Longwoods Blog

Thank you. It is great to be here. This is actually my fifth visit to HealthAchieve.

I know this is the last speech of a long conference. You’ve heard a lot of great ideas and perspectives from a lot of great speakers. You’ve reunited with old friends and made new ones. And I know this because I’ve been following it on Twitter.

I want you to know you are not the only thing on Twitter these days. But you are on Twitter and it has been great. And now, you’re ready to head for home and put those great ideas to work. Trains, planes and automobiles await you.

So, I’m going to keep this short …ish.

I can’t come to HealthAchieve and not take the opportunity to thank you.

I want to reflect on how far we’ve come, together, over the past little while. And I want to talk about what I see as what more we can, and should do, to make health care in Ontario even better. Because, we’re here to get it right, not for me, not my government, not health care providers, not for organizations.

We’re here to get it right for patients, and I know that you know that.

I’m proud to say that the people who work in Ontario’s health care system are the best in the world. Not only do you provide excellent care to your patients, but you are rising to the system challenges – the fiscal challenges and demographic challenges – that we collectively face.

You, too, are asking the two questions that matter most: “Is this change better for patients?” And, “Is this change better value for money?” And, if it’s better for patients, and better value, you’re prepared to drive innovation. You’re prepared to drive change that’s better for patients, change that’s better value for money.

I can tell you; those are the only two questions I ask myself.

And that’s why I have made tough decisions when they have been called for – whether it’s on drug reform, physician compensation, hospital system funding reform or physiotherapy, to name just a few.

I can assure you, there are more tough decisions ahead. But they will always be driven by the questions, is this change better for patients, and is it better value for money?

So I make no apologies for making tough decisions, and for continuing to drive transformation, because what is at stake is nothing less than our uniquely-Canadian universal health care.

It’s worth fighting for.

I want to take just a few minutes to remind you of some of the many ways that patients are better off, thanks to your hard work. After all, this is HealthAchieve, and we have to celebrate our achievements.

So let’s take a little journey through the eyes of a patient, brought to you by the health care providers of this province, and see what changes you have brought about.

That journey starts with birth.

Ontario now has the most comprehensive newborn screening program in Canada. Just 10 years ago, we screened for only 2 diseases. Today, thanks to the great work at Newborn Screening Ontario at CHEO, we screen for 29.

The newest one is Severe Combined Immune Deficiency, SCIDs, or Bubble Boy disease. The importance of this screening became real to me when I met young Ethan Peters.

His big sister, Brooklyn, died from SCIDS. So when Ethan was born, he was tested.

Ethan did have SCIDS, but because it was caught early, it was successfully treated with a bone marrow transplant. He’s doing great. And now, we’re looking to bring comprehensive newborn screening to babies born right across the country.

From newborns to children, the health care journey continues.

In 2003, we had eight publicly-funded vaccines. Today there are 21.

Not only is this great prevention, but it saves parents about $2500. Per child!

And today kids five and over, and their parents, can get the flu shot at a local pharmacy, in addition to the traditional options such as doctors’ offices and clinics, and so on.

And speaking of prevention, we know that we need to do a lot better keeping our kids healthy, in helping them to lead healthy, active lives. Because unhealthy kids today mean unhealthy adults later.

We owe a big thank you to Alex Munter and Kelly Murumets and the rest of the Healthy Kids Panel for their thoughtful and ambitious report.

And now we’re beginning to move forward on those recommendations.

So now let’s move on to the teenage years.

We want to do everything we can to protect teenagers against cancer. It’s why we have passed legislation now to ban the use of tanning beds by kids under 18.

And it’s why we are so committed to our Smoke Free Ontario Strategy. A big part of this strategy is focused on preventing young people from ever lighting up.

The good news is, smoking rates are down in Ontario. They’re down significantly from about 24.5% in the year 2000 to about 19% now. We’re going to keep on working until

we have the lowest smoking rate in Canada. That means we have to get below B.C., which is now at 14.5%. So we’re about half way to our goal of having the lowest smoking rate in Canada.

Again, a big thank you to leaders like Michael Perley, the Canadian Cancer Society, the Heart & Stroke Foundation, and the Ontario Lung Association, and others, for their advocacy on this.

When it comes to mental health, I think we would all agree that mental health is a long-neglected part of our health care system. That’s why we created Ontario’s Comprehensive Mental Health and Addictions Strategy.

The first three years of the10-year plan are focused on children and youth. The reason we did that is because we know that 70% of adults’ mental health and addictions issues start in youth and adolescence. Thank you to everyone who contributes to giving kids the mental health supports they need, when they need them.

We all know the powerful impact of the social determinants of health. Our Poverty Reduction Strategy is having a real impact, and, at last count, has lifted 40,000 children and their families out of poverty, altogether, and raised the standard of living for others.

It was also through the Poverty Reduction Strategy that we expanded dental care for kids living in low-income families. Healthy Smiles Ontario and our Children in Need of Treatment (program) are helping over 70,000 kids each year get the dental care they need, and that they wouldn’t otherwise be able to afford.

