Transcript: Health Care Promises | Apr 11, 2004

The opening sequence rolls.
Music plays as clips of politicians and demonstrations appear on an animated number 4.

A clip shows a gavel banging against a desk, and MPPs voting in the Legislature.

Steve says THIS IS WEEK ON
"FOURTH READING."
THE BATTLE OVER HEALTH CARE.
THE DALTON MCGUINTY LIBERALS
TAKE ON THE HOSPITALS IN AN
ATTEMPT TO CONTROL THE
HEALTH AGENDA.

Steve, Ruth, Richard, and another panelist sit with two guests around a table in the shape of a number 4. A logo on screen reads "4th reading."

Steve is in his early forties, clean-shaven, with short curly brown hair. He's wearing a green suit over a yellow shirt and glasses.

Steve says
HI EVERYBODY I AM
STEVE PAIKIN WELCOME "FOURTH
READING" DALTON MCGUINTY
RODE VICTORY IN LAST
ELECTION PROMISING TO FIX
WHAT ONTARIO SAYS IT THEIR
BIGGEST WORRY OUR HEALTH
CARE SYSTEM.
LIBERALS HAVE UNVEILED THEIR
PLAN TO DO JUST THAT.
A NEW BILL THAT SUPPOSE TO
SHOWCASE THEIR COMMITMENT TO
MEDICARE BUT PREPARED
LEGISLATION HAS THE PARTY
THAT PROMISED AN END TO
CONSERVATIVE ERA OF POLITICS
GETTING INTO A WAR OF ITS
OWN.
THIS WEEK WE WILL ASK
MINISTER OF HEALTH JUST WHY
HE IS TAKE TAKING ON THE
HOSPITALS.

A caption reads "George Smitherman. Minister of Health" as he appears on screen talking to the press. He’s in his mid-forties, bald and clean-shaven and wears a black suit, white shirt and red tie.

George says WE ARE INVOLVED IN A
CHALLENGE OF INTRODUCING
MORE ACCOUNTABILITY TO THE
HEALTH CARE SECTOR.

Steve continues THE COMMITMENT TO
FUTURE OF MED DARE ACT WAS
SUPPOSED OUTLAW HEALTH CARE
DELIVERY IN THE PROVINCE.
BUT INSTEAD IT HAS HOSPITALS
AND UNIONS UP IN ARMS.

Fast clips show images of a hospital.

Steve continues
BILL 8 MAKE IT ILLEGAL
TO PAY FOR FASTER ACCESS TO
MEDICARE.
AND IMPOSE FINES OF 10,000
DOLLARS FOR DOCTORS THAT ALLOW
PATIENTS TO JUMP THE Q.
IT WILL ALSO ESTABLISH
QUALITY CONTROL COUNCIL TO
MONITOR AND REPORT TO
ONTARIO THE STATE OF HEALTH
CARE IN THE PROVINCE.

While a clip shows a group of doctors performing surgery in the back, the screen reads "Bill 8-Hospital Accountability. Performance agreements, 60 days or government can impose agreement, CEOs could face a financial penalty."

Steve continues
BUT THE BILL ALSO CONTAINS
GREATER ACCOUNTABILITY
PROVISIONS FOR ONTARIO'S
HOSPITAL WHICH RECEIVE 1
BILLION DOLLARS IN FUNDING
EVERY YEAR.
UNDER THE BILL HOSPITALS
WOULD BE REQUIRED ENTER INTO
PERFORMANCE AGREEMENTS.
THAT WOULD DETERMINE WHERE
HEALTH CARE DOLLARS ARE
SPENT.
FOR EXAMPLE THE GOVERNMENT
MAY REQUIRE THAT A
PARTICULAR HOSPITAL SPEND
MONEY HIRE MORE NURSES.
OR REDUCE WAIT TIMES.
HOSPITALS HAVE 60 DAYS TO
REACH AN AGREEMENT WITH THE
GOVERNMENT.
IF NO AGREEMENT IS REACHED,
THE MINISTER OF HEALTH WOULD
HAVE THE RIGHT TO IMPOSE AN
AGREEMENT ON A HOSPITAL
BOARD.
AND IF A HOSPITAL FAILS
TO LIVE UP PERFORMANCE
AGREEMENT THE CEO HIM OR
HERSELF COULD FACE FINANCIAL
PENALTY.

The caption changes to "Shelley Martel. NDP Health Critic." She’s in her mid-forties and wears a red suit.

Shelley says
THE BILL GIVES VERY
SWEEPING POWERS TO THE
MINISTER OF HEALTH TO
EFFECTIVELY TAKE OVER
HOSPITAL BOARDS AND REDUCE
COMPENSATION AND SALARY OF
CEOs.
AND YOU KNOW QUEEN'S PARK
DOES NOT NEED TO BE RUNNING
LOCAL HOSPITAL.

Steve continues
THE HOSPITAL ASSOCIATION
SAYS THE COMMUNITY
VOLUNTEERS THE CURRENTLY
MAKE UP HOSPITAL BOARDS
SHOULD DECIDE WHERE THE
MONEY SPENT.
NOT THE GOVERNMENT.

The caption changes to "Hilary Short. Ontario Hospital Association." She’s in her late fifties, with short white her and dresses a black suit over a patterned blouse, and glasses.

Hilary says
TAXPAYERS EXPECT PUBLIC
INSTITUTIONS LIKE HOSPITALS
TO BE ACCOUNTABLE AND WE
CERTAINLY SUPPORT THAT.
OUR ISSUE NOT WITH
ACCOUNTABILITY BUT HOW IT IS
GOING TO BE PUT IN AND THE
NEED PROTECT THE COMMUNITY
VOICE AND HEALTH CARE.
AND MAKE SURE THAT COMMUNITY
DOES HAVE A VOICE IN
DETERMINING WHAT SERVICES
ARE PROVIDED.

Steve says SOME OTHER WORE
RIGHT BILL MAY ALLOW THE
GOVERNMENT TO FORCE CUTS.
RATHER THAN FOR EXAMPLE
DOCTORS SALARIES.
BILLING BY DOCTORS ACCOUNT
FOR 20 PERCENT SPENDING.

The caption changes to "Sid Ryan. CUPE." He’s in his fifties, clean-shaven, with short dark blond hair. He wears glasses, a brown leather jacket and a pale yellow shirt.

