Transcript: Ontario's Cuts to Public Health | May 07, 2019

Steve sits in the studio. He's slim, clean-shaven, in his fifties, with short curly brown hair. He's wearing a gray suit, pale peach shirt, and checked blue tie.

A caption on screen reads "Ontario's cuts to public health. @spaikin, @theagenda."

Steve says IN ITS FIRST BUDGET, THE
FORD GOVERNMENT PROPOSED MERGING
AND MODERNIZING PUBLIC HEALTH
UNITS AS A WAY TO FIND
EFFICIENCIES AND SAVE TAXPAYER
DOLLARS.
IT WAS NOT IMMEDIATELY CLEAR
WHAT IT ALL MEANT, BUT AS MORE
DETAILS EMERGED, IT'S A MOVE
THAT'S PROVOKED SUBSTANTIAL
PUSHBACK.
ROBIN MARTIN IS PARLIAMENTARY
ASSISTANT TO THE MINISTER OF
HEALTH AND LONG-TERM CARE AND
THE PROGRESSIVE CONSERVATIVE MPP
FOR EGLINTON-LAWRENCE, AND SHE
JOINS US NOW TO EXPLAIN THE
GOVERNMENT'S APPROACH ON THIS.

Robin is in her early sixties, with short wavy blond hair. She's wearing glasses, a green blazer over a black blouse, and a beaded necklace.

Steve continues WELCOME BACK.

Robin says THANK YOU.

Steve says NICE TO HAVE YOU IN
THAT CHAIR.
LET'S JUST PUT UP THE...
SHELDON, CAN WE DO THIS, PUT UP
THE PIE CHARTS HERE?
THIS IS WHAT THE TORONTO PUBLIC
HEALTH 2019 BUDGET LOOKS LIKE.

A slate appears on screen, with the title "Toronto public health budget 2019."

Two pie charts appear, depicting the previous funding formula, on the left, and the new one, on the right.

Steve reads data from the slate and says
FOR PEOPLE LISTENING ON PODCAST,
I'LL DESCRIBE THE TWO CHARTS
HERE.
THE PIE CHART ON THE LEFT HAS
GOT 151 MILLION DOLLARS OF PROVINCIAL
FUNDING AND 43 MILLION DOLLARS OF CITY
OF TORONTO FUNDING.
75-25 IN A RATIO.
THE NEW CHARTS THAT THEY'RE
PUTTING FORWARD SAY THAT THE NEW
FUNDING FORMULA HAS THE
PROVINCIAL ALLOCATION
ESSENTIALLY CUT IN HALF TO 86
MILLION DOLLARS.
THE 43 MILLION DOLLARS FROM THE CITY
STAYS THE SAME, BUT OF COURSE IT
LEAVES A 65 MILLION DOLLARS UNFUNDED
OBLIGATION COMPARED TO THE LAST
TIME.
SO FIRST QUESTION IS: DO YOU
DISPUTE ANY OF THESE NUMBERS?

The caption changes to "Robin Martin. PC MPP, Eglington-Lawrence."
Then, it changes again to "Math dispute."

Robin says YES.
I DON'T DISPUTE THE EXISTING
NUMBERS, WHAT EXISTS RIGHT NOW,
THE 151 MILLION DOLLARS AND THE 43
MILLION DOLLARS FROM THE CITY, BUT THE
OTHER NUMBERS THAT THE CITY'S
COME UP WITH, WE HAVE DISPUTED
ALL THE WAY ALONG.
WE DON'T AGREE WITH THOSE
NUMBERS AT ALL.
WE'RE TALKING ABOUT A VERY
MODEST REALIGNMENT OF SERVICES
IN PUBLIC HEALTH, AND THE AMOUNT
OF FUNDING THAT WE WOULD BE
GIVING.
FOR EXAMPLE, NEXT YEAR WOULD BE
114 MILLION DOLLARS.

Steve says YOU BELIEVE THAT THE CORRECT
NUMBER IS NOT 86 MILLION DOLLARS FROM
THE PROVINCE BUT 114 MILLION DOLLARS?

Robin says YES.

Steve says ALL RIGHT, WHICH STILL LEAVES
TENS OF MILLIONS OF DOLLARS UNFUNDED AT THE MOMENT,
OBLIGATIONS, RIGHT?

Robin says IT'S 33 MILLION DOLLARS, AND WE
DON'T CONSIDER THEM UNFUNDED
OBLIGATIONS.
WE'RE ASKING THE CITY TO LOOK AT
THE PROGRAMS, TO PRIORITIZE AND
TO MAKE THE BEST CHOICES THEY
CAN.
WE'RE ALL WORKING HARD TO GET
THE MAXIMUM VALUE WE CAN FOR
TAXPAYER DOLLARS, ESPECIALLY
IN... WELL, IN EVERY AREA, BUT
ESPECIALLY IN HEALTH CARE.
IT'S VERY IMPORTANT, AND YEAH,
WE BELIEVE THAT THEY CAN FIND
SOME EFFICIENCIES AND MAYBE SOME
THINGS THAT WE CAN DO BETTER AND
DELIVER BETTER.

Steve says WHAT IS THE
JUSTIFICATION FROM GOING FROM A
75-25 COST-SHARING ARRANGEMENT
TO A 50-50 COST SHARING
ARRANGEMENT?

