Remarks By Dalton McGuinty, Premier Of Ontario To The Registered Nurses Association Of Ontario AGM
Check Against Delivery
It's a privilege to be with you today.
We've met many times over the years.
But this is the first time I've been able to address you as Premier.
So, now on behalf of all Ontarians, I want to thank you for the work you do, day in and day out.
Our people's health is our most precious resource.
Our province's health care is one of our most pressing priorities.
And Canada's system of medicare is one of our greatest legacies.
And you, registered nurses, are essential to all three.
Our government understands this.
It's one reason why we have provided additional funding to hospitals, specifically targeted at:
Creating more full-time jobs for nurses,
Improving working conditions for nurses;
And purchasing equipment that will help reduce workplace injury amongst nurses.
It's a start, but it's a very significant start, and it signals a new direction, one that will see government ... and nurses ... working together.
Nursing, while not always heavenly work, is enormously important work.
The philosophy behind our system -- the belief that health care should be available on the basis of how sick you are, not how rich you are -- is essential to who we are as Canadians, to our basic notions about right and wrong.
It's our system of medicare that I want to talk about today.
I believe we have reached an important moment in our history.
After years of talk from the right about more privatization, Roy Romanow, who I am pleased to say is with us here today, put the focus back where we've always wanted it: on saving medicare, not by dismantling it, but by improving it.
Mr. Romanow, Canadians thank you for your vision.
And after years of governments fighting with each other, divided by politics and ideology, we now have an opportunity for Ontario and Ottawa to work together, on solutions.
We have a historic opportunity to sustain medicare for future generations and make it more responsive for this generation.
Earlier this month, I met with the Prime Minister at 24 Sussex.
We discussed this opportunity, and our shared responsibility to seize it.
And a few days later, Mr. Martin announced he wants to reach a new 10-year agreement with the provinces, on medicare, when we meet this summer.
I am pleased to take the Prime Minister up on that offer.
Now I understand Canadians get as excited about federal-provincial conferences in July as they do about snow in April.
They want more than talk.
They want results.
I understand that.
Ontarians want shorter waiting times for important procedures and tests: cancer care, cardiac care, joint replacements and cataracts, and MRI and CT scans.
For example, a recent report on cardiac procedures states that patients in Ontario had to wait an average of 24 days for important cardiac surgeries, the second-highest wait time in Canada.
And, according to Cancer Care Ontario, there are some cancer patients in our province who are waiting 13 weeks or more to receive radiation treatment.
Ontarians want a solution to the shortage of family doctors that affects more than 130 communities in Ontario, including some of our major cities.
Ontarians deserve access to top-quality primary care, from a family doctor, or a team of health care professionals.
So I understand Ontarians may be sceptical about another round of talks.
That's their privilege.
Our responsibility is to do whatever it takes to deliver the results they want and deserve.
So I say to the Prime Minister and my fellow premiers:
Let us seize this moment now before it passes by, yet again.
Let's sit down, and work together to fix today's system.
Let's develop a plan to sustain medicare for our children and grandchildren.
Let's agree on the money and do it.
For a change, let's focus on fixing health care, instead of fighting each other.
This is the spirit in which I will meet with the Prime Minister and my provincial counterparts.
And here, in more detail, is what Ontario will bring to the table:
Ontario will assume its leadership role in Confederation.
We will propose solutions, not promote division.
We will broker ideas, not ideology.
We will not make the artificial choice between putting Ontario first or Canada first.
We will put Ontarians first by putting their country first.
We have already shown this leadership on the national stage, working with our colleagues to end the stalemate over a National Health Council.
I'm proud to say we now have a national body that will monitor outcomes, and give Canadians the straight goods on the progress in health care, because Ontario said this is the right thing to do, and it's high time we did it.
2. We will bring to the table Ontarians' unwavering commitment to medicare.
We believe in a universal, publicly funded heath care system that gives us the care we need, when we need it, on the basis of need.
Medicare defines us.
It's a symbol of our compassion -- and a source of economic strength.