Sid says
THE MOST POWERFUL GROUP
TO TAKE ON IN THIS PROVINCE
ARE THE DOCTORS IF YOU ARE
GOING TO TOUCH THE DOCTORS 5
BILLION DOLLAR PLAN WHICH
YOU KNOW POOL OF MOON THAT
HE DISTRIBUTED MONTH DOCTORS
AT THIS PROVINCE THAT'S ONE
HAEFL POLITICAL FIGHT YOU
HAVE GOT ON YOUR HANDS WHO
SELLS LEFT?
THE LOWEST PAID WORKERS THAT
WHO CLEAN THE FLOORS AND
PREPARED THOSE THAT
ARE LOW END OF THE INCOME
SCALE.

Steve says
OPPOSITION WRIT TIBS
STATE GOVERNMENT CAN'T JUST
LOOK TO HOSPITALS TO FIX THE
SYSTEM.

The caption changes to "Elizabeth Witmer. PC Health Critic." She’s in her late forties with short dark brown hair in a bob and wearing a Bordeaux jacket over a black blouse.

Elizabeth says
THERE NEEDS TO BE
ACCOUNTABILITY ON THE PART
OF THE MINISTER AND
MINISTRY.
THAT'S IMPORTANT.
I MEAN, WE NEED TO MAKE SURE
PEOPLE HAVE THE ACCESS TO
THE SERVICES AND THE
PROVIDERS THAT THEY NEED.

Steve continues BUT GEORGE
SMITHERMAN SAYS HE WANTS TO
MAKE SURE THAT THE MONEY
HOSPITALS RECEIVE IS MONEY
WELL SPENT.

George says
FACT OF THE MATTER IS THAT I
WANT TO BE ABLE TO LOOK
ONTARIANS IN THE COPY SAY
THAT IN EXCHANGE AS EXAMPLE
FOR THE 1 BILLION DOLLARS
THAT WE PROVIDE TO ON TAR
GOES A THAT WE CAN OFFER
ONTARIO VERY STRONG
ASSURANCES THAT WE KNOW WHAT
WE WILL GET NEXT CHANGE.

The clip ends, and George sits in the studio with Steve.

Steve says AND AT THE END OF
THE DAY WILL THIS
LEGISLATION ACTUALLY MAKE
OUR HEALTH CARE SYSTEM
BETTER?
WITH HIS VIEWS THERE HE IS.
GEORGE SMITHERMAN.
MINISTER OF HEALTH.
WELCOME BACK.

George says
THANK YOU FOR HAVING ME.

Steve says I WILL CALL YOU
MINISTER.
OUR QUEEN'S PARK ANALYSTS ON
OTHER SIDE OF THE TABLE.
SEAN CONWAY AND JANET ECKER,
AND NDP MINISTER, DAVE COOKE.
YOU HAVE SAID THAT PART OF
THIS BILL IS ABOUT MAKING
THE PLAYERS IN THE HEALTH
CARE SYSTEM MORE ACCOUNTABLE
AND I LIKE YOU TO START BY
GIVING US EXAMPLE OF HOW FOR
EXAMPLE HOSPITAL IS NOW NOT
ACCOUNTABLE BUT WOULD BE IF
THE CHANGES YOU WANT COME
IN.

George says SURE.
WELL I THINK FIRSTLY WHERE
DOES THE WORD ACCOUNTABILITY
COME FROM.
I THINK PEOPLE SHOULD LOOK
BACK.
ONE OF THE KEY
RECOMMENDATION OF THE REPORT
WAS THAT WE NEEDED TO BRING
USHER IN A NEW YEAR OF
ACCOUNTABILITY.
SO THIS BUILDS ON THAT
THAT'S THE REASON OF IT.
ONTARIO THE GOVERNMENT OF
ATTORNEY JOE PROVIDES AROUND
11 BILLION DOLLARS A YEAR TO
THE HOSPITALS.
BUT IT IS NOT ON OBLIGATED
DELIVERY SO IN OTHER
WORDS, IF WE ARE TRYING TO
AFFECT CHANGE ON A
PARTICULAR WAIT TIME HIP AND
KNEE THE LIKE WE WANT TO
MOVE AN ENVIRONMENT WHERE WE
SAY IN EXCHANGE FOR THESE
PRECIOUS MILLIONS OF DOLLARS
FOR THIS
SERVICE WE EXPECT THIS
NUMBER OF THEM TO BE DONE.
AND TO HOLD PEOPLE
ACCOUNTABLE FOR THAT.
I THINK ACCOUNTABILITY
AGREEMENT JUST FANCY
LANGUAGE FOR SAYING,
CONTRACTS.

Steve says HERE'S WHAT WE
WANT FOR THE MONEY YOU GET?

George says YES.
AND IN THE SAME WAY, PEOPLE
ARE INVOLVED IN THOSE KINDS
OBLIGATIONS EVERY SINGLE DAY
IN THEIR NORMAL LIVES.
WHY DOES IT -- WHY IS IT
SUCH A STRANGE IDEA?
THAT WE WOULD BEGIN TO
OPERATE THAT WAY WITH
RESPECT TO 11 BILLION DOLLAR
PROFIT OUR HEALTH CARE
SECTOR.
WE HAVE MADE THIS SEEM ALL
ABOUT HOSPITALS THE REALITY
ACCOUNTABILITY AGREEMENT
THAT WE ARE SPEAKING OF
THERE 154 HOSPITAL
CORPORATION IN PROVINCE WE
ARE TALKING ABOUT 1,000
DIFFERENT PLAYERS IN THE
HEALTH CARE SECTOR SIGNING
AND ACCOUNTABILITY AGREEMENT
IF AND HOSPITALS ARE ONLY
GROUP THAT'S ACTUALLY TAKEN
PUBLIC POSITION AGAINST IT.

Steve says
I WANT TO STAY WITH THE
HOSPITAL THRZ HAS BEEN A
TRADITION OF HOSPITALS BEING
SOMEWHAT IN HOW THEY RUN
THEIR AFFAIRS WHAT THEY DO
WITH NOT NOON -- MONEY.
DOES THIS THREAT THEN?