The caption changes to "Robin Martin, @RobinMartinPC."

Robin says WELL, UNDER THE HEALTH
PROTECTION AND PROMOTION ACT,
MUNICIPALITIES ARE RESPONSIBLE
TO PROVIDE PUBLIC HEALTH
SERVICES.
IN THE PAST, IT WAS A 50-50 COST
SHARE ARRANGEMENT.
MORE RECENTLY THERE HAVE BEEN A
75-25 COST SHARE ARRANGEMENT,
BUT WE FEEL THAT IT MAKES SENSE
TO MAKE IT MORE OF A 50-50
ARRANGEMENT GOING FORWARD.
IT'S AN IMPORTANT THING THAT
MUNICIPALITIES HAVE A SAY IN
WHAT THEY'RE PROVIDING WITH THE
SERVICES, AND WE WANT TO MAKE
SURE THAT EVERYBODY IS LOOKING
AT HOW THEY MAXIMIZE HOW TO
SPEND THOSE HEALTH DOLLARS.

The caption changes to "Connect with us: Twitter: @theagenda; Facebook, agendaconnect@tvo.org, Instagram."

Steve says LET'S USE YOUR NUMBERS
JUST FOR ARGUMENT'S SAKE, 33
MILLION DOLLARS.
ON AN 11 BILLION DOLLAR BUDGET IN THE
CITY OF TORONTO, IT'S NOT THAT
MUCH MONEY, BUT IT STILL HAS GOT
TO BE FOUND.
AND I'M WONDERING HOW MUCH OF A
HEADS UP YOU GAVE THEM TO LET
THEM KNOW THAT YOU NOW HAVE TO
FIND 33 MILLION DOLLARS YOU DIDN'T HAVE
TO FIND BEFORE.

Robin says SO IT'S ACTUALLY LESS THAN
ONE QUARTER OF 1 percent OF THE CITY OF
TORONTO'S BUDGET, WHICH IS 13.5
BILLION DOLLARS, I BELIEVE.
AND SO IT'S A VERY SMALL AMOUNT
OF MONEY.
IT'S 0.24.
IT'S TWO thousandths OF THE BUDGET.
SO IT'S A VERY SMALL AMOUNT OF
MONEY.

Steve says BUT SOMETHING THEY
DIDN'T THINK THEY HAD TO FIND.

Robin says SURE, BUT WE KNOW THAT THERE
ARE LOTS OF PLACES IN THE BUDGET
OF THE CITY OF TORONTO, LIKE ALL
GOVERNMENTS, YOU KNOW, WHERE
THERE ARE INEFFICIENCIES, WHERE
THEY ARE SPENDING MONEY, AND
FRANKLY THE TORONTO PUBLIC
HEALTH HAS BEEN ACTUALLY RUNNING
A SURPLUS FOR SEVERAL YEARS,
INCLUDING I THINK IN 2011 THEY
HAD A 12 MILLION DOLLAR SURPLUS.
SO THERE'S MONEY SITTING THERE
THAT IS AVAILABLE THAT IS NOT
BEING SPENT RIGHT NOW, AND THEN
OF COURSE THERE IS MONEY THAT IS
BEING SPENT BUT PERHAPS NOT ON
PRIORITY PUBLIC HEALTH SERVICES.

Steve says FOR EXAMPLE?

Robin says FOR EXAMPLE, THEY HAVE A...
THEY COMMISSIONED A STUDY TO BAN
ENERGY DRINKS.
YOU KNOW, INTERESTING, BUT NOT
REALLY A CORE PUBLIC HEALTH SERVICE.

Steve says HOW MUCH DID THEY
SPEND ON THAT?

Robin says I HAVE NO IDEA.
IT'S JUST AN EXAMPLE.

Steve says CAN'T BE MUCH.

Robin says STILL, IT'S SOMETHING THAT
SHOWS THE CITY IS NOT JUST
FUNDING CORE PUBLIC HEALTH
SERVICES OUT OF THE TORONTO
PUBLIC HEALTH.
ANOTHER EXAMPLE IS THEY
COMMISSIONED A STUDY TO... FOR
HEALTH AND SAFETY IMPACTS OF
REIMAGINING YONGE STREET, WHICH
IS ABOUT BIKE LANES.
AGAIN, NOT CORE PUBLIC HEALTH
SERVICES, NOT WHAT THE PROVINCE
IS GIVING THEM MONEY FOR IN
PUBLIC HEALTH.

Steve says SO WHEN WE HEAR
OFFICIALS FROM THE CITY OF
TORONTO SAY THINGS LIKE: STUDENT
NUTRITION PROGRAMS ARE GOING TO
BE AT RISK, VACCINATIONS ARE
GOING TO BE AT RISK, FOOD SAFETY
INSPECTIONS ARE GOING TO BE AT
RISK, YOU'RE NOT BUYING?

The caption changes to "Services at risk?"

