Thank you Joe [D'Cruz] for that very kind introduction.

Thank you also to Roger [Martin] and John [Crispo], and the entire Rotman School of Management for hosting this event. It's a real pleasure to be here.

So this is World Health Day. Since 1950, World Health Day has been marked every April 7th.

The point is to focus the attention of people everywhere on the importance of achieving the principal objective of the World Health Organization which is, and I quote :

As it turns out, that's my job description too!

Imagine having your performance bonus tied to those expectations!

So on this World Health Day, and with those expectations clearly in mind, I'd like to tell you a little about my job - about this task that we have undertaken.

Because the attainment by all people in Ontario of the highest possible level of health is exactly what we are about.

It's what we told people we were about, it's what they expect from us, and I plan to be part of a government that is returned to office precisely because we made demonstrable progress towards fulfilling those expectations.

Because as good a system of public health as we have, and we have a very good one indeed, it is far from perfect. There are problems — I call them Medicare's frailties — that have built up over the years, and we must solve them.

That is our mission. Simple as that. And it's the motivation behind our government's plan for health care.

Before I go any further, I must add that as an enthusiastic practitioner of practical politics, I am to say the least intrigued by the approach of our chief opponent, who is on the record promising to cut health care by $2.4 billion.

Mr. Tory fails both the health care test and the fiscal policy test with that one.

Our publicly-funded health care system represents an enormous competitive advantage that unlike Mr. Tory, we intend to build upon.

Because US employers have to cover as much as two thirds of their workers' health insurance costs, they are on the hook for thousands of dollars per employee.

As a result of that increased cost of doing business — just as an example — it costs significantly less to build a car in Ontario than it does south of the border…because of our Medicare advantage.

It is narrow-minded to simply view health care as a cost. It's actually an investment…one that pays enormous dividends in jobs, innovation, competitiveness and of course - because we must never forget this - in the health of our friends, families and communities.

Now it could be that Mr. Tory is simply intent on scoring political points. Because that $2.4 billion, of course, is the amount we are bringing in through the Health Premium we introduced in last year's budget.

Well those might be easy points to score now, but they ignore some pretty basic realities.

So let me start by outlining a few of those. Let me paint a picture of the system we were elected to fix, and the steps we've already taken to rebuild it.

Much of this will be familiar, perhaps even nauseatingly so. It's a song that's been sung by me and others many times before, but it sets a necessary context for what we are trying to do in health care.

Unfortunately there are still some people who think that money is the only answer to all things health care.

So here's a number: 32 Billion. Dollars. That's the health care budget for the province of Ontario. Just 14 years ago, it was half that.

Over the past five years, our health care spending has grown at an average annual rate of 8 percent — twice the rate of our spending on everything else.

For the next couple of years, this province's growth rate is only projected to average 3.2 percent a year! Does anyone seriously believe we can responsibly sustain 8 percent growth in health care spending?

It's very simple, and terribly clear. Health care as we inherited it was not sustainable.

That's the cost curve we inherited, combined — please remember — with the $5.6 billion dollar deficit we also inherited.

In that context, the decision to introduce the health premium, while extremely difficult, was also absolutely the right thing to do.

It allowed us - despite the deficit — to begin our journey towards restoring confidence in our health care system.

And in that context, Mr. Tory's promise to scrap the premium is absolutely the wrong thing to do.

In that promise one can see a direct path back to the Harris-Tory legacy of reckless cuts that set our health care system, along with many other social programs, so far back on their heels.

The premium is allowing us to invest in the changes we need to make to bring spending under control in the long run, while ensuring we have the resources for core health care services now.

One of the changes we need to make is to bring our hospital budgets into balance. Things are proceeding well on that front. More than half our hospitals have already submitted plans to balance their books, and we will work with the remainder to ensure they find the savings they need within the next year.

That's a good start, but there is still much to do in terms of making this sprawling health care system of ours more efficient and sustainable. I'll have more to say on that in a moment.