George says
I THINK THAT WHAT -- HERE
WHAT I ENCOUNTER I COME TO
MINISTER OF HEALTH AND WHAT
I HAVE TAKEN TO SIGNIFICANT
THAT THE MORE I LOOK FOR
HEALTH CARE SYSTEM THE LESS
AFTER SYSTEM I SEAR.
WE VP FIND BALANCE BETWEEN
LOCAL AND PEOPLE THE
CAPACITY TO ACTUALLY HAVE A
HEALTH CARE SYSTEM.

Steve says HAVE WE NOT HAD
IT?

George says
ONE OF THE REALITIES WE
HAVE INVOLVED IN VERY
SIGNIFICANT CHANGE AROUND
THE IDEA THAT EVERY HOSPITAL
WOULD PROVIDE ALL RANGE OF
SERVICES.
WE ARE LOOK FOG FOCUS
SERVICES BECAUSE WE KNOW
THAT IF YOU DO MORE SERVICES
IN ONE PLACE YOU GET A
BETTER CLINICAL OUTCOME
PEOPLE HAVE A BETTER RESULT
AND IT IS LESS EXPENSIVE.
YOU KNOW THERE ARE VOLUNTEER
MEMBERS OF BOARDS ON THIS
PANEL AND NOT ONE OF THE
HOSPITAL THAT JANET ECKER
SERVES ON IS INVOLVED IN THE
TOUGH WORK THAT IS WITH THAT
BECAUSE THEY ARE OPERATING
ON MORE THAN ONE SITE.
HE THINK THAT THE PEOPLE OF
ATTORNEY JOE I THINK WOULD
BE ASTONISHED IF THEY WERE
IN MY POSITION TO SEE HOW
LITTLE AFTER SYSTEM EXISTS
AT THE END OF DAY I WOULD
MAKE ONE MORE POINT.
I DON'T KNOW WHY ANY ONE
WOULD THINK THAT HOSPITALS
ARE GOING TO GET LESS MONEY.
AT THE THEY NEVER HAVE.
EXCEPT MAYBE A YEAR OR TWO
OF THE TIME THAT JANET ECKER
PARTY WAS --.

Steve says I DON'T THINK IT
IS ABOUT MONEY.
BUT ABOUT THE WRITE TO SAY
WHAT HAPPENS.

George continues
BUT ARGUMENT THAT HAS
BEEN OFFERED THERE
COULD BE SOME YOU KNOW
REDUCTION IN AMOUNT MONEY
HOSPITAL HAS TO OPERATE.
AND ALL WE PREDICT REALLY IS
THAT HOSPITALS WILL CONTINUE
TO GROW.
AND IN TERMS AMOUNT OF
RESOURCES THAT THEY HAVE.
BECAUSE THEY ARE DOING SUCH
AN IMPORTANT JOB.

Steve says AS PEOPLE TRY TO
FIGURE OUT WHO REALLY HAS
THEIR BEST INTERESTS AT
HEART HERE, WHO DO YOU THINK
THE PUBLIC TRUSTS MORE TO
DELIVER THE HEALTH CARE
NEEDS THAT THEY SEE?
THE MINISTRY OR MINISTER OF
HEALTH OR THE LOCAL HOSPITAL
BOARD?

George says
WELL AT THE END OF THE
DAY, THE MATH TESTIFY TRUST
SOMETHING YOU ASKED ME A
QUESTION I PLAN TO -- TELL
STRAIGHT TO THE PEOPLE OF
PROVINCE THAT THEY SHOULD
HAVE TRUST AND CONFIDENCE IN
THEIR GOVERNMENT AT THE END
DAY OF THE I AM ELECTED A
PART AFTER GOVERNMENT THAT
RAN ON COMMITMENT TO ENHANCE
QUALITY OF PUBLIC SERVICES
IN ONTARIO.
AND HEALTH CARE OBVIOUSLY IS
FIRST AND FOREMOST IN THE
PUBLIC'S MIND.
AND WE INTEND TO DO THAT.

Steve says OKAY.

George continues
AND DO DEMONSTRATE THAT
WE ARE INVOLVED
TRANSFORMATION OF OUR HEALTH
CARE SYSTEM TOWARDS ONE
THAT'S BETTER ABLE TO MEET
THE NEEDS OF THE PEOPLE.

Steve says YOU POINTED OUT
BOTH JANET ECKER AND SEAN
CONWAY SERVE AS VOLUNTEERS.
AND IN FACT BRING SOME ADDED
EXPERTISE TO THIS ISSUE.
WHAT DON'T YOU LIKE ABOUT
WHAT THE GOVERNMENT IS UP TO
HERE?

The caption changes to "Janet Ecker. Former PC Cabinet Minister." She’s in her fifties. She has short dark brown hair and wears glasses, a black blazer and a red striped blouse.

Janet says WELL, FIRST OF ALL,
WHAT'S INTERESTING IS HERE
THAT WHEN THE PREVIOUS
GOVERNMENT MAKE A
PARTISAN COMMENT HERE.
I GOT TO MAKE A COMMENT
HERE.
BECAUSE WHEN PREVIOUS
ACCOUNTABILITY MEASURES
THERE WITH A GREAT DEAL OF
CRITICISM FROM OPPOSITION
PARTY OF THE DAY.
I THINK AND WE ALL AGREE I
THINK NOW, WE CERTAINLY SAY
ACCOUNTABILITY IS GOOD
THING.
BUT, LET ME ASK YOU
MINISTER HOW CAN YOU HOLD
HOSPITALS ACCOUNTABLE FOR
SERVICES AND AS YOU SAY
WAITING LINES YOU KNOW
REDUCING WAITING LINES WHICH
IS GOOD LINE TO TRY AND GO
BUT WILL WOULD YOU BE
PREPARED TO PUT THE
GOVERNMENT ON THE LINE BE
ACCOUNTABLE AS WELL IN TERMS
OF FUNDING?
BECAUSE AS YOU KNOW ONE OF
THE BIGGEST CHALLENGES HAS
BEEN THEY HAVE NOT BEEN ABLE
TO KNOW FROM YEAR TO YEAR
WHAT THEIR FUNDING GOING TO
BE THEY CAN'T PLAN.
THEY ALWAYS COME IN THE
MIDDLE OF THE YEAR IF YOU
ARE GOING TO EXPECT
ACCOUNTABILITY FROM THEM ARE
YOU GOING TO GIVE THEM MULTI
YEAR FUNDING FRAMEWORK THAT.

George says YES.

Steve says YES.
HOW QUESTION YOU ANSWER
THAT?