Robin says NO.
THESE ARE CORE PUBLIC SERVICES,
CORE PUBLIC HEALTH SERVICES,
WHICH WILL CONTINUE TO BE
PROVIDED AS THEY ALWAYS HAVE
BEEN.
WE'RE FUNDING 114 MILLION DOLLARS FOR
TORONTO PUBLIC HEALTH, AND ALL
WE'RE ASKING IS THAT THEY FOCUS
ON THE PRIORITIES AND THAT THEY
REVIEW EVERY PROGRAM, LIKE WE'VE
BEEN DOING, TO MAKE SURE THAT
THEY'RE SPENDING THE MONEY IN
THE BEST POSSIBLE WAY, AND WE'VE
OFFERED TO WORK WITH THEM TO DO
THIS, TO LOOK AT THESE PROGRAMS
WITH THEM AND FIND IF THERE ARE
BETTER WAYS TO DELIVER SOME OF
THESE PROGRAMS, AND THAT'S PART
OF OUR MODERNIZATION EFFORTS,
YOU KNOW.
WE CAN FIND SOME SAVINGS PERHAPS
IN DIGITIZATION, WE CAN FIND
SOME SAVINGS PERHAPS IN MAKING
SURE THE RIGHT LEVEL OF
GOVERNMENT IS DOING THE RIGHT
THINGS, BUT THEY WILL CONTINUE
TO PROVIDE PRIORITY PUBLIC
HEALTH SERVICES.

Steve says CAN YOU UNDERSTAND
FROM THEIR POINT OF VIEW WHEN
PREMIER FORD SORT OF SURPRISES
THEM WITH I'M CUTTING YOUR CITY
COUNCIL IN HALF AND NOT REALLY
CONSULTING YOU AHEAD OF TIME AND
I'M MAKING THESE CUTS TO YOUR
BUDGET WITHOUT GIVING YOU A
HEADS UP ON THAT, AND THERE HAVE
BEEN OTHER THINGS OBVIOUSLY
ALONG THE WAY WHERE THE PROVINCE
MADE A DECISION AND, YOU KNOW,
TAKEN THE SUBWAY AWAY, FOR
EXAMPLE.
CAN YOU UNDERSTAND WHY THE CITY
MIGHT NOT THINK THAT YOUR OFFER
OF HELP IS ALL THAT HELPFUL?

Robin says I DON'T KNOW, STEVE.
WE'RE TRYING TO WORK WITH THE CITY.
WE'RE NOT TAKING THE SUBWAY AWAY.

Steve says WELL, YOU'RE UPLOADING.

Robin says WHICH WE RAN ON.
AND WE MADE SURE TO GET MAXIMUM
VALUE FOR EVERY TAX DOLLAR.
WE'RE MAKING SURE WE PROTECT THE
THINGS THAT MATTER MOST, AND
THOSE THINGS ARE HEALTH CARE AND
EDUCATION, BOTH OF WHICH WE'RE
PUTTING MORE MONEY INTO IN THIS
BUDGET.
WE MEET REGULARLY WITH
MUNICIPALITIES AT AMO
CONFERENCES, AND WE HAVE MONTHLY
REGULAR MEETINGS WITH AIMO, AND
WE DISCUSS ALL...

Steve says THAT'S THE ASSOCIATION
OF MUNICIPALITIES OF ONTARIO.

Robin says THAT'S RIGHT, AND WE DISCUSS
ALL ISSUES, SO ALL THE MINISTERS
COME AND DISCUSS ISSUES THAT
IMPACT MUNICIPALITIES, SO WE'RE
REALLY TRYING TO DO OUR BEST TO
WORK WITH OUR MUNICIPAL
PARTNERS, AND I CERTAINLY HOPE
TORONTO'S GOING TO BE ONE OF THE
PARTNERS THAT, YOU KNOW, WE CAN
WORK WITH ON THESE THINGS.
WE ALSO HAVE TECHNICAL WORKING
GROUPS THAT WE'RE SETTING UP
ON HEALTH CARE TRANSFORMATION
AND WE HOPE THAT THE CITY OF
TORONTO WILL BE PARTICIPATING IN THOSE.

Steve says YOU ARE CONSOLIDATING
LOCAL HEALTH UNITS, GOING FROM
35 TO 10 WITH AN EXPECTED
SAVINGS, I GUESS, OF 200
MILLION DOLLARS IN REDUCED FUNDING OVER
THE NEXT COUPLE OF YEARS.
WHAT'S THE THINKING BEHIND THAT?

Robin says WELL, IT'S PARTLY THIS
MODERNIZATION AND REALIGNMENT OF
PUBLIC HEALTH SERVICES TO MAKE
THINGS MORE RATIONAL.
RIGHT NOW WE HAVE 35 PUBLIC
HEALTH UNITS.
WE HAVE 35 MEDICAL OFFICERS OF
HEALTH.
WE HAVE 35 BOARDS OF HEALTH AND
WE HAVE, I THINK, FIVE DIFFERENT
GOVERNANCE MODELS FOR THOSE.
NONE OF THAT IS BASED ON
ANYTHING, YOU KNOW, THAT WAS
RATIONALLY SET OUT.
WE'RE TRYING TO REALIGN AND
PRIORITIZE OUR HEALTH CARE
SERVICES, YOU KNOW, GOING
FORWARD.
AND WE THINK WE HAVE A BETTER
IDEA TO HAVE A MODEL WITH 10
REGIONAL HEALTH, PUBLIC HEALTH
ENTITIES AND 10 MEDICAL OFFICERS
OF HEALTH TO GO WITH IT, OR
BOARDS OF HEALTH, AND WE HAVE
ONE GOVERNANCE MODEL THAT WE'RE
GOING TO PROPOSE.
SO PART OF THIS IS JUST TRYING
TO MAKE OUR HEALTH CARE SYSTEM
WORK IN THE BEST POSSIBLE WAY
FOR EVERY ONTARIAN, AND YOU
KNOW, WE'RE NOT LEAVING ANYTHING
ALONE.
WE'RE LOOKING AT EVERYTHING TO
MAKE SURE THAT WE DO THINGS
BETTER.
THAT'S WHAT THEY ELECTED US, THE
PEOPLE OF TORONTO AND ONTARIO
ELECTED US FOR.

