Transcript Ontario: Progress?

Ontario: Progress?
Who is McGuinty?
 The “Education Premier”
 Wanted to rebuild public services after Harris government
 Vowed:
 Education
 Add $1.6 billion to school system
 Move away from private school funding and invest further in the
public system
 Reduce class sizes
 Health
 Make two-tier health care illegal
 Stop privatizing MRI/CT clinics, and open more public clinics
Ontario Progress Report
 Sixth in a series of Progress Reports updating Ontarians on
the results we have achieved together in a transparent and
measurable way
 From the point of view of the government of the day, can
be biased or misleading
Agenda
 Health Care Analysis and Critique
 Education Analysis and Critique
 Misleading Facts and Figures
HEALTH CARE
Ontario’s Top 5 Healthcare
Problems
As quoted by Michael Decter, former chair of the Health
Council of Canada and the Canadian Institute for Health
Information:
1. Chronic Disease
2. Integrating Health Services
3. Smarter Systems
4. Need for More Doctor and Nurses
5. Wait Time Reductions
Dalton’s Claims: Chronic Disease
 Banned smoking in vehicles with children under 16 present
 Helped the growing number of Ontarians living with
diabetes through a mix of prevention, technology,
personal planning and access to specialized resources and
health professionals, benefitting 310,202 Ontarians so far.
 Banned trans fat from food and beverages sold in schools.
 Offered free measles, mumps, rubella vaccines through a
catch-up immunization program
Dalton’s Claims: Integrating
Health Services
Helping Ontario patients get the care they need, faster
 You could have your fracture set by a qualified nurse
practitioner
 People needing a prescription re-fill can make one trip to a
pharmacist
 Physiotherapist can now order an x-ray
 If your nurse practitioner suspects pneumonia, she order
your x-ray, she could prescribe your antibiotics.
Dalton’s Claims: Smarter Systems
 Implemented e-Health (Electronic Health Record)
 Medication Management
 Enable online prescription & medication history
 Provide decision support for physicians ordering drugs
 Wait Times
 Enable public reporting & performance management
Dalton’s Claims: More Nurses &
Doctors
 That’s why we’ve provided funding to create nearly 10,000
more nursing positions. More than 900 nursing positions
will be created in 2009–10.
 About 800,000 more Ontarians now have access to a
family doctor, compared to 2003
 Over 7,700 nursing graduates have been matched to job
opportunities through our Nursing Graduate Guarantee.
 There has been a 23 per cent (160 students) increase in
medical school enrolment from 2005–06 to 2008–09.
Dalton’s Claims: Wait Time
Reductions
Compared to four years ago, Ontarians are getting:
 cataract surgery 197 days faster
 hip and knee replacements 185 days and 262 days earlier
 cancer surgery 16 days sooner
 cardiac procedures up to 23 days quicker
 MRI and CT scans 15 days and 34 days faster
We have expanded the Wait Times Strategy to include
general surgery. Ontarians received an additional 8,240
general surgery procedures since October 2008
Criticism: Smarter Systems
 Implemented the e-Health System
 Used $1 Billion of Ontario taxpayers money for Electronic Healthrecord system
 $4.8 million in no-bid contracts during first four months
 $50,000 to refurnish the CEO’s office
 Paying consultants $300/hour
 Despite decades of work, Ontario still back of the pack compared to
other provinces in developing electronic health-care
 Auditor General Jim McCarter: “We did not get value for money for
this billion dollars”
 The report also linked the untendered contracts to McGuinty’s role in
the hiring of eHealth Ontario’s chief executive and not providing
oversight in the hiring of consultants
Criticisms: More Nurses &
Doctors
Improper diagnoses of problem…
Canada has been slowly losing its doctors and would-be
doctors to the USA - thanks to two main factors –
 The much higher salaries in America
 Ample and better post-graduate training opportunities.
 1 in 12 Canadian-educated physicians practiced in the United
States
 This is equivalent to having 2 average-sized Canadian
medical schools dedicated to producing physicians for the
United States.“
Criticisms: More Nurses &
Doctors
 Several possible causes of shortage of doctors:
 The number of dissatisfied physicians leaving Canada is
said to be increasing.
 The baby boomer generation of doctors will soon start to
retire.
 Doctors are increasingly concerned about their lifestyle
and may be reducing their hours of work
 Aging of the population is increasing need for medical care
Facts & Figures
 The cost of health care in Ontario in the year 2000 was $22.2 billion; in
2011 the cost is going to be $47.4 billion
 Increase has not improved the quality of service compared to what
Ontarians received in the past
 Ontario also has the lowest per-capita number of nurses
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We have 633 registered nurses per 100,000 people
Compared with 983 in Newfoundland
920 in Prince Edward Island
And 717 in Quebec.
 We also have the lowest ratio of physicians.
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In Ontario, there are 85 doctors per 100,000 people
Compared with 116 in Nova Scotia and 111 in Quebec
National Canadian average is 98
Only Nunavut has a lower number: 26 physicians per 100,000 people.
EDUCATION
Dalton’s Claims - Early Learning
 Has created more than 22,000 childcare spaces across
Ontario since 2003.
 Ontario will start phasing in full-day learning.
 Up to 35,000 kindergarten students across Ontario will be
enrolled in September 2010.
 The goal is to have the program fully implemented in all
schools by 2015-16.
Current Reality - Early Learning
 According to the Canadian Centre for Policy Alternatives:
 The Ontario budget includes no allocation to implement
federal recommendations .
 What happens to funding for 22,000 child care spaces when
federal funding expires next year?
 According to the Child Care Resource and Research Unit:
 Ontario is considering allowing fewer staff to care for larger
groups of young children.
 Ontario could be the first province to lower child care
standards
Dalton’s Claims – Funding
Students
 In 2003–2004, one quarter of all primary classes had 25 or
more students.
 By 2008–2009:
 90.3 % of primary classes had 20 or fewer students.
 100 % of primary classes had 23 or fewer students.
 As of 2009–2010, are funding more than 10,500 additional
teaching positions
Current Reality - Funding
Students
Further, according to the CCPA:
 Ontario’s per student school funding places the province
far behind most peer jurisdictions in North America .
 The gap is most notable between Ontario and key North
American cities.
 In 46th place compared to American states and ninth
among Canada’s 13 jurisdictions.
 New York City invests twice as much per student in public
education as Toronto.
Dalton’s Claims – Education
Standards
 Overall, 67 % of Ontario Grade 3 and 6 students are
meeting or exceeding the provincial standard in reading,
writing and math.
 A 13 % increase over 2002–2003.
Education Standards - Ontario
Steady improvement in in EQAO results over the past five
years:
 Since 2008, the percentage of students meeting or
exceeding the provincial standard in Grade 6 reading
is 69%
 Grade 9 applied mathematics, the percentage
meeting or exceeding the standard is 38%.
Other criticisms
Some flaws in the funding formula:
 Underinvestment in programs required to support
students with special needs in Ontario.
 A lack of funding for local priorities.
 A complete lack of accountability to ensure the provincial
government responds to the inadequacy of its funding to
schools.
Misleading Facts and Figures
(Health Care)
 1,790 new international medical graduates (IMGs) entered
practice in Ontario between 2003 and 2006
 How many remained in Canada?
 Shorter wait times
 What are the original wait times?
Misleading Facts and Figures
(Education)
 Smaller class sizes
 Smaller class sizes ONLY in primary schools (JK to
Grade 3)
 Higher test scores
 5,100 new primary school teachers
 But only 126 teachers for Grades 4 to 8
Misleading Facts and Figures
(Education)
 Good, safe places to learn
 3500 schools have safety audits, how many schools in
Ontario does that cover?
 Reaching higher
 Invested $3 million in bursary support over three years
 Which means only 1 million per year, divided over 800 is only
$1250
 Capped tuition increases — after freezing tuition for
two years — at an average of 5% annually
 Still growth of 5% per year
Misleading Facts and Figures
 Health Care and Education spending = +5% / year (2009
Budget)
 Reality
 Freezing hospital funding (Healthzone)
 Cutting in education (Policy Alternatives)
 Early Learning in question (Globe and Mail)
Conclusion
 Health care is close to 50% of operating budget
 Education is another $19.9 billion (20%)
 Combined, 70% of operating budget
 Sustainability is a huge issue
 Demand for investment in new tech, infrastructure, and
other vital social services will increase
 Deficit will only grow larger