George says
WELL I HAVE ANSWERED IT.
I HAVE SAID IT HUNDRED TIMES
SINCE I HAVE BEEN MINISTER.
THIS IS PROMISE THAT WE HAVE
RAN ON.
AND ONTARIO HOSPITAL
ASSOCIATION WELL KNOWS THIS.
WE ARE ENTERING NEW ERA.
SHOULD WE BE PREPARED TO
HELD ACCOUNTABLE IN
RESPONSE?
I SAY YES ABSOLUTELY.
FIRSTLY THE AGREEMENTS ARE
LAY OUT WHAT EXPECTATIONS
ARE ON GOVERNMENT AS WELL.
THIS IS NOT ONE-SIDE THING
SECONDLY WE ARE GOING
ESTABLISH IN THIS BILL THE
ONTARIO HEALTH QUALITY
COUNCIL WHICH WILL GIVE
ONTARIO -- WE WOULD ALL
AGREE THERE IS LOT OF NOISE
AND INFORMATION ABOUT HEALTH
CARE AND IT IS REALLY
COMPLEX AND HARD TO FIGURE
OUT AND THE NUMBERS ARE
ALWAYS BIG.
AND IT IS VERY EMOTIONAL
ENDEAVOR.
WE WILL PROVIDE ONTARIO
THROUGH ONTARIO HEALTH
QUALITY COUNCIL WHICH WILL
BE REPRESENTATIVES OF VERY
HIGH ESTEEM FROM ALL AROUND.
PEOPLE WHO NOT LIBERAL BUT
PEOPLE THAT ARE THERE TO
PROVIDED ONTARIO WITH ADDED
GLANCE ONCE A YEAR ON A WIDE
VARIETY OF INDICATORS THAT
TELLS US HOW WE ARE PE
PERFORMING.
I THINK THAT'S REALLY
ESSENTIAL REFORM.

Janet says
WHY DO YOU NEED THAT KIND
OF AUTHORITY TO ACTUALLY...
I MEAN WHAT LOT OF HOSPITALS
WERE PREPARED TO DO WITH
MINISTRY ANY WAY.
SOME OF THAT STARTED.
WHY DO YOU NEED AUTHORITY BY
PASSES BOARDS, AND CAN STEP
INTO THE CEO THE CONTRACTUAL
RELATIONSHIP BOARD
AND THE HOSPITAL AND THE
EMPLOYEES BECAUSE THAT GOES
AGAINST THE GOVERNANCE
MECHANISMS THAT PEOPLE
RECOMMEND NOW.
WHY DO YOU NEED THAT KIND OF
CONTROL?
BECAUSE YOU HAVE ALREADY GOT
ACCOUNTABILITY OUT THERE.

George says A COUPLE OF POINTS.
IF I COULD FIRSTLY, I THINK
YOU AND I BOTH WELL KNOW
THAT WAY THAT BILL IS
INTRODUCED -- YOU
DON'T BYPASS BOARD YOU GO
THROUGH THE BOARD AND ONLY
TIME MINISTER COULD EVER
SANCTIONS THE CEO OF A
HOSPITAL IS WITH THE APPROVE
1-2 CABINET AND ONLY IF THE
BOARD HAS FAILED TO DO SO.
IT IS ALL FLOWS THROUGH THE
BOARD AND THAT'S OBVIOUSLY
VERY, VERY.

Janet says
THAT'S NOT WHAT IT SAYS.
YES DOES.
IT ABSOLUTELY DOES.

Steve says WHAT HOSPITAL DO
YOU VOLUNTEER?

The caption changes to "Sean Conway. Former Liberal Cabinet Minister." He’s in his fifties. He has short dark blond hair in a neat cut and is clean-shaven. He wears glasses, a dark grey suit, white shirt and a contrasting tie.

Sean says
I AM BOARD MEMBER OTTAWA
HEART INSTITUTE.

Steve says DO YOU LIKE WHAT YOUR
FORMER PARTY IS DOING HERE?

Sean says
WELL, LISTEN, I THINK
MINISTER QUITE RIGHT NO LESS
A PERSON THAN ROY HAS
ADVICED AND IN SENSE SENATOR
KIRBY DID AS WELL IN HIS
IMPORTANT REPORT OF COUPLE
YEARS AGO THAT IF THERE IS
ADDITIONAL MONEY TO BE PUT
INTO HEALTH CARE SYSTEM IT
HAS GOT -- I THINK THE
PHRASE WAS BE USED TO BUY
TRANSFORMING CHANGE.
YOU CANNOT KEEP PUTTING
MONEY INTO SAME OLD PLACES
AND EXPECT THAT NEW HEALTH
CARE DELIVERY METHODS ARE
GOING TAKE ROOT.
BUT MY QUESTION TO THE
MINISTER MIGHT IF IMPATIENT
IN OTTAWA WHAT I WOULD WANT
MY MINISTER TO TELL ME IS
WHAT KIND OF EVIDENCE IS
THERE REALLY THAT HOSPITALS
GENERALLY ARE NOT KIND OF
DELIVERING THE SERVICES THAT
WE MIGHT EXPECT THEM TO
DELIVER FOR THE MONIES WE
HAVE GIVEN THEM?

George says
WELL FIRSTLY IT IS NOT
HOSPITAL SPECIFIC
INITIATIVE.
THIS SOMETHING THAT I SAID
IS GOING TO AFFECT 1,000
DIFFERENT PROVIDERS.
IT IS WAY WE ARE GOING IN
HEALTH CARE.
IS THERE MORE TRANSPARENCY
EVERY DAY AND MORE
ACCOUNTABILITY.
IT IS AFFECTING ALL IN
MANNER OF WORK.
THE OTHER POINT THAT I MAKE.
YOU ARE TALKING ABOUT OTTAWA
CONTEXT.
WELL TAKE A LOOK AT THE
OTTAWA HOSPITAL.
THE REFERENCE IN THE TAPE TO
THE MINISTER GETTING THESE
GREAT EXPANSION OF POWERS.
UNDER THE PREVIOUS GOVERNMENT,
7 TIMES, SINCE 2000, THE
GOVERNMENT REACHED IN AND IN
SOME CASES SWEPT OUT BOTH
BOARDS AND THE CEO AND TOOK
THEM OVER ENTIRELY.
AND THIS IS --.

Janet says WHY DO YOU NEED MORE
AUTHORITY.