Steve says DO YOU THINK THERE
WILL BE ANY REDUCTION IN
ANYTHING IMPORTANT IF 200
MILLION DOLLARS PROVINCIAL LESS ARE NOW
NOT GOING TO BE GOING TO THOSE
LOCAL AREAS?

Robin says NO, WE DON'T.
WE THINK THAT THEY WILL BE ABLE
TO PROVIDE THE PUBLIC HEALTH
SERVICES, THE CORE PUBLIC HEALTH
SERVICES THAT EVERYBODY RELIES
ON.
WE'RE DOING ALL THIS, YOU KNOW,
WITH THAT IN MIND, THAT WE WILL
CONTINUE TO PROVIDE OUR PUBLIC
HEALTH SERVICES IN THE WAY THAT
IS GOING TO BE THE BEST
DELIVERED FOR PEOPLE ACROSS THE
PROVINCE.
AND I THINK THAT IT'S IMPORTANT
THAT PEOPLE REALIZE THAT.
WE ARE ACTUALLY PUTTING 1.3
BILLION DOLLARS MORE INTO HEALTH CARE
THIS YEAR.
SO ALL THE MONEY THAT WE SAVE IN
THIS INITIATIVE GOES BACK INTO
HEALTH CARE, AND WE'RE JUST
MAKING SURE THAT THE SPENDING IS
AS RATIONAL AS POSSIBLE AND
GETTING THE BEST BANG FOR THE
BUCK.

Steve says I HEAR YOU.
I JUST WANT TO PUT THAT IN
PERSPECTIVE, THOUGH.
1.3 BILLION DOLLARS MORE ON A 60
BILLION DOLLARS BUDGET IS WHAT
PERCENTAGE?
I'M NOT FABULOUS AT MATH OFF THE
TOP OF MY HEAD.

Robin says ME EITHER.
DON'T CHALLENGE ME.

Steve says I'M BETTING IT'S NOT
HEALTH CARE... LIKE, I'M BETTING
IT'S A VERY MO TEST INCREASE AND
DOESN'T COVER HEALTH CARE
INFLATION, THE INCREASED USE ON
THE SYSTEM, ET CETERA,
ET CETERA, ET CETERA.
THAT'S MY HUNCH.

Robin says WELL, AND YOU KNOW THAT WE
WERE FACED WITH A 15 BILLION DOLLAR
DEFICIT WHEN WE TOOK POWER.
WE HAVE A 338 BILLION DOLLAR DEBT.
THE FORMER GOVERNMENT WAS
SPENDING 40 MILLION DOLLARS EVERY DAY,
WHICH IT DID NOT HAVE.
AND WHAT WE'RE TRYING TO DO IS
GET OUR FISCAL HOUSE IN ORDER.
THAT'S WHAT PEOPLE ELECTED US TO
DO, AND TO GET THINGS ON TRACK
WHILE PROTECTING THE THINGS THAT
MATTER MOST, LIKE HEALTH CARE,
AND THAT'S WHAT WE'RE DOING.

Steve says CAN I PICK UP ON THAT?
MY HUNCH IS PEOPLE GET THAT,
RIGHT?
THERE WAS A BIG DEFICIT WHEN YOU
TOOK OVER, AND THERE IS A BIG
DEBT THAT HAS TO BE PAID OFF
EVENTUALLY.
CAN THE GOVERNMENT NOT SIMPLY
COME OUT AND SAY, LOOK, I KNOW
YOU'RE ALL UNHAPPY WITH THE CUTS
THAT WE'RE MAKING, BUT HERE'S
OUR FINANCIAL REALITY, AND WE'RE
JUST GOING TO HAVE TO GET BY
WITH LESS.
CAN YOU NOT SAY THAT?

Robin says WELL, I THINK WE... YOU KNOW,
WE'VE BEEN SAYING TO PEOPLE
WE'RE TRYING TO PRIORITIZE THE
THINGS THAT MATTER MOST, AND
WE'RE DOING THAT.
SO WE'RE EFFECTIVELY SAYING
SOMETHING VERY SIMILAR, I THINK.

Steve says I KEEP HEARING
GOVERNMENT MINISTERS SAY DON'T
WORRY, NOTHING... LIKE...
EVERYTHING THAT'S IMPORTANT
WE'RE HANGING ON TO.

Robin says WELL, THAT'S RIGHT.
WE'RE PROTECTING THE THINGS THAT
MATTER MOST, AND I THINK WE ARE.

Steve says BUT THERE'S CERTAINLY
A DIFFERENCE OF OPINION ABOUT
WHAT'S IMPORTANT, ISN'T THERE?