Moving on…one million. That's the number, give or take, of Ontarians who don't have access to that most intrinsic element of health care - a family doctor.

A million people who aren't getting the health care they need - the health care that should be theirs by basic right of citizenship in this province.

That is selective public health care at best, and it's just not good enough.

Finally…wait times. We've all heard about them. Many of us have experienced them, and all of us know someone who has.

Just yesterday, the highly-regarded Institute For Clinical Evaluative Sciences, or ICES, released a Wait Times Atlas for the province of Ontario, outlining as well as could be done the state of wait times in this province, before we came to office and embarked on our Wait Times Strategy.

That Atlas gives us a starting point — a rough picture of the situation facing Ontarians who were waiting for important health services in fiscal year 2003-2004.

In some cases it's not a pretty picture. People are waiting too long for too many services, too often.

Well it's our job to improve that picture, and the Atlas gives us a baseline against which we will be measured.

Because I have said many times that the best health care services in the world are pretty cold comfort if you don't get them in time.

That, ladies and gentlemen, is just a snapshot of the system we inherited, or to be fair, of some of the biggest problems we inherited.

I really have no intention of standing here and doing a Chicken Little routine. The sky is not falling. I'd rather get sick in Ontario than anywhere else.

But I'm not going to be a Pollyanna either. Were we as a government to just stand by and ignore the problems in health care, were we to embrace the status quo, there would come a time - and soon - when Ontario would no longer be a good place to get sick.

That's not happening on our watch.

Nearly a year ago, my colleague Greg Sorbara, the Finance Minister, released our government's first budget. It was a four-year plan for change, and in concluding his speech he said, quote :

”Four years from now, the people of Ontario will be able to judge our plan by the results it has achieved.”

Within the next few weeks, Minister Sorbara is going to release his second budget, outlining how we've done so far and detailing the next steps in our plan for change.

Let me do a little bit of that with respect to health care.

In very broad terms, out plan for health care can be seen to operate on three fronts — laying out three key measurables :

• Healthier Ontarians.
• Better access to doctors
• Shorter wait times

So let me start with healthier Ontarians.

At the risk of stating the obvious, it'd be a lot easier to run a health care system if nobody got sick.

Now I realize that's not likely to happen on our watch, but we are determined that fewer Ontarians are going to get sick.

It is time to seriously revisit the notion that an ounce of prevention is worth a pound of cure.

That's why we have completely renewed this province's commitment to Public Health, investing an additional $190 million in 04/05 and easing the burden on municipalities by uploading the province's share of public health funding from 50 to 75 percent by 2007.

We launched Operation Health Protection, a three year action plan that contains the most comprehensive changes to public health since the 1980s.

We passed legislation to make the Chief Medical Officer of Health more powerful and independent of government.

We created a new Ontario Health Protection and Promotion Agency and a Provincial Infectious Disease Advisory Committee.

We are vaccinating more than two million children, free of charge, against pneumonia, chicken pox and meningitis.

And to top it off, we have also devised an anti-tobacco strategy of which I am extremely proud. Our Smoke Free Ontario Act is presently making its way through the legislature.

Combined with prevention campaigns like stupid.ca, our youth tobacco initiative, and a strong cessation strategy, we will have the toughest and most comprehensive anti-smoking plan in North America.

We have also made an absolute priority of delivering more care to people at the community level.

It is now established health care wisdom that the reform of primary care is the key to improving, and sustaining, health care. Successive experts have talked about it. Successive governments have, in varying degrees, tried to accomplish it.

A lot of successive…not enough success.

We are putting Ontario on a path to success.

If you dig down to the very core of our plan, you will come to the idea that we must drive care into the community, because that is where the best care is delivered — as close to home as possible.

That is where you find the kind of health promotion and disease prevention initiatives that are so critical to good health care.

And that is how you take the pressure off our hospitals, freeing them up to deliver the kind of acute care they were designed to deliver.

The fact is that an estimated 700,000 or more of the Emergency Room visits made by Ontarians every year do not warrant ER care, but patients lack any other appropriate choice.

