As recently as one year ago, the chance to make meaningful transformation in Ontario seemed inevitable. There was a perfect storm of factors that we may not see again in our generation.
There was a need, a will and a cluster of talented, dedicated people and organizations who all wanted to work together to improve our health care system.
The needs were and are obvious.
We need to improve the Primary Care system to improve access, increase equity, expand multi-disciplinary team care and bring a sense of ‘system’ to the whole thing.
We need to improve hospital efficiency and we need to stop using the secondary and tertiary care systems where long-term, palliative and primary care are more appropriate.
We need to provide proper resources and structure to home care so that people don’t end up in hospital as a default.
We need to improve end of life care so that people have substitute decision makers and a plan in place before they get sick. We need to provide palliative care to everyone who would benefit, either in a hospice, in their own homes or in hospital.
We need to let people decide where they die and make sure they get the help they need to respect their wishes.
We need a seniors strategy……..well the list goes on and on.
The length of the list and the complexity of the problems did not seem insurmountable a year ago. People of good will were prepared to work with others to make things better.
We all accepted the principle that if we did what was right for the people, for the patients, we could improve things.
Nurses, Doctors, Nurse Practitioners, Hospitals and home and community care organizations were all committed to working together with Government, the Ministry of Health and other government sponsored organizations like Health Quality Ontario, Local Health Integrated Networks and Cancer Care Ontario.
And the Government had people in place with the knowledge and credibility to make major changes.
Starting with the Minister who is a doctor, a Rhodes Scholar and an Officer of the Order of Canada for his International work. We have not seen a more qualified Health Minister for many years. His Deputy is a famous cancer surgeon and one of the most respected hospital executives in Ontario. And they had the support of an enthusiastic Associate Minister and Parliamentary Assistants. There was and is an impressive array of Associate and Assistant Deputy Ministers to help in meaningful change.
So what did the Premier and Cabinet do with this rare confluence of need, will and talent?
They lost their nerve. They decided that rather than make real change, they would save a little money by cutting doctor’s fees. That was their priority. Unbelievable.
A task that was better done by a junior accounting clerk with a red crayon and an adding machine has occupied the attention of the Ministry of Health for the past year.
Reform is abandoned. Hope for change is gone.
But they sure showed the doctors, didn’t they?
Scott Douglas Wooder, MD