Robin says WELL, I THINK... YOU KNOW,
WITH THE TORONTO PUBLIC HEALTH
THING, YOU KNOW, THEY'RE
SUGGESTING THAT IF THEY DON'T
CONTINUE FUNDING EVERYTHING
EXACTLY THE SAME WAY THAT IT WAS
LAST YEAR IS THAT THERE WILL BE
A CRISIS AND CHILDREN WILL STARVE.

Steve says ACTUALLY THEY SAID
PEOPLE WOULD DIE.
THAT'S WHAT THEY SAID.

Robin says YES, OUTRAGE, INDIGNATION AND
OVERBLOWN RHETORIC OVER
SOMETHING THAT IS MINIMAL.
I THINK MATT GURNEY WHO WROTE A
BLOG ON "THE AGENDA," YOU KNOW,
HAD ARTICLES WHICH SORT OF SAID
YOU'VE GOT TO BE CRAZY IF YOU
THINK THAT EVERY DOLLAR THAT
TORONTO PUBLIC HEALTH SPENDS IS
SPENT, YOU KNOW, TO MAXIMUM
IMPACT AND MAXIMUM VALUE.
OF COURSE THERE ARE THINGS IN
THERE THAT MAYBE ARE THINGS THAT
THEY'VE DONE FOR A WHILE THAT
THEY COULD LOOK AT AND DO
BETTER.
YOU KNOW, WE'RE PUTTING 90
MILLION DOLLARS INTO SENIORS DENTAL
CARE.
THAT'S A NEW ANNOUNCEMENT IN
PUBLIC HEALTH THAT WE'VE MADE
AND A NEW COMMITMENT TO PUBLIC
HEALTH.
IT'S TAKEN UP A RESPONSIBILITY
THAT REALLY WAS THE
RESPONSIBILITY OF MUNICIPAL
PUBLIC HEALTH UNITS TO PROVIDE,
AND THE PROVINCE IS TAKING THAT ON.

Steve says OKAY, LET ME READ A
LITTLE SNIPPET HERE OF A LETTER
WRITTEN FROM THE CHAIR OF THE
CANADIAN PUBLIC HEALTH
ASSOCIATION.
THIS WAS CO-THE MINISTER OF
HEALTH AND PREMIER FORD, AND IT
INCLUDES 320 PLUS HEALTH
PROFESSIONALS SIGNING ON.
IT SAYS...

A quote appears on screen, under the title "Open letter to the Premier and Health Minister." The quote reads "YOUR GOVERNMENT'S PROPOSED CUTS PUT THESE COST
EFFECTIVE AND COST SAVING PROGRAMS AND SERVICES IN JEOPARDY. THEY CAN BE EXPECTED TO HAVE THE UNINTENDED NEGATIVE CONSEQUENCE
OF INCREASING THE PRESSURE ON YOUR PROVINCE'S ACUTE HEALTH CARE SYSTEM AS PEOPLE WITH HEALTH CONDITIONS THAT COULD
HAVE BEEN PREVENTED WILL BE PRESENTING THEMSELVES IN EMERGENCY ROOMS AND DOCTORS'
OFFICES THROUGHOUT THE PROVINCE."
Quoted from Richard Musto, Canadian Public Health Association. May 2, 2019.

Steve says LET ME USE THE METAPHOR THAT I
KNOW PEOPLE IN PUBLIC HEALTH
LIKE TO USE, WHICH IS, YOU KNOW,
YOU CAN SOLVE PROBLEMS EITHER
UPSTREAM OR DOWNSTREAM, RIGHT?
YOU CAN SOLVE THE PROBLEMS
BEFORE THEY HAPPEN AT A CHEAPER
COST OR YOU CAN WAIT FOR YOU
KNOW WHAT TO HIT THE FAN AND
HAVE TO CLEAN UP THE RIVER IN
THE POLLUTION DOWNSTREAM WHICH
IS GOING TO COST TWICE AS MUCH.
NOW THAT'S AN ARGUMENT THAT I
THINK IS AN EMPIRICALLY PROVABLE
ARGUMENT.
DOES YOUR APPROACH NOT FLY IN
THE FACE OF THAT ARGUMENT?

The caption changes to "Putting health care in jeopardy?"

Robin says ABSOLUTELY NOT, STEVE.
WE THINK THAT PUBLIC HEALTH IS
VERY IMPORTANT, AND THE CORE
SERVICES THAT PUBLIC HEALTH
PROVIDES WILL CONTINUE, AND WE
VALUE THOSE SERVICES, AND WE
THINK THEY ARE VERY IMPORTANT,
SO WE VEHEMENTLY AGREE WITH ALL
OF THESE PUBLIC HEALTH
PROFESSIONALS.
ALL WE'RE SAYING IS THAT EVERY
GOVERNMENT, JUST LIKE WE HAVE
DONE, SHOULD LOOK THROUGH THEIR
PROGRAMS AS OFTEN AS POSSIBLE
AND SAY IS THIS PROGRAM STILL
SERVING, YOU KNOW, THE PEOPLE TO
THE MAXIMUM VALUE?
IS IT THE RIGHT LEVEL OF
GOVERNMENT DELIVERING THE
SERVICE?
IS IT DELIVERED IN THE RIGHT
WAY?
ARE THERE THINGS THAT WE CAN DO
TO IMPROVE IT, AND ARE THERE
SOME THINGS THAT WE ARE DONE
THAT COULD BE BETTER DONE BY
ANOTHER LEVEL OF GOVERNMENT.