We're changing that. In our relatively short time in government, we have made unprecedented investments in community care - more than $600 million this past fiscal year for everything from home care to community mental health, Long-Term Care, community support services and expanding Community Health Centres and access to midwives.

As these investments take root, two things will happen :

Hospitals will feel the difference in terms of reduced patient and financial stresses, meaning they will be able to provide their patients with better acute care.

And Ontarians will benefit from having the option of quality health care delivered where they need it most – closer to home.

Now speaking of care closer to home, let's talk about better access to doctors.

I mentioned at the outset the million Ontarians without a family doctor. We have worked very hard since the day we came to power to begin bringing that number down, with an eye — eventually — to eliminating it altogether.

I don't know when that will be, and I don't expect to be Health Minister when it happens, but I know on the day it does my successor will be smiling. And the roots of that success will be found in the plan I'm talking about today.

Consider this :

We have increased training spots for International Medical Graduates from 90 to 200.

To be blunt, that's a lot of taxi drivers and pizza deliverers who will get a crack at the basic training they need to upgrade their skills so they can practice medicine.

On top of that, we have established a new Registration Through Practice Assessments program with the College of Physicians and Surgeons to very quickly assess and register physicians practicing outside Ontario who would like to work here.

We are increasing the number of residency positions in our medical schools by 21.5 percent by 2006-2007, and increasing family residency positions by a whopping 70 percent.

As a result of that, there will be 337 more family doctors ready to practice in this province by 2008, providing care to 400,000 more Ontarians.

You may also have heard something recently about a deal we reached with the Ontario Medical Association.

This is something of which I am very proud. It is an extremely good deal, both for patients and for doctors.

It will reward docs for practicing medicine in new and better ways, including spending more time working with seniors and managing chronic disease - helping people stay healthy.

It will also reward them for working in more efficient, comprehensive health teams — something I'll have more to say about shortly — and it will offer specific incentives to doctors who practice in northern and rural communities.

Overall, it will bring more doctors to Ontario because it will make Ontario a better, more rewarding place to practice medicine.

We are also making Ontario a better, more rewarding place to work for nurses.

The previous government occasionally treated nurses with outright contempt.

We all know about the comparison to hula hoop workers.

That seems to me to be a short-sighted way to treat an absolutely critical component of a health care system.

We are bringing more nurses to Ontario, and giving them the best kind of full time jobs. We have already funded more than 3,000 full-time nursing jobs in our hospitals, long-term care homes and community agencies.

We have also made significant investments in education, mentoring programs, bedlifts and other safety equipment designed to make the job of nursing a safer and more rewarding one.

Nurses are the heart and soul of the system, and they deserve to be treated that way.

Now…wait times.

If there is a yardstick by which people more frequently measure their health care system, I don't know about it.

Last year we unveiled our Wait Times Strategy, which we kick-started with an investment of $107 million dollars.

It focuses on five key areas: Cancer care, cardiac surgeries, cataract procedures, MRI/CT scans and hip and knee joint replacements. These are our first priority, but let me assure you they will not be our only priority.

Between December 2004 and the end of March, we delivered :

• an extra 1,700 cancer surgeries
• an additional 1680 hip and knee joint replacements
• 2,000 new cataract surgeries
• and an additional 7,851 cardiac procedures

As well, our investments in 2004-05 will increase the number of MRI exams in the province by 40,000 — nearly 20 percent!

We will shortly be announcing our wait times allocations of 2005-2006, and they will build aggressively upon those for 04-05.

So…a little less than a year and a half into our mandate, that's an overview of what we've accomplished in health care.

I would like to think that Ontarians can see the outline of our plan emerging, as well as some of the results by which they are going to judge us in October 2007.

What we are entering into now is really the second leg of our journey.

Our objectives are clear. Our methods have been established.

In the next few weeks, we are going to be moving forward on some initiatives of enormous importance to health care in Ontario. In a very real sense these will be the glue that holds our plan together.

One of the signature initiatives of our entire government is Family Health Teams.