George continues
I VIEW THAT AS USE -- AS
NUCLEAR WEAPONRY.
AND THAT I THINK WHAT'S MORE
APROPOSE SPRITE TO HAVE
SERIES OF CHECKS BALANCES
POWERS KAEUL CALL THEM THAT
ALLOWS US MORE NEGOTIATING
CAPACITY TO ACHIEVE THE
RESULTS THAT ONTARIO EXPECT.

Sean says
I WANT TO COME BACK TO THAT
PART.
WE ARE ALL EITHER PRESENT OR
PAST POLITICIANS.
BUT, IF I AM A PATIENT
LISTENING TO THIS DEBATE AND
I AM LIVING IN NIAGARA FALLS
OR THUNDER BAY, AND THIS IS
GOING TO BE REAL FOR ME
BECAUSE IT IS GOING TO BE
ABOUT MY COMMUNITY HOSPITAL,
WHAT WOULD YOU SAY THE
PATIENTS WHO ARE GOING TO BE
PAYING A LOT OF ATTENTION
AND MAYBE GETTING THE
IMPRESSION THAT THIS SOMEHOW
ATTACK ON COMMUNITY
VOLUNTEER AND THE WAY IN
WHICH THEY ORGANIZE AND
MANAGE THE COMMUNITY
HOSPITAL.
IS THERE GOOD EVIDENCE THAT
THE LONDON HOSPITAL OR THE
HOSPITALS IN YOUR AREA ARE
SOMEHOW NOT ACTUALLY PUTTING
THE MONEY TO PURPOSES
INTENDED?

George says
WELL I AM NOT REALLY HERE
TO MAKE THOUGH SUGGESTS IN
CERTAIN CASES OF COURSE THE
PREVIOUS GOVERNMENT BY ITS
ACTIONS FELT THAT WAS THE
CASE.
I THINK A LOT OF PEOPLE
WOULD BE SURPRISED THEIR
HOSPITALS ARE REALLY OPEN TO
COMMUNITY INFLUENCE IN THE
SENSE THAT YOU CAN ACTUALLY
GO IN THERE AND INFLUENCE
THE BOARD MEMBERS
AND THE LIKE.
BUT THEY -- THEY OPERATE
WITH DIFFERENT LEVELS
TRANSPARENCY AND COMMUNITY
ENGAGEMENT AND IN VERY FIRST
SPEECH THAT I GAVE TO
ONTARIO I SAID TWO THINGS.
ONE I BELIEVE IN VOLUNTEER
AND THERE IS LOT OF FEAR IN
HEALTH CARE SYSTEM AND AMONG
HOSPITALS ABOUT
REGIONALIZATION WHICH HAS
BEEN DONE IN OTHER PLACES.
I HAVE CLEARLY SAID AND
THAT'S NOT OUR GAME PLAN AND
THAT'S A FIGHT THAT I AM NOT
INTERESTED IN.
IF FACT I WILL FIGHT FOR GO
OFF RANS BECAUSE I THINK IT
IS CRITICALLY IMPORTANT.

Steve says CAN I ASK YOU
ABOUT SOMETHING DISH KNOW
YOU HAD A SECOND THING.
ONE OF THE THINGS THAT IS
THE GREAT UNTOLD STORY
ANYWAY HOSPITALS ARE FUNDED
OR HAD A THEY DO WITH THEIR
MONEY AND WE ARE TOLD THIS
ANECDOTALLY AND YOU CAN MEET
ON THIS.
HOSPITALS POACH DOCTORS FROM
OTHER HOSPITALS THEY GIVE
UNDER THE TABLE MONEY TO
DOCTORS THAT ARE NOT
IDENTIFIED IN THEIR BUDGETS
OR MAYBE IT IS IN
MISCELLANEOUS CATEGORY IN OR
THE TO GET DOCTOR A TO COME
FROM HOSPITAL B AND SERVE AT
HOSPITAL C.
IS PART OF THIS BILL GOING
TO TACKLE THAT?

George says
WELL I THINK WHAT BILL
BEGINS TO DO IS CLARIFIES
THE ROLE OF PAYMENTS AND
EXTRA PAYMENT IN THE
HOSPITAL AND HOSPITAL
ENVIRONMENT.
THERE IS ALWAYS THIS
CHALLENGE NOT JUST FROM
HOSPITAL TO HOSPITAL BUT TO
THE COMMUNITY SECTOR ALSO
VERY OFTEN INVOLVED IN
BATTLE THEY CAN'T WIN
BECAUSE HOSPITALS HAVE
TENDED TO BE BERM RESOURCE
IN.

Steve says THIS WILL NOT CHANGE
THAT?
THIS WILL ALLOW IT?

George says
WELL, WHAT THIS BILL...
WELL IN PART MEASURE BECAUSE
WHAT YOU HAVE GOT IN THE
PROVINCE OF ONTARIO RIGHT
NOW AS A RESULT OF EXAMPLE
OF NOT HAVING ENOUGH DOCTORS
PROVIDING FAMILY CARE AT THE
COMMUNITY LEVEL IS THAT LOT
OF PEOPLE HAVE SHOWING UP IN
OUR HOSPITALS WITHOUT A
DOCTOR.
AND ON CONTINUING CARE BASIS,
SOME HOSPITALS ARE HIRING
DOCTORS ARE BROUGHT PRIMARY
CAROL INSIDE WE COULDN'T
WIPE OUT ROLE OF THE
HOSPITALIST.
OR THE EMERGENCY ROOM DOCTOR
WHO DOES ONLY THAT.
BAUMAN KNEE OF THE HOSPITALS
AROUND ONTARIO I THINK AFTER
PLACE LIKE THE HEALTH
CORPORATION IN BELLVILLE
THEY ONLY SURVIVE BECAUSE
THEY ARE ABLE TO MAKE THOSE
KINDS OF ARRANGEMENTS.

The caption changes to "Dave Cooke. Former NDP Cabinet Minister." He’s in his mid-forties. He has short dark hair in a neat cut and is clean-shaven. He wears a black suit and a light blue shirt.