A recent report from Northwestern University points out that in the U.S., where there is no universal, public medicare, carmakers spend more on health insurance than steel.
In Canada, health care is not a commodity to be bought and sold.
It is a basic right of citizenship.
We will defend and preserve the principles of the Canada Health Act.
Our government has already demonstrated this commitment.
One of our first actions was introduction of the Commitment to the Future of Medicare Act.
If passed by the Legislature, it will ban pay-your-way-to-the-front-of-the-line health care in Ontario.
3. We will bring to the table clear-eyed realism.
Even the most passionate defender of medicare -- and I am one -- cannot defend the status quo.
The truth is the path we are on today will simply not sustain medicare for future generations.
And it threatens to sideline other important priorities of the new century -- education, skills training and government's role in supporting new and innovative sectors of the economy.
Here in Ontario, health care costs have been rising at the rate of 8 per cent a year, for the last five years.
In that same time, the cost of running our hospitals has increased by a third.
We now spend over $28 billion a year on health care.
That's 46 per cent of our provincial budget.
More than we spend on education and social assistance combined.
We are not alone.
Provinces are battling deficits -- and rising health care costs are one of the reasons why.
At the same time, the federal government is forecasting a $4 billion surplus this year.
This is, in part, a product of good management in Ottawa, and mismanagement under the previous government at Queen's Park.
But it is also a reflection of the fiscal imbalance in Canada.
When we built our Confederation, the federal government assumed responsibility for fisheries, while the provinces assumed responsibility for health care.
At the time, hospitals were modest, and few and far between -- and the vast majority of Canadians lived a rural life, depending on farming or fishing to make a living.
Today, hospitals are common and complex -- and the vast majority of Canadians live in cities, with many working at keyboards, not on board.
Our structures have not kept pace with change, and we are left with a fiscal imbalance.
The federal government controls the lion's share of resources: the provinces bear the responsibility for delivering health care, as the lines get longer, and the care becomes more complex.
I am not calling for a new division of powers.
I am not advocating constitutional wrangling that will divide us, distract us and drag us down.
But I am calling on the federal government to address this imbalance, so we can all focus on results.
I do want Ottawa to commit to provide the provinces with adequate, long-term funding.
The one-time commitment to spend an additional $2 billion over two years -- of which Ontario will receive $778 million -- is a good first step.
But it cannot be the final step.
We need a new funding arrangement.
We do need a new health care deal.
We need to act urgently -- but responsibly.
1977 was the last time the federal and provincial governments actually negotiated a funding agreement.
All subsequent arrangements have been the result of consultation -- not negotiation.
The 1977 deal took five years to negotiate.
And while we cannot make Canadians wait that long, it would be naïve to think we can, or even should try to, fix this overnight.
I appreciate Prime Minister Martin's sense of urgency on this matter.
This is bigger than the next federal election, or, for that matter, the next provincial election. It is bigger than any one Prime Minister or Premier.
We need to get this right, so it can withstand the vagaries of politics, budgets and elections, so it can serve a generation of Canadians.
I'm proposing that, as First Ministers, we commit ourselves this summer to working on an interim agreement, one that will allow provinces to work right away on improving results for patients.
And that we also agree on a framework and process for working out a long-term deal, one that will serve Canadians for the long term.
4. Ontario will insist on accountability.
You know ... there's a funny thing about administration: sometimes, if you just put more money on the table, somebody goes out ... and buys a nicer table.
We must ensure that new investments deliver change and results -- not just more of the same.
Again, on this, Ontario is leading by example.
When our Health Minister George Smitherman recently announced an additional $385 million in hospital funding, he tied that money to results -- better results for patients, and better working conditions for nurses.
And I'm proud to say that as a result of our investments in nursing over the past few months, some 800 nurses will be able to have full-time jobs.
Going forward, we have made it clear that hospitals will have to negotiate with the government clear, deliverable accountability agreements, that spell out what patients will get for the money taxpayers invest.
We can only save medicare if we fund it properly.
But with additional funding comes additional responsibility.
We must account for every health care dollar we spend and hold every part of the system accountable to patients.