Next week, we will be officially announcing the creation of the first batch of our Family Health Teams.

I'm going to be one exuberant Health Minister on that day.

The idea of multi-disciplinary health teams isn't new, but we are taking it to a whole new level with FHTs, and I can tell you already that we are enjoying a whole new level of success.

We will be creating 150 FHTs across Ontario by 2007-2008.

We have already received 213 applications — representing 1300 doctors and 2600 other health care professionals — from communities who want an FHT of their own.

213 applications. I am gratified, to say the least.

It seems that people understand instinctively that this is a great idea.

Doctors, nurses, nurse practitioners, pharmacists - health care professionals working as a team to provide the best kind of integrated, patient-centred care.

24/7.

This model leverages the benefit our doctors deliver like no other model. A doctor working in a team practice can help 52 percent more patients than a doctor working in solo practice.

So not only are patients receiving better care, more of them are receiving it!!

This is the future of health care…here in Ontario and I believe in other jurisdictions as well.

So look for that announcement next week and stay tuned after that..

The next thing I want to talk about today is something that I have to admit, is not always an audience favourite.

LHINs. Local Health Integration Networks.

Now I'm not going to deny it. The very name has a kind of eyeball-glazing quality to it.

People like to hear me talk about wait times. Whether they agree or disagree, they get it. They know why it's important to them.

Same with Family Health Teams. Community-based care. The OMA deal.

LHINs just aren't that accessible to people. They don't really see why they should care.

Well they should. They shouldn't worry — quite the opposite — but they should care.

LHINs are a quality improvement initiative. There will be 14 of them — planning, coordinating and even funding the delivery of health care services within their geographic boundaries.

Local Health Integration Networks. It's a mouthful, but it says a lot.

Local. LHINs are based on the simple principle that local people, close to the action, are best able to determine the urgency of local priorities.

Integration. LHINs will create an environment where local players are asked to come together and coordinate their service delivery with patients in mind.

It's very simple. You can't micromanage a $32 billion operation from head office.

You can shovel the $32 billion out the door, but you can't properly ensure that it will wind up exactly where it should, doing what it should.

For example…an elderly person looking for home care through a Community Care Access Centre. It may be that there is enough home care technically available in Ontario, but today we can't be sure it's available in the right places.

LHINs will integrate health care services, like home care, according to the specific needs of the community, and to the specific benefit of the patient.

Another example…community mental health. We made a significant investment — an additional $65 million — this past year in community mental health. It was the first such increase in 12 years. It would be nice to know — absolutely know — that that investment is being distributed throughout the province in such a way as to best meet the needs of all our communities.

We have 600 agencies in this province delivering community mental health and addiction services. The only way we can find — and fill — the gaps that will inevitably ensue is by having local people, the folks on the ground, working together. LHINs will help us do that.

It is a platform for system-wide action.

Picture a person requiring several different stages of treatment, beginning with a family doctor, moving on to various specialists.

As if he or she doesn't have enough to worry about, this person must now navigate this complicated system essentially alone — frequently having to recount his or her problem and history at every stage.

I have spoken before about the silo effect in health care — lots of individual silos doing great work, but too little inter-cooperation.

In the case of our patient, this makes it very hard to navigate the system, and can ultimately result in a less than positive health care experience.

Under LHINs, there will be help for patients moving through the system, because patients will be at the very centre of that system.

Let me tell you a very quick story that I think perfectly demonstrates the needs for LHINs.

I made an announcement in February — $66 million to replace all MRI and CT scanners that were more than eight years old.

The most remarkable thing about that announcement was not the money we spent, or the nearly 100,000 new procedures we were delivering as a result of bringing in more efficient equipment…

No, it was the fact that for the first time in this province's history we were bulk purchasing this equipment.

The first time!!

We saved $25 million dollars as a result. Think about how much money we could have saved over the past years and decades in this province if we had simply taken the sensible approach, treated our health care system as a system instead of a collection of silos, and capitalized on what I call the Medicare Advantage.