Steve says THESE ARE ALL...
SUGGESTION, AND IF YOU SIT DOWN
WITH WHOEVER IT IS FROM THE
CITIES AND GO THROUGH LINE BY
LINE, NUMBER BY NUMBER, LOOKING
AT ALL THE PROGRAMS, AND IF...
ARE YOU OPEN TO THE POSSIBILITY
THAT THEY ACTUALLY HAVE... THAT
THEY ACTUALLY DO NEED ALL THE
MONEY THEY WERE GETTING FROM YOU
BEFORE, AND ARE YOU OPEN TO
RESTORING IT IF THEY MAKE THE CASE?

The caption changes to "Connect with us: Twitter: @theagenda; Facebook, agendaconnect@tvo.org, Instagram."

Robin says WELL, I MEAN, I DON'T WANT TO
PREJUDGE WHAT THE TECHNICAL
WORKING GROUP WILL DECIDE
TOGETHER.
I DON'T WANT TO PREJUDGE THOSE
CONVERSATIONS, BUT I WOULD SAY
WE'RE DOING THIS ALL THE WHILE
EXPECTING THAT IT WILL NOT
IMPACT CORE PUBLIC HEALTH
SERVICES, AND WE SAY THAT
BECAUSE WE'RE NOT ASKING FOR
MUCH OF A CHANGE.
AS I SAID, IT'S 0.24 OF 1 percent OF
THE CITY'S BUDGET.
SO IF THAT'S THE CASE, YOU KNOW,
THERE IS NO REASON THAT THEY
CAN'T FIND THAT KIND OF MONEY IN
THEIR 13.5 BILLION DOLLAR BUDGET, OR
EVEN WITHIN THEIR PUBLIC HEALTH
BUDGET ITSELF.

Steve says THAT'S THE TORONTO
NUMBER, BUT OF COURSE IT'S A
DIFFERENT NUMBER FOR OTHER
MUNICIPALITIES ALL AROUND THE
PROVINCE.

Robin says ABSOLUTELY, AND WE'RE WORKING
WITH THOSE MUNICIPALITIES AND
WE'RE HAVING DISCUSSIONS WITH
THEM, BUT WE FULLY ANTICIPATE
THAT THE CORE PUBLIC HEALTH
SERVICES WILL BE ABLE TO BE
FUNDED IN THE NEW MODEL.

Steve says THAT WAS PROBABLY NOT
THE THINKING OF THE HUNDREDS IF
NOT THOUSANDS OF PEOPLE WHO HAVE
BEEN DEMONSTRATING AT QUEEN'S
PARK AGAINST THESE CUTS.
DO YOU THINK, POLITICAL QUESTION
HERE, DO YOU THINK YOU
UNDERESTIMATED THE OPPOSITION
FROM AROUND THE PROVINCE TO
PEOPLE SEEING THEIR PUBLIC
HEALTH CARE BUDGETS CUT?

Robin says WELL, I WAS IN THE
LEGISLATURE, I SUPPOSE, WHEN THE
ONE DAY OF SOME DEMONSTRATION
ABOUT HEALTH CARE HAPPENED.
I THINK MOST OF THE
DEMONSTRATIONS HAVE BEEN
SOMETHING ELSE.
SO I DIDN'T SEE THE
DEMONSTRATION.
MY UNDERSTANDING, THOUGH, FROM
THE MEDIA COVERAGE I SAW WAS
THAT PEOPLE WERE OUT THERE FOR
ANY NUMBER OF REASONS, NOT JUST
HEALTH, SO PEOPLE WERE OUT THERE
TO PROTEST ANYTHING THAT THEY
THOUGHT WAS SOMETHING THAT THEY
DIDN'T LIKE.
SO I DON'T THINK THAT THAT IS
ANY REFLECTION OF WHETHER OR NOT
THIS IS A GOOD IDEA.
TAXPAYERS DO NOT BELIEVE THAT
EVERYTHING THE CITY OF TORONTO
DOES GETS MAXIMUM VALUE FOR
EVERY DOLLAR THEY SPEND OR
THAT THEY CAN'T REVIEW THOSE
PROGRAMS AND IMPROVE UPON
SERVICE DELIVERY. I THINK MOST
PEOPLE EXPECT THAT THEY CAN AND
THAT THERE ARE SOME THINGS THAT
THEY CAN FIND AND WE'VE GIVEN
A FEW EXAMPLES TO DO THAT.

Steve says YOU KNOW THE MAYOR OF
TORONTO.

Robin says I DO.
VERY NICE GUY.
I LIKE HIM VERY MUCH.

Steve says JOHN TORY.
HE'S NOT NUTTY ABOUT THIS, I GOT
TO TELL YOU.
NOW SHALL WE PLAY THIS CLIP?
HERE HE IS, THE MAYOR OF
TORONTO, JOHN TORY ON THE CBC
MORNING PROGRAM LAST WEEK.
SHELDON, IF YOU WOULD.

