ll need even more teamwork and even stronger leadership as we move ahead.
Because, as we go forward in the context of our fiscal reality we have to focus on value.
What is value? Well, to me I think of it simply as quality, divided by cost.
You can increase value in three ways:
You improve quality.
You lower costs.
Or, ideally, you do both.
That’s why the Excellent Care for All Act – or ECFAA — is so important.
It’s about quality, value and evidence.
By increasing the quality of care people receive, we can also save money and have a stronger, viable system for tomorrow.
I know you’re all working hard on this now, implementing quality improvements, tracking, measuring.
But you know — like I know — that quality includes putting the patient at the centre of the system, and delivering the kind of care that patients expect.
Let me give you an example of this:
Staff at one hospital in Ontario changed the way they were dealing with patient complaints.
They became more proactive, reached out, talked to patients about the hospital experience, involved them in improving care.
In doing so, the hospital increased the quality of care for patients, but they also saved money.
Because the number of patients who pursued legal action against the hospital dropped. And, as a result, the hospital’s insurance rates came down.
That’s improving value: Better care. Lower cost.
Our focus on quality and value is one of the reasons that I’m such a big proponent of home and community care.
I think most people in this room would agree, given the choice, that home is where they want to be.
Home care is more comfortable. More dignified. More convenient.
And less expensive. Way less expensive.
We could borrow a page from Denmark…where, as a matter of public policy, community care takes precedence over residential care and long-term care.
Denmark has adapted a variety of care settings to suit older people, and funded home care services that allow people to stay out of institutions.
And it works. Denmark hasn’t built a new nursing home since 1987.
We’re on the right track here in Ontario.
Through our own initiatives, we’re driving value, evidence and quality in new, innovative ways.
Take a look at the University of Ottawa Heart Institute’s Telehealth program:
Recently-discharged patients are taught to measure and report their own vital signs daily…
…And to submit that data via telephone to the health care team at the Institute.
The program has cut hospital readmission rates for heart failure patients in half….
….Which is good news for patients, but also good news for the health care system.
Because for every patient safely diverted from a hospital readmission, we save up to 20 thousand dollars.
In Ontario, we need to do more things like this….
…that is, things that work. And we need to do less of the things that don’t.
It’s that simple.
Keeping people at home works. We know that.
That’s why so much of our election platform was designed to help Ontarians, particularly elderly Ontarians, get care in their homes….
…To help keep them out of the emergency departments, hospitals, and long-term care homes.
Take the Healthy Home Renovation Tax Credit, for example.
It’ll help seniors make changes – like installing ramps or walk-in showers – to help make their homes healthy and liveable.
It’s a $1,500 tax credit that helps them continue to be an active member of their community.
And we’re going to make sure they have access to more home care too – we committed to adding 3 million more hours of PSW care.
We’re also bringing back house calls, so Ontarians in need can count on home visits from their family doctors, nurses and other professionals.
The program will offer services ranging from phone or online consultations to actual home visits…
….whatever is required to ensure that patients are receiving the care they need in their homes.
I recently went on a house call with Dr. Mark Nowaczynski here in Toronto.
We visited a woman named Barbara Burns. She’s 83 and has some trouble getting around.
Without Dr. Mark’s house calls, she would likely have to live in a long-term care home.
But she told me that long-term care isn’t where she wants to be.
She’s happier at home with her family.
Dr. Mark has been looking after her for three years now…
…at a fraction of what it would cost if Barbara had to spend her days in a long-term care home.
The simple fact is, if we are going to walk the twin paths of improving health care and safeguarding the province’s economy…
…then our focus in the months and years ahead is going to have to be on improving home and community care.
This isn’t a brand new idea – we’ve been focussing on Aging at Home for several years now.
It’s working. As a result of our investments, here in Toronto, it means 235 fewer seniors are putting their names on the wait list for long-term care.
We know what we need to do: Better value. Smarter spending. Better care.
It also means we need a renewed focus on prevention and health promotion.
Because people don’t want health care. They want health.
That’s why I’m so excited that Health Promotion is now part of my portfolio.
Because we’ve known for a long time that the best way to keep people healthy is to help them avoid getting sick in the first place.
We want Ontario to be the healthiest place to grow up and grow old.
That’s why, as promised in our platform, we will create a council on childhood obesity…
…with the goal of reducing the childhood obesity rate in this province by 20 percent over the next five years.
If we can do that, the health care system will realize significant savings further down the road.
Same story with tobacco.
We have to continue the war on tobacco so Ontarians can live healthier lives.
As the OMA will tell you, tobacco-related disease costs Ontario’s health care system about 1.6 billion dollars every year.
We also have to empower people to eat healthy and stay active so we can reduce diabetes and heart disease.
All of these things will help keep Ontarians healthy and help us avoid unnecessary health care costs down the line.
All of this comes down to how we think about health care…
….how we deliver health care….
And how we spend on health care.
We need to shift spending.
We need to shift spending from the things that aren’t working to the things we know will deliver patients results.
We as a government can’t do it alone. I know this.
But we, as a health sector…
…as a bunch of likeminded people who are determined to deliver results for Ontarians…
….and who are committed to building the world’s best health care system for our kids and our grandkids….
….Well, ladies and gentlemen, we can.
Never has there been a time when so many leaders in this system were willing to put aside their self-interests for the betterment of patients.
Look at the number of voluntary hospital integrations we’re seeing…
…look at the OHA who, right before the election, didn’t advocate for more hospital funding…but for more funding for the home care sector.
You want to work together.
You want to make improvements.
You’re prepared to deal with challenging economic times because you’re prepared to innovate.
It’s when times get tough that innovation triumphs.
They say necessity is the mother of invention.
It’s my job as health minister to empower you to look for — and act on — those opportunities to invent…
….to encourage you to look outside your organization’s walls to see how you can increase quality and find the best, most efficient way to deliver care…
…To improve value.
When times are tough, governments – and political parties – have a choice: they can foster innovation, or they can cut services.
We’re firmly on the side of innovation and I know that I have leaders all across this health care sector standing alongside me…
…who can see opportunities to improve patient care and drive down costs everywhere they look.
You’re prepared to put in the hard work. And I want you to know that I am too.
In fact, I’m excited about it…
This is our time to make an impact.
Our time to prove to Ontarians that we have what it takes to deliver the best health care…
…and to keep our system strong for generations to come.
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