That is something else LHINs will help us do.

LHINs are the next evolution of health care. They represent an understanding that community-based care, reflecting the needs of that community, is best planned, coordinated and funded in an integrated manner within that community.

Consequently, we will be devolving a good deal of power and authority to our LHINs, leaving the Ministry of Health and Long-Term Care to function more as a head office should, rising to a much more strategic level.

Later this spring, we will be announcing the 14 LHIN Board Chairs, 14 CEOs and 28 founding board directors who will be helping us lead the province into this next chapter of health care in Ontario.

Finally, I want to talk to you just a little about accountability.

In this day and age, in this line of work, it isn't enough to say you're going to do something. It isn't even enough to do it.

You have to be seen to be doing it.

You have to prove it.

Last month we sent out a call for people who want to be members of the new Ontario Health Quality Council.

I really can't overstate the importance of this body.

You've all sat here for the past 15-20 minutes — and it has probably felt like an hour — listening to me tell you about what we've accomplished in health care.

You've been very polite, and I like to think that for the most part you've believed me. I am, at least, forever hopeful.

But the fact is that you have no real way of knowing how much of what I say is true.

You have no real way of knowing the state of play throughout much of our health care system.

And that's because it is difficult, bordering on impossible, to get timely access to consistent data about the state of health care in Ontario today, and about the health of Ontarians.

The Ontario Health Quality Council will change that.

It will be an arms-length, independent body that exists quite simply to monitor the state of health care, the state of health of Ontarians, and report to the public on how well the system is performing.

Through the Council, Ontarians will be well informed about the progress we're making on the key commitments we've made.

Let me give you an example :

Wait Times.

We are going to have benchmarks in this province for what minimum wait times ought to be.

The Health Quality Council will look at where wait times started, where they really are, and report publicly on the results.

In this way Ontarians will know, and we will know, how well we are doing in living up to our commitments.

The council will also monitor and test the effectiveness of the system through broader measures like population health status and the prevalence of serious and preventable diseases such as diabetes.

It will track rates of physical activity, obesity and smoking. This should help to motivate Ontarians to take control of their own health — to live a healthier lifestyle, and begin practicing the kind of health promotion and disease prevention that will help us help them become the healthiest people in the country.

The Council will be made up of 10 bright, independent Ontarians who have skills, expertise or experience that is relevant to the work the Council is going to do, and who have stepped up to help make health care in this province better.

The Ontario Health Quality Council will perform two absolutely vital functions. It will ensure that Ontarians and their government have the information they need to make the right decisions about health care, and by reporting to Ontarians it will help hold the government to account for the decisions it ends up making.

Now I was told I should limit my remarks to three minutes…

Well, no, I wasn't really given a limit. But I think I've probably bent your collective ear for long enough.

In conclusion let me return to the notion of plans, and results, and what is fair in terms of people's expectations.

The problems in health care aren't going to be solved overnight. Truth is, they're not going to be solved by October 2007 — or at least not completely.

Reasonable people understand this.

But reasonable people also understand that progress must be shown, and results must be achieved.

They have a right to demand continuous improvement.

We were elected because Ontarians were not happy with the status quo.

They didn't like how things were going - particularly in health care.

Well say what you will about our plan, but it ain't the status quo!

We are - and I say this with great pride — agents of change. We are building a system of health care such as this province has never seen, we are delivering results, and we are going to show continuous improvement.

What we're not going to do is spend tens of millions of taxpayer dollars, like the previous government did, telling taxpayers what a great job we're doing. We're putting that money to better use — investing it in health care, and other social programs people rely on.

And that's why I was so emphatic about the importance of the new Ontario Health Quality Council. Through the Council, and because of our various initiatives, Ontarians will be able to see continuous improvement, and measure what I expect to be very good results.

In a society that defines itself by its commitment to quality public health care, people are entitled to these results :

Shorter wait times.

Increased access to doctors.

And healthier Ontarians. Over and above all else, healthier Ontarians.

Thank you.