Our government is assuming its responsibility to be accountable.
We have introduced legislation that would create the Ontario Health Quality Council, to monitor and report to the public on the state of health care here at home.
We have released task force reports on mental health, reports our predecessors had kept hidden.
We have launched unannounced annual inspections of long-term care facilities.
And we have given the provincial auditor new powers, to audit not only government itself, but our transfer partners as well, including hospitals.
I say to my fellow premiers and the Prime Minister: any new deal must include accountability.
But I want to add an important point: let us not confuse accountability with conditionality.
I have been talking with my fellow premiers -- I had a very productive meeting just yesterday with Quebec Premier Charest.
I can report that none of the premiers want the federal government to micromanage our 13 health budgets.
I believe where we can and must find common ground is in the area of results.
I believe all Canadians want shorter wait times and better access to primary health care.
I don't think we should be fighting over how we get there -- but I do think we should all be accountable for getting there.
And, we're not accountable to the federal government -- together, we're accountable to all Canadians.
How each province delivers shorter wait times and better access to primary health care isn't the issue -- as long as we get there.
And, as long as we travel within a universal, publicly funded system of medicare, respecting the principles of the Canada Health Act.
Again, it's results that matter to Ontarians, and Canadians.
5. Ontario wants real reform that delivers real change.
That means more people being cared for in the community, by teams of primary care professionals: doctors, nurses, nurse practitioners and others providing families with care, around the clock, seven days a week.
It means health providers and administrators -- in hospitals, public health departments and the community -- working together to create integrated local health care systems that really meet the needs of people.
It means a new emphasis on healthy living, illness prevention and health promotion.
It means change that will deliver the results that matter most to people: shorter waiting times.
6. Ontario will call for a coordinated, national approach to public health and infectious diseases.
I don't have to tell a gathering of nurses, in the city that faced down SARS, that this is long overdue.
Today, we have to do more than defeat the illnesses we know; we have to prepare for the ones we haven't even heard of yet.
Obviously, this is something all governments have to work on together.
A virus does not respect provincial boundaries or political jurisdictions, any more that it respects human life.
Again, our government has put a new emphasis on public health.
We've hired more water inspectors and meat inspectors.
We have hired the most passionate, committed defender of public health we could find: Dr. Sheela Basrur, our new chief medical officer of health.
We have brought together experts and emergency professionals from the health care delivery system and all three levels of government to develop Ontario's Health Pandemic Influenza Plan.
And we have also implemented emergency response measures, including rapid response teams and the Emergency Medical Assistance Team.
Directives have been issued to all health care facilities for use during both outbreak and non-outbreak situations.
We are in a better position today than we were prior to the advent of SARS in Ontario.
But this week, the Campbell and Walker reports forcefully made the point that there is still much to be done -- and we agree.
For medicare to thrive for our children and grandchildren, we must demonstrate its ability to change and cope with changing conditions.
And there is no better example of that than the rapidly changing challenge in public health.
These are the things Ontario brings to the national stage:
An unwavering commitment to medicare.
A clear-eyed realism about the need to ensure we sustain medicare for future generations.
An insistence on accountability.
A determination to deliver change.
And a call for a national strategy for public health.
These are the things we bring to the Canadian discussion.
These are the things we are delivering here at home.
These are the things that will provide Ontarians with what they deserve: results.
Real, tangible, measurable results.
Cancer care that is as timely as the need is urgent.
Cardiac care that's there for you or someone in your family.
Access to primary care so there are health care professionals in your corner -- instead of you waiting in a corner to see a health care professional.
Results that matter to Ontarians and Canadians.
We can build medicare that is responsive today, sustainable tomorrow and equipped for the challenges of the future.
This is our responsibility, one we share ... you, who do so much on the front lines, and we in government, who influence the bottom lines with which you work.
I know that we can reform and improve medicare ... so it continues to speak to our highest ideals ... while providing the highest standard of care ...
My friends, a health care system that is second to none ...
In a province with a quality of life that's second to none ...
That health care, and that Ontario, are ours to deliver.