An audio clip plays on screen with a picture of John Tory and the caption "Voice of John Tory. Mayor of Toronto."

Tory says I DON'T THINK THERE'S A
SINGLE PROGRESSIVE CONSERVATIVE
MPP IN TORONTO WHO GOT ELECTED
ON THE COMMITMENT OR EVEN ON THE
NOTION THAT THEY WOULD
ACQUIESCE
TO CUTBACKS IN CHILD CARE,
PUBLIC HEALTH, IN GASOLINE TAX
WHICH IS USED TO HELP KEEP
TRANSIT GOING, AND SO WE'RE
GOING TO GO AND ASK THEM THAT
QUESTION.
ARE THEY GOING TO STAND UP?
BECAUSE WE SURE ARE AS A CITY
COUNCIL AND I AM AS THE MAYOR.
ARE THEY GOING TO STAND UP ON
THIS AND SAY INSIDE THEIR OWN
GOVERNMENT THAT IT IS TIME TO
TAKE A HARD SECOND LOOK AT THESE
THINGS?
THESE ARE NOT EFFICIENCIES.
THESE ARE DRAMATIC CUTBACKS,
SOMETIMES MORE HARSHLY IMPOSED
ON TORONTO, WHICH LEAVE THE CITY
GOVERNMENT WITH ONLY TWO
ALTERNATIVES, ESPECIALLY WHEN
THEY ARE DONE RETROACTIVELY IN
THE MIDDLE OF THE BUDGET YEAR,
WHICH IS TO CUT SERVICES OR TO
RAISE TAXES.

The clip ends.

Steve says OKAY.
BUNCH OF THINGS TO UNPACK THERE.
YOU'RE ONE OF THE TORONTO MPPs
HE'S ASKING TO TAKE A SECOND
LOOK AT THESE THINGS.

Robin says YES, I AM.

Steve says AND?

The caption changes to "Fighting City Hall."

Robin says I WOULD SAY THAT I AM
STANDING UP.
THERE'S ONLY ONE TAXPAYER.
I'M STANDING UP FOR THE PEOPLE
WHO ELECTED ME.
THEY ELECTED ME, AND THE PC
GOVERNMENT, TO DEAL WITH THE
FISCAL MESS THAT WE'RE IN, AND
TO GET ONTARIO BACK ON TRACK,
AND THAT'S EXACTLY WHAT WE'RE
DOING.
ALL WE'RE ASKING MAYOR TORY TO
DO, AND OTHER CITY COUNCILLORS,
IS TO FOCUS ON THE THINGS THAT
MATTER MOST, TO REVIEW THEIR
PROGRAMS AND MAKE SURE THAT
THEY'RE GETTING MAXIMUM VALUE
FOR TAX DOLLARS, AND NOBODY,
NOBODY BELIEVES THAT THEY ARE.
AND IT'S NOT JUST THEM.
IT'S SOMETHING EVERY GOVERNMENT
NEEDS TO DO ONCE IN A WHILE.
CERTAINLY IT'S NOT BEEN DONE
PROVINCIALLY FOR MANY YEARS, AND
THAT'S WHY WE'RE VERY FOCUSED ON
DOING IT NOW.
AND THIS KIND OF MODERN,
PROGRESSIVE THINKING AND
REVIEWING OF PROGRAMS AND
GOVERNMENT I THINK SHOULD BE
GOING ON ALL THE TIME.

Steve says HE SAYS THAT IN THE...
YOU'VE DONE THIS IN THE MIDST OF
A BUDGET YEAR IN WHICH YOU'VE
LEFT HIM NO ALTERNATIVE BUT TO
EITHER CUT PROGRAMS OR RAISE
TAXES IN ORDER TO FILL THAT GAP
OF, IN THIS CASE, 33 MILLION DOLLARS AS
YOU'VE OUTLINED IT.
DO YOU SEE ANY OTHER COURSE
BESIDES CUTTING SERVICES OR
RAISING TAXES?

Robin says YES, I THINK THEY CAN LOOK AT
THEIR... WHAT THEY'RE FUNDING
AND SAY, YOU KNOW WHAT, WE
REALLY DON'T NEED TO DO A STUDY
TO BAN ENERGY DRINKS, FOR
EXAMPLE, BECAUSE EVEN IF WE
FOUND IN OUR STUDY THAT WE
SHOULD BAN ENERGY DRINKS, WE
DON'T HAVE POWER TO ACTUALLY BAN
ENERGY DRINKS.
THAT'S SOMETHING SOMEBODY ELSE
CAN DO AND IT'S NOT A CORE
PUBLIC HEALTH SERVICE WORTH
SPENDING MONEY ON.

Steve says SOME OF THIS IS ABOUT
STICKING TO YOUR KNITTING, ISN'T IT?

