OHA Accountability Conference
Ontario Hospital Association
200 Front Street West, Suite 2800
Toronto, Ontario, M5V 3L1
Tel: (416) 205-1345 Fax: (416) 205-1360
Visit our Web Site: http://www.oha.com
Tuesday, January 25, 2005
Speaking Remarks
Hilary Short, President & CEO, Ontario Hospital Association
Tuesday January 25, 2005, 8:45AM
Doubletree International Plaza Hotel
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Good morning, and behalf of the Ontario Hospital Association, welcome to our second annual conference on health system accountability.
In a time of relentlessly growing demand for services, limited budgets and a more activist public, all of us involved in healthcare – hospitals, government, health professionals – are being called upon to be even more accountable for the work we do.
So today’s conference has been designed with you in mind.
In just a few minutes we will hear from our Health and Long Term Care Minister George Smitherman about mutual accountability and what we can expect from the government in the time ahead.
We will also learn from Anne Corbett of Borden Ladner Gervais about the impact of accountability agreements, and the important changes they are making to the way in which hospital Boards and senior managers are expected to be accountable to the public and to the government.
We will have an incredibly important panel discussion about the challenges that hospitals and their Boards face in continuing to provide the same level of health services while meeting the requirement to balance their budgets in just over one year’s time.
And following this important discussion, we will talk about the future as the Ontario government moves ahead with its plan for health system transformation and shorter waiting times.
To begin, and to help frame today’s discussion I’d like to spend a few minutes talking about accountability and what has happened over the past year.
I’d also like to talk about the months ahead, the further changes we can expect and what they may mean to hospitals and our health care system.
You know, this past year marked my 30th year of service with the Ontario Hospital Association. I’ve had the privilege of working with our member hospitals for three decades.
Over the course of my time with OHA, Ontario’s hospitals have become Canadian leaders when it comes to accountability.
They’ve done it the hard way – through hard work and an unprecedented dedication to excellence.
From financial performance to patient satisfaction, hospitals have never been afraid to answer questions about how well they do their job.
We are already accountable to the government and the taxpayers for the funds we receive to provide care.
How do we show this accountability?
Simple. We are extremely efficient.
And we know that the taxpayers already receive excellent value-for-money because by any standard or measure, Ontario hospitals are the most efficient in Canada.
And through our Report Card initiative, a grassroots, hospital driven initiative, Ontario hospitals have been reporting publicly about their performance on a wide variety of measures.
No other hospital system in Canada reports to the public the way we do. But even though we already achieve a very high standard when it accountability, we know that we have to do even more.
With more than $11 billion a year in public funds, the taxpayers have the right to expect no less.
In Minister Smitherman’s very first speech to the OHA back in November 2003, he told us that he and his government were embarking on a new era of accountability in healthcare.
Because of our commitment to accountability, Ontario’s hospitals embraced this agenda, naturally - because we were already leading the way.
But lets also be clear.
Major, structural change can also bring challenges.
They can take time.
They often come with legitimate and serious challenges along the way – challenges that must be recognized and addressed together – for everyone to move forward.
Over the course of the past fourteen months, the Ontario Government and Ontario’s hospitals have together learned a great deal.
Through an open and honest exchange over Bill 8, the Commitment to the Future of Medicare Act, the government learned about our genuine concerns over key parts of the bill and made meaningful and important changes.
The Ministry and Minister have also had the opportunity to review the balanced-budget plans of Ontario hospitals and through this review, we have both come to learn even more about the facts and evidence underscoring our efficiency performance.
The balanced budget review process has been a learning experience because it has yielded greater understanding. And in yielding this greater understanding, it has helped shape our accountability to each other.
It has not always been easy, but we have made important strides over the past year.
This is important because we must build on what we have learned to meet the complex challenges of the next fourteen months together
It appears as though Local Health Integration Networks will fundamentally change the lines of accountability between the Government of Ontario and hospitals.
Hospital Boards will continue to be accountable to the patients in their home communities, but more than likely over time they will likely be negotiating accountability agreements with the appointed Board members and staff of their LHIN.
From my experience, I know that hospitals will rise to the challenge triggered by the creation of LHINs, and the move to be more accountable by better integrating local health care services.
In fact, I know that hospitals will embrace it.
Although it also appears as though LHINs will not receive their funding responsibilities immediately, that will be on the horizon.
So with the March 31st 2006 balanced budget deadline for hospitals and the time it will take to see the impact of the government’s welcome investments in community services and primary care reform, it is important to also remain focused on solutions that can transition hospitals through the deadline in the time that lies ahead.
That’s why at the OHA, we are also very pleased to see renewed, serious interest in moving forward with joint accountability agreements.
Mutually negotiated accountability agreements that hold each party accountable, rather than agreements that can be unilaterally imposed, reflect the careful balance that is needed for hospitals and government to be genuinely accountable to each other.
We are working very closely with the Ministry and are pushing ahead with work that is needed to make these agreements a success.
We believe that the work being done today has the potential to be important building blocks when it comes to establishing the accountability relationship that will ultimately exist between local hospital Boards and their Local Health Integration Networks.
But most of all, we will continue to work with the Ministry in designing and implementing these joint accountability agreements because ultimately, they will establish the hospital accountability framework with the Government of Ontario in the lead up to the March 31, 2006 balanced budget deadline.
From the government’s own balanced budget process, including the peer review panels, we all know the facts and evidence about the size of the fiscal gap that remains for 2005/2006 after the savings from the current year have been implemented.
We know what the stakes are for our workforce and for our patients in order to balance by the government’s deadline.
Hospitals and the Government of Ontario have a shared responsibility to the people of Ontario to develop and implement solutions that will protect patient care and minimize the impact on the workforce during this period of change and transition.
Just look at what we are already achieving when it comes to reducing waiting times.
Through the leadership of Dr. Alan Hudson, and the hard work of the OHA Reference Group on Access to Service and Wait Times, we are moving forward with implementing a practical and concrete plan to reduce waiting in times in five key areas – cancer, cardiac, hip and knee replacement, cataract surgery and diagnostic care.
Through this work we are making breakthroughs when it comes to hospital funding.
We are breaking from the past and embracing a new way of allocating funds that is based on incentives, maximizing volumes and recognizing the real cost of providing care.
So to maintain true accountability to the people of Ontario in the lead up to the March 31st, 2006, balanced budget deadline all of us have a responsibility to work closely together.
All of us have a responsibility to recognize the scope of the challenge that lies before us, and redouble our efforts in serving our most important constituency – the one that we are all truly accountable to.
And that constituency is, of course, the people of Ontario.
Thank you again, to everyone, for being here today.
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416-205-1348