Dave says
WELL I AM INTERESTED IN
MINISTER COMMITMENT TO
COMMUNITY BOARDS LOCAL
BOARDS.
WHICH I UNDERSTAND THE
POLITICS THAT WITH WE HAVE
TO ESPECIALLY WITH TWO OF MY
COLLEAGUES THAT ARE ON LOCAL
BOARDS.
BUT I GUESS I HAVE A US HAD
A REAL QUESTION ABOUT HOW
CONNECTED THEY ARE TO THE
COMMUNITY.
THERE IS VERY FEW PEOPLE IN
MY HOME TOWN OF WINDSOR,
THAT WOULD KNOW IS ON THE
TWO HOSPITAL BOARDS WE HAVE
AND WHAT THE CONNECTION IS.
WHEN I READ THROUGH SOME OF
THE MATERIAL THAT ONTARIO
HOSPITAL ASSOCIATION HAS PUT
OUT IN REACTION TO THIS BILL
I REALLY WONDER WHETHER WE
SHOULD NOT HAVE A GENERAL
DISCUSSION ABOUT THE
GOVERNANCE EVER OUR HOSPITAL
SYSTEM AND WHETHER WE SHOULD
PUT THIS UP FOR DISCUSSION
ABOUT WHETHER THERE YOU ARE
TRYING TO BRING IN
ACCOUNTABILITY AND THERE IS
A LOT OF WHAT I SEE IN YOUR
WILL AND THE PRINCIPALS THAT
I HAVE TO AGREE WITH.
I THINK YOU MIGHT BE MOVING
IN RIGHT DIRECTION.
AND I AM NOT SURE WHETHER
YOU GOT CART BEFORE THE
HORSE.
BUT I THINK WE HAVE GOT TO
MAYBE COME TO GRIPS WITH
WHETHER LOCAL HOSPITAL
BOARDS ARE TRANSPARENT AND
WHETHER THERE IS THAT LOCAL
COMMUNITY CONNECTION.

Steve says
THERE IS IS A COMPLIMENT
FROM HIM.
HERE IS LIBERAL MPP WHO YOU
USED TO SIT WITH.

George says WELL THIS SOUTH OF DATE.

Steve continues
DID HE SAY BILL EIGHT IS
NOT PRODUCT OF -- WHAT'S THE
DATE? WELL TELL ME WHAT WAS THE
DATE?

George says THIS IS -- IS HERE THE
THING.
BILL 8 HAS GONE THROUGH VERY
SIGNIFICANT EVOLUTION AND I
BROUGHT IN SERIES OF
AMENDMENTS THAT HAVE I THINK
EVERYBODY HAS ACKNOWLEDGED,
HAS DRAMATICALLY NARROWED
THAT ARE OUT THERE.
AND WITH RESPECT TO THE I
HAVE GONE SOME GREAT
DISTANCE AND WE HAVE HAD A
CHANCE TO TALK ABOUT THAT.
ON DAVE COOKE'S POINT.
THIS HAS BEEN CHARACTERIZED
AS WAR.
I MIND -- I KNOW THIS IS
SERIOUS ISSUE.
I FIND THAT FUNNY BECAUSE WE
HAVE MADE A LOT OF PROGRESS
IN OUR RELATIONSHIP.
AND THERE IS LOTS OF
ACKNOWLEDGMENT OF THAT AND I
THINK YOUR HOSPITAL CEO
WOULD ACKNOWLEDGE THAT I
HAVE STRUCK A VERY GOOD
CORD.
I STRUCK A VERY GOOD CORD
WITH HIM.
I THINK THAT WHAT WE ARE
WORKING WITH ONTARIO
HOSPITAL ASSOCIATION IS
ACTUALLY IN SPONSORING SOME
OF THEIR MOVE TOWARDS
CHARGING IN GOVERNANCE MODELS
AND BETTER TRUSTEE TRAIN
SEWING TRUSTEES ARE MORE
AWARE OF THEIR ROLE.

Dave says
I MEAN YOU HAVE MADE SOME
AMENDMENTS.
AND I SEE THAT.
AND SOME OF IT YOU HAVE
TAKEN OUT SOME OF THE
OFFENSIVE SECTIONS TO
PHYSICIANS FOR EXAMPLE.
AND I GUESS I KIND OF WONDER
HOW ARE YOU GOING TO BE ABLE
TO COPE WITH WHAT COULD BE
FRO TWO-FRONT WAR.
ONE ABOUT THE DOCTORS AND
NEGOTIATION AND THE REFORM
THAT HAVE TO BE MADE AT THE
NEGOTIATING TABLE WHICH I AM
STILL NOT SURE WHAT YOU ARE
TRYING TO ACHIEVE IF YOU ARE
GOING TO BE ABLE TO ACHIEVE
ANYTHING.
ALSO, TRYING TO REFORM TO
SOME EXTENT THE INSTITUTIONAL
SIDE.
HOW CAN YOU BRING THOSE TWO
TOGETHER?
WOULDN'T IT HAVE BEEN BETTER
TO FOCUS ON SOME REFORMS AND
PRIMARY CARE AND GET THAT
DONE.

George says WELL, YOU KNOW THE
REALITY OF THE SITUATION IN
HEALTH CARE IS THAT THEY ARE
COMPLIMENTARY PIECES.
PRETEND COULD YOU DO ONE AND
NOT THE OTHER KIND OF ONE
OFFS PASSES --.
WE ARE -- I WILL TELL
YOU.
WE ARE MAKE TERRIFIC PROCESS
ON PRIMARY CARE.
DOCTOR LARRY AND I -- WE
AGREED RIGHT FROM THE
GET-GAP THAT NUMBER ONE
PRIORITY FOR BOTH THE
GOVERNMENT AND THE ONTARIO
MEDICAL ASSOCIATION IN THESE
AGREEMENTS IS TO ENHANCE THE
RIGHT ABILITY OF FAMILY.

Dave says WHAT'S THE GOAL?

George continues
TO ENHANCE THE VIABILITY
OF FAMILY PRACTICE.
TO ENSURE THAT COMPREHENSIVE...
THAT COMPREHENSIVE FAMILY
PRACTITIONER IS PROPERLY
REWARDED TO GET PEOPLE AT
RESIDENTS THAT ARE MAKE
DECISIONS NOW ABOUT WHERE
THEY WANT TO PRACTICE TO
ENCOURAGE THEM TO SET UP
PRACTICE.
AND WHAT WE ARE LOOKING AT
NOT BEING OVERLY.
WE ARE TRYING TO GET PEOPLE
INTO PRACTICING IN TEAM
ENVIRONMENT AND WE WILL
OFFER DIFFERENT SOLUTION.
AND I WOULD JUST SAY...
THAT'S WHAT EVERY GOVERNMENT
SAYS.