Robin says I THINK SO.
WE GIVE THEM MONEY TO FUND CORE
PUBLIC HEALTH SERVICE DELIVERY,
WHICH EVERYBODY AGREES IS
IMPORTANT.
AND YOU KNOW, WE'RE GOING TO
FUND THEM 114 MILLION DOLLARS THIS
YEAR, AND REALLY IT'S UP TO THEM
TO CHOOSE WHAT THEY WANT TO DO
WITH THAT SMALL PRESSURE OF 0.24
OF 1 percent OF THEIR BUDGET.
I THINK WE'RE WILLING TO WORK
WITH THEM AS I SAID I
WOULDN'T PRESUME TO ADVISE THEM
BUT I THINK WE COULD LOOK
AT THINGS TOGETHER AND SEE IF
THERE ARE SOME OF THESE PROGRAMS
I'VE MENTIONED A FEW THAT I
THINK ARE MAYBE OUTSIDE OF
WHAT THEY'RE DOING OR THINGS
THAT COULD BE DELIVERED BETTER
AND MORE EFFICIENTLY
AND I THINK THERE'S GOT TO BE
LOTS OF OPPORTUNITIES. THERE'S
A RECENT REPORT OF THE CITY OF
TORONTO'S OWN INDEPENDENT
AUDITOR WHO IDENTIFIED LOTS
OF OTHER WASTEFUL SPENDING AND
THERE HAVE BEEN YEARS OF
IDENTIFICATION OF SPENDING
THAT COULD BE CORRECTED THAT
THEY HAVEN'T DONE.

Steve says ARE NOT URGING THE
CITY TO RAISE TAXES.

Robin says I'M NOT URGING THE CITY TO
RAISE TAXES. I DON'T THINK
IT WILL BE NECESSARY. THIS IS
SUCH A SMALL AMOUNT REALLY AND
AS WE'RE COMMITTED TO OUR 114
MILLION DOLLARS WORTH OF FUNDING
AND WE'RE COMMITTED TO WORK
WITH THEM SO I DON'T SEE THAT
AS THE NECESSARY WAY TO GO.

Robin says RIGHT.
(UNDECIPHERABLE)
A LITTLE GERMAN THERE, OKAY.

Steve says LAST QUESTION HERE,
YOU MADE AN ANNOUNCEMENT
YESTERDAY ABOUT MENTAL HEALTH,
AND YOU KNOW, SOME PEOPLE ARE
GOING TO BE ASKING, HOW DOES IT
MAKE SENSE TO ON THE ONE HAND
PUT FORWARD AN ANNOUNCEMENT OF
MANY MILLIONS OF DOLLARS IN THE
PROMOTION OF BETTER MENTAL
HEALTH AND ON THE OTHER HAND
TAKE AWAY MONEY FROM PUBLIC
HEALTH BUDGETS THAT MIGHT
ACTUALLY BE HELPFUL TOWARDS
BETTER MENTAL HEALTH.

The caption changes to "Mental health awareness week."

Robin says HMM.
WELL, WE HAVE MADE A HISTORIC
COMMITMENT, AS YOU KNOW, TO
MENTAL HEALTH AND ADDICTIONS.
IT'S 3.8 BILLION DOLLARS OVER 10 YEARS,
AND...

Steve says HALF OF WHICH IS FEDERAL.

Robin says HALF OF WHICH IS FEDERAL, AND
HALF OF WHICH COMES FROM US, SO
1.9 BILLION DOLLARS FROM EACH LEVEL OF
GOVERNMENT, AND IT'S IMPORTANT
AS EVERYBODY REALIZES, MENTAL
HEALTH IS HEALTH, AND WE HAVE TO
DO BETTER, SO WE'VE GOT... WE
HAD A GREAT ANNOUNCEMENT, AND
WE'RE... IT'S MENTAL HEALTH
WEEK, SO WE'RE GOING TO BE
ROLLING OUT ANNOUNCEMENTS THIS
WEEK.
AND WE THINK IT'S A VERY
IMPORTANT AREA.
WE ARE INCREASING THE FUNDING
GENERALLY TO HEALTH CARE, AS
I'VE SAID.
WE PUT 1.3 BILLION DOLLARS MORE DOLLARS INTO HEALTH CARE, WHICH INCLUDES
384 MILLION DOLLARS FOR HOSPITALS.
IT INCLUDES 267 MILLION DOLLARS FOR
HOME AND COMMUNITY SERVICES.
AND 174 MILLION DOLLARS FOR MENTAL
HEALTH, WHICH THE MINISTER HAS
ANNOUNCED WILL BE ONGOING
FUNDING, SO IT WON'T CHANGE, SO
THE ORGANIZATIONS THAT RECEIVE
IT CAN RELY ON THAT AND PLAN
WITH IT.
AND SO THIS IS EXACTLY WHAT
WE'RE DOING.
WE'RE TAKING ANY MONEY WE SAVE
AND PUTTING IT BACK INTO HEALTH
CARE AND PUTTING IT INTO THE
PRIORITIES THAT MATTER MOST FOR
PATIENTS.

The caption changes to "Producer: Colin Ellis, @ColinEllis81."

Steve says THAT'S ROBIN MARTIN.
SHE'S THE MPP FOR EGLINTON
LAWRENCE AND THE PARLIAMENTARY
ASSISTANT TO THE MINISTER OF
HEALTH AND LONG TERM CARE, AND
WE'RE GRATEFUL YOU SPARED SOME
TIME FOR US TO COME INTO TVO
TONIGHT.
THANK YOU.

The caption changes to "Subscribe to The Agenda Podcast: tvo.org/theagenda."

Robin says MY PLEASURE.
THANK YOU, STEVE.

Watch: Ontario's Cuts to Public Health