We are committed to doing even more when it comes to improving access to dental care for kids in low-income families.

So as our journey continues, let’s move from our teenage years into adulthood. I can tell you the most extraordinary change that adults have seen in our health care system is access to primary care.

Family health teams now are employing 2,500 doctors and 1,800 interdisciplinary health professionals, such as Nurse Practitioners, Social Workers and Dietitians, providing holistic care for nearly three million patients across this province.

Back in 2003, there were no family health teams.

There are now 25 nurse practitioner-led clinics across the province. Once they are at full capacity, they will be caring for more than 40,000 people, many of whom did not have access to primary care before.

Before 2003, there were none.

We have also expanded Community Health Centres, from 54 sites to over 105 sites, caring for approximately half a million Ontarians.

And the other extraordinary success is with regards to wait times.

Indeed, we’ve gone from worst in Canada to the first in Canada.

For the sixth consecutive year, the Wait Times Alliance has given Ontario straight A’s for reducing surgical wait times in five priority areas.

The report also gave Ontario straight A’s for reducing wait times for non-admitted patients in hospital emergency departments – 87 per cent of ER patients are getting treatment within the target.

That is due to you. So a big thank you to all of our hospitals, to all our providers who made this happen. I also want to give a special shout out to Dr. Alan Hudson and to Dr. Howard Ovens, who were really there at the very beginning, leading the strategy.

Ontario is a world leader in fighting cancer.

We have consistently expanded our screening programs for breast, cervical and colorectal cancer.

And we’re also among the top jurisdictions in the world when it comes to cancer survival rates. And for that I have to give thanks to the extraordinary work done by our friends at Cancer Care Ontario and leaders like Dr. Bob Bell, not to mention so many of our providers and our hospitals. Thank you for making cancer survivor rates among the best in the world.

November is not only my birth month … I had a very big birthday yesterday, I want you to know. I’m not going to tell you what the number is, but it starts with a six, and it ends with a zero. So, it is what it is.

November is also Diabetes Awareness Month. It is an opportunity to thank the many health care providers who help us deliver our Ontario Diabetes Strategy. One of the elements of that is that we said anyone who has diabetes, who wants a primary care provider, should have one.

Now, I’m happy to say, 100 percent of people with diabetes who want a family doctor or a nurse practitioner, have one.

So as we continue our life journey, it takes us into our senior years, which is where I am now.

Over the next 20 years, Ontario’s seniors’ population will more than double. So we know that if we don’t fundamentally change how we deliver health care to our seniors, we simply won’t be able to keep up.

That’s why we asked Dr. Samir Sinha to provide us with some advice. In a ground-breaking report, and I hope you’re had a chance to read it, he made a number of recommendations. In fact, he made 166 recommendations. And we’re taking action.

At the foundation of that is that people want to stay in their homes as long as it is possible, and we need to make that possible for them. That’s why the expansion of home care services has been a hallmark of this government.

We owe a giant thank you to the Nurses and Personal Support Workers who are providing this care. And to the CCACs and to the LHINs who are making it happen.

This past summer I spent a morning with a personal support worker, Juliette Chestney, who lives and works in Milton. I followed her on her rounds as she provided care to patients in their homes.

I have to tell you I was in awe of her. I was in awe of her skills and I was in awe of her compassion. And I was in awe of the way she dealt with her patients and their families.

So people like Juliette are providing the care we need as we age.

We remain committed to the Home First philosophy. It’s all about putting the right supports in place, so that when people are ready to leave the hospital, they can go home safely, and they can continue their healing at home.

As a result of the changes in our home care and community care, we’re seeing a reduction in our ALC (Alternate Level of Care) rates, and we’re seeing a reduction in wait times for long-term care, which is extraordinary.

When people do need Long-Term Care, though, it’s important that they’re safe, and that’s why we have increased staffing in long-term care homes and training for people who work in long-term care homes.

And that’s why we have a zero-tolerance approach when it comes to abuse and neglect, with stronger enforcement and more frequent inspections.

At the end of the health care journey is palliative care, end-of-life care, and we are determined to give Ontarians dignity throughout their final days.

We have expanded hospice care across the province. We have 30 residential hospices now up and running, and we have 70 community-based nurse practitioner new palliative care positions.

There has been a lot of discussion about end-of-life and palliative care, and that’s a good thing. And there’s more to do. I want to thank the palliative care community for the work they do. And I’d like to thank Dr. Scott Wooder of the OMA for making this issue a priority of his presidency.

Obviously, these are really just a few highlights of what is better when it comes to health care in Ontario. All of these changes were made possible by you. So thank you for that.

The transformation that we hear so much about is underpinned by the commitment to quality in the Excellent Care for All Act, which laid the foundation for funding reform, quality improvement plans and more evidence-based care.