Dave says WELL, NO.
IT IS NOT TRUE.

George says
I WOULD SAY AND I HAVE BEEN
VERY CLEAR SAY THIS.
IN TO GIVE CREDIT PREVIOUS
GOVERNMENT THERE IS MOMENTUM
ON THIS FILE.
3.5 MILLION ONTARIANS ARE
NOW RECEIVING THEIR HEALTH
CARE COVER FROM PRIORITY
CARE PHYSICIAN WHO IS
ROSTERED THEM WHICH MEANS
THEY HAVE ACCESSIBILITY TO
CARE EVEN IF FAMILY
PRACTICER IN NOT AVAILABLE.
THE PREVIOUS GOD MADE
PROGRESS.
THE MISTAKE THEY MADE THEY
SIT OUT VERY, VERY HIGH
NUMBER IN VERY SHORT TIME TO
ACHIEVE IT AND MEASURED
AGAINST THAT THEY SEEM
LIKE --.

Steve says HOSPITAL DEFICITS
FOR MINUTE.
EVERY PREMIER OR MINISTER OF
HEALTH HAS COME FORWARD AND
SAID WE ARE NOT PICKING UP
THE DEAF HOSPITAL.
AND EVERY YEAR RPS THEY DO
IT.
NOW YOU JUST WROTE THEM A
CHECK FOR 358 MILLION
DOLLARS.
I KNOW 50 MILLION FOR
NURSES.
AND YOU ALSO SAID WE ARE
NEVER GOING TO DO THIS AGAIN.
IS HERE THE BIG
DIFFERENCE.

George says
THIS IS ONE OF THOSE ONES
WHERE THIS IS CHALLENGE THIS
IS A CHALLENGE TO ME AND TO
OUR GOVERNMENT.
BUT THERE IS A DIFFERENT
THIS TIME.
THERE IS A REASON IN PART
MEASURE THAT HOSPITALS WERE
ABLE TO USE FOR HAVING
PROBLEMS WITH ANY DEFICIT
OBVIOUSLY SERVICE AND
DEMANDS HUGE PIECE OF IT.
WE WILL ACKNOWLEDGE
PRESSURES THEY ARE UNDER.
BUT IT IS WHAT JANET WAS
REFERRING TO EARLIER WHICH
IS THAT IT IS OFTEN TAKEN
THE GOVERNMENT A LONG, LONG
TIME TO TELL A HOSPITAL WHAT
THEY HAD TO OPERATE WITH AND
YEAR THIS IS WHY THE COMMIT
KNOWN THE STABLE AND
PREDICTABLE FUNDING SO
CRITICAL SO PEOPLE CAN START
TO PLAN BECAUSE WE ARE
ASKING PEOPLE WHO RUN HOSPITALS
VERY COMPLEX ENVIRONMENTS WE
ARE ASKING THEM TO OPERATE
WITHOUT PROPER KNOWLEDGE OF
WHAT DOLLARS ARE.
AND THAT'S PART OF THE
OBLIGATION AND
ACCOUNTABILITY THAT COMES
UPON ME AS MINISTER OF
HEALTH AND SOMETHING I AM
INTENT DEAN LEVERING ON.

Steve says DOES IT BOTHER YOU
THAT CEOS MAKE ABOUT 4, 5, 6 HUNDRED
THOUSAND DOLLARS A YEAR--

George giggles and says NO, I
AM MINISTER OF HEALTH I AM
USED TO BE MEETINGS WHERE
EVERYBODY ELSE MAKES MORE
MEAN THAN ME.

Sean says
ISN'T PART OF THE STORY HERE
AND STEVE IS RIGHT THAT OVER
THE DECADES, ALL GOVERNMENTS
ESSENTIALLY BAIL OUT THE
HOSPITALS IN PART BECAUSE,
NO GOVERNMENT OF POLITICIANS
IS ABLE TO WITHSTAND THE
POLITICAL PRESSURE THAT
COMMUNITY HOSPITALS END TO
BRING TO THE EQUATION.
BUT HERE IS THE DIFFERENCE.
ARE YOU CONFIDENT THAT IN
THIS TUSSLE NOW BETWEEN --.

George says THERE IS NEW GAME IN
TOWN.
IT CAN'T WORK THAT WAY ANY
LONGER BECAUSE IT HAS BEEN
INEFFECTIVE AND EVERYBODY
HAS GOT RECOGNIZE ONE POINT
IN LAST FIVE YEARS SOME OF
WHICH WHEN JANET ECKER WAS
MINISTER OF FINANCE IN THIS
PROVINCE HOSPITALS RECEIVED
ON AVERAGE 10 PERCENT INCREASES.
THE COMMUNITY SECTOR
COMMUNITY MENTAL HEALTH
SERVICES HAVE SEEN 1 PERCENT
INCREASE I LIKE TO SAY SINCE
BEFORE BOB RAY'S HAIR TURNED
WHITE THEY HAVE SEEN SEEN
NOTHING SINCE 1992-1993.
WHAT WE ARE SAYING WE HAVE A
RESPONSIBILITY TO OFFER YOU
STABLE AND PREDICTABLE
FUNDING.
RATES THAT ARE LOW IN GROWTH
THAN WHAT YOU HAVE SEEN SO FAR
AND WE WILL MAKE THOSE
INVESTMENTS IN COMPLEMENTARY
COMMUNITY-BASED SERVICES TO
TAKE PRESSURE OFF HOSPITALS
THAT STEMS FROM THE FACT
THAT THEY ARE BEING ASKED TO
DO.

Janet says ARE YOU GOING TO BE USING
THE AUTHORITY IN IN BILL TO
FORCE THE HOSPITAL TO
BALANCE THEIR BUDGETS THE
FIRST QUESTION AND SECONDLY
HOW DOES BILL-8 IMPROVE
ACCESSIBILITY?

George says FIRSTLY ON
ISSUE OF BALANCING THEIR
BUDGETS THE FACT OF THE
MATTER WE WILL HAVE A
ACCOUNTABILITY AGREEMENT
WHICH LAY OUT WHAT WE
ROVERING AND WHAT WE EXPECT
IN RETURN I HAVE MADE VERY,
VERY CLEAR TO HOSPITALS AND
I MEAN IT THAT THEIR ON
BRING TO OPERATE
WITHIN WHAT THEY ARE
PROVIDED WE ARE NOT BAILING
THEM OUT ANYMORE AND THAT.

