Good afternoon. It's a real pleasure to be here.

Although as I say that, I have to admit that I have mixed feelings about talking to you on this particular day, after the events of five years ago.

There are very few things that I care about more than what I am here today to talk about, but even so September 11th has a way of making even the most important things seem inconsequential. I suppose it'll be that way for a good many years to come.

The fact is, though, health care is not inconsequential, even on this day, so I am very glad to be here talking about it, and I am pleased that so many of you are here to listen.

Now…this might seem to be an odd way to kick off a health care speech, but I'd like to start by talking about elephants. One in particular.

We have an elephant in the room in health care.

Nobody really wants to talk about it, but it's a big elephant, and a small room, and it is posing a grave threat to our values and our economic competitiveness.

That elephant is represented by one Dr. Brian Day, the recently elected president of the Canadian Medical Association.

For years we have been shadow-boxing with often obscure voices agitating for two-tier health care