It’s also supported by the progress made at eHealth Ontario. Thanks to our physician community, today nearly 9 million Ontarians have an electronic medical record. And every day new linkages are being made, and that is the future of eHealth.

Patients are getting better care because we have more doctors. Almost 5,000 more doctors are working in Ontario now just a decade ago.

And 16,400 more nurses are working in Ontario than just a decade ago.

These are important investments and the result is better care.

At the same time, we know there is a lot we can do to get better care and better value for our health care dollars. We’re on a journey, and we’re not deviating from that journey. We know what we need to do. We are not deviating from the plan. We are continuing to implement the Action Plan.

A year ago, I stood here and I talked about creating more patient-centred linkages between health care providers. The result was community Health Links. And I have to say, I’m enormously impressed how the health care community is embracing community Health Links.

So let me tell you just one story that makes it real for me. This is about one woman from the North East Toronto Health Link. This Health Link made possible what nobody thought was possible before. They gathered a dozen providers around a table, from the community, from the hospital, with one patient, her family, her caregiver. And working together, and listening to the patient, they came up with one plan with 10 recommendations.

There were more than a few “aha” moments as they did that work, including one that described how the patient was suffering from sheer exhaustion trying to get to a physiotherapy appointment across town, when conserving energy was crucial to her quality of life and exercise could be done at home.

Among the recommendations: dropping one medication and cutting in half a second medication, wearing an oxygen mask 24 hours a day, thinking about a motorized

wheelchair, and one more simple way to improve her quality of life – using a speaker phone to talk to their grandkids.

The goal of the patient – and this is what’s so important about Health Links, they listen to what the goal is for the patient – so the goal for this patient and her husband was to enjoy their life more. That’s what they wanted. They wanted to enjoy life more. They wanted more time with their family and they wanted to get to the mosque more frequently. That was what was important to this particular person and her family.

So this plan came together in mid-October, so just a few weeks ago. And already, transportation issues are being dealt with. A new wheelchair and a new oxygen mask are in the works. And most important, the connection with the mosque is no longer a dream. It appears now to be within reach.

The patient’s goals are being met and the health care providers wrapped around the patient to make that happen.

There are many more Health Link stories that we are starting to hear, and they are all enormously gratifying. I can tell you that the way the health care sector has embraced Health Links is astounding. I hear that there was a standing-room-only crowd at yesterday’s session. That you barred the doors. You wouldn’t even let my staff in. But that tells me a lot about this, that it is the right way for Ontario right now.

In just one year, 37 Health Links have been created. And we’re shooting for the entire province to be covered, so that every person in Ontario who needs that special care, will get that special care.

This systemic change is not a government program. It’s happening because you – providers, administrators, thinkers – are making it happen. It’s your creativity. It’s your leadership that is driving this extraordinary change.

As Sir Ken Robinson said yesterday, “If you can’t change the whole system, change the part you can.” And that’s what’s happening with Health Links. And with Health Links, we’re doing our best at the ministry level to empower you to do even more, if it’s better for patients and it’s better value for money. Health Links have become a crucial element of transformation.

So we’ve come long way on our journey to transform Ontario’s health care system. The Action Plan is working. But we’re not resting on our laurels.

So what is the next step on our health care journey?

Just as Health Links are the result of an obsessive focus on patient-centred care, I want to always consider how our health care system can be better from a patient’s perspective.

I know we can continue to transform…from a system that provides care FOR patients to a system that provides care WITH patients.

Evidence shows that when patients are engaged in their care, hospital stays are shorter, and patient outcomes are better.

The patients pay the bills for our health care system. They own the system. We work for them.

So it’s not up to patients to fit into “our” system – it’s up to us to create a system that works for them.

Many providers reach this same conclusion, as we heard from Marsha, when they have a loved one who needs care. That’s when we get to really see how the system works.

We’ve started this conversation – and there are many throughout the system who are doing great work on patient engagement who we can learn from.

I’m watching with great interest parts of the system where this has become a part of their culture.

And again, credit to all of you and so many others within this great system. We are seeing this happen more and more.

At a patient level, we are learning valuable lessons through Health Links.

At a provider level, many health care institutions now see patient engagement as a key component of their quality agenda.

Going forward, you’ll be hearing more about patient engagement. You’ll be hearing more about how we can engage patients at the patient level, provider level, and at the provincial level.

We hear a lot about transformation. But what does transformation mean to you?

So it’s clear to me you get it.

Ontario’s health care system is in very good hands.

I want to thank you all for listening to your patients. And for making healthy change happen.

There really is no question about it. Every problem we have in health care is solved, in the final analysis, by you.

It’s about your passion, it’s about your commitment, it’s about your skills.

Patients are lucky to have you. And so am I.

Thank you.

OHA HealthAchieve 2013: Closing Remarks 

The Honourable Deb Matthews, Minister of Health and Long-Term Care 

Metro Toronto Convention Centre, November 6, 2013 

This entry was posted on Wednesday, November 13th, 2013 at 11:40 am and is filed under Publisher's Page.