Janet says HOW WILL YOU DEAL WITH
THAT?
WHAT DO YOU DO WITH THAT
HOSPITAL -- YOU MENTIONED
POINT ABOUT A HOSPITAL
PEOPLE COME IN THE DOOR.
OR SOMETHING LIKE SARS OR
SOMETHING.
I MEAN SARS OR SOMETHING
LIKE THAT HAPPENS IN
COMMUNITY WHERE THE HOSPITAL
IS SUDDENLY IN DEFICIT.
HOW ARE YOU GOING TO DEAL
WITH THAT?

George says
IT IS NICE TO DRAG SARS
OUT AS AN EXPLANATION.

Janet says LET'S JUST SAY THAT THERE
SOMETHING THAT HAPPENS.

Steve says LET'S SAY FLU
SEASON.

Dave says IT SAYS THAT
ADMINISTRATION CEO AFTER
HOSPITAL HAS NO OPTION BUT
TO PAY FOR THOSE SERVICES
AND CHOICE MADE BY THE
DOCTOR NOT BY THE CEO.

George says BUT LISTEN TO EACH OF
WHAT YOU ALL FORMER
POLITICIANS IS INVOLVED IN.
YOU ARE INVOLVED IN IN
ARGUMENT THAT SUGGESTS IN
EXCHANGE FOR 11 BILLION
DOLLARS MANY OF THE OF THE
PEOPLE OF THE PROVINCE OF
ONTARIO.
THAT HOSPITALS THEY ARE SO
CRITICAL IN ESSENTIAL THEY
SHOULD BE ABLE TO OPERATE ON
A ANNUAL BASIS AND AT THE
END OF THE YEAR SEND CHECK
FOR THE -- SEND INVOICE FOR
COSTS OVERRUN AND GET A
CHECK. MY ONLY POINT IS
WHAT WE ARE ASKING THEM TO
CHALLENGING BUT WE ARE GOING
TO DO OUR PART STABLE AND
PREDICTABLE FUNDING AND
INVESTMENT IN COMMUNITY
SECTOR TO TAKE PRESSURE OFF
SO THAT EMERGENCY WARD IS
NOT PLACE WHERE ALL SERVICES
ARE PROVIDED.
WHERE IT IS NOT THAT 24-7
OUTLET WHERE EVERYBODY GOES
FOR HEALTH CARE WE HAVE MAKE
IT AVAILABLE TO COMMUNITY
LEVEL IF WE FAIL TO DO THAT.

Steve says I CAN'T GET IN THERE, HE
IS GOOD.
THAT'S GOT TO BE LAST WORD.
WE DO HAVE ONE MORE THING.
GEORGE SMITHERMAN THANK YOU
FOR VISITING US HERE.
APPRECIATE YOU HAVING HERE
AND WE HAVE GOT ONE MORE
ITEM BEFORE WE LEAVE YOU
TODAY.
THERE WAS AMUSING AND MOMENT
QUEEN'S PARK THIS WEEK NORM
MILLER PARRY SOUND AND A
PICTURE PERFECT DOUBLE FOR
HIS LATE FATHER FORMER
PREMIER FRANK MILLER ROSE IN
LEGISLATURE TO MARK A
SPECIAL OCCASION.
WATCH.

A clip on screen shows Norm Miller, PC Parry Sound-Muskoka, speaking in the Legislature.

He says I RISE TODAY CELEBRATION
OF TARTAN DAY.
THE TARTAN IS IMPORTANT
SYMBOL OF SCOTTISH HERITAGE
AND IT IS WITH PRIDE THAT I
WEAR THIS JACKET.
MY MOTHER AND TESTIMONY WAS
BORN IN WHITING SCOTLAND
OUTSIDE.
WHILE MY FATHER FRANK MILLER
WORE THIS SAME JACKET IN
VERY LEGISLATURE MANY TIMES
IN THE PAST.
PARTICULARLY ON MESS SHAL OF
INTRODUCING ONTARIO BUDGET.

The clip ends.

Steve says SO THAT'S THE BUDGET
THAT -- THAT'S JACKET THAT
FRANK MILLER WORE EVERY YEAR
WHEN HE DID THE BUDGET.
DO WE HAVE ANY SCOTTS AT
THIS TABLE HERE?
I DON'T THINK SO.

Janet says NOT A ONE.

George says MAYBE A LITTLE IN MY MAKE
UP.

Sean says IT IS SAID THAT IRISH ARE
BUT SHIPWRECKED SCOTT.
THEY SAID TRUDEAU WAS
STYLE MAN HIMSELF WHO COULD
FORGET FRANK MILL LETTER AND
THE STYLE OF THOSE
APPEARANCE.

George says I DIDN'T KNOW FRANK
MILLER TOO WELL BUT NORM
SUCH A NICE MAN.
AND IT IS THAT WAS REAL FUN
TIME.

Steve says AND FOR THOSE WHO
KNEW THE PREMIER THIS NORM
MILLER LOOKS LIKE CARBON
COPY OF HIS FATHER.

Dave says LUCKILY HE IS MUCH MORE
MODERATE.
I'M DON'T KNOW.

Janet says FRANK DID SOME VERY GOOD
BUDGETS BY THE WAY.

Steve says YOU THINK SO?

Janet continues YES.
JACKET AND ALL.

Steve says HE DIDN'T BALANCE
ANY OF THEM, DID HE?

Sean says IT WAS A DIFFERENT TIME.
ONE BEST SALES PERSONS TO
EVER HIT THE LENGTH TURE.

Steve concludes THAT'S TRUE.
AND LOTTERY TICKETS.
MINUTESTER THANK YOU FOR
BEING HERE AND TO THE THREE
OF YOU THANK YOU AS WELL.
AND THAT'S "FOURTH READING."
THEY ARE THIS WEEK I AM
STEVE PAIKIN UNTIL NEXT
SUNDAY, THANK YOU.

Music plays and the end credits roll, as Steve and the rest continue the conversation.

Queen’s Park Bureau Chief, Susanna Kelley.

Producer, Erica Balch.

Director, Michael Smith.

A production of TVOntario. Copyright 2004, The Ontario Educational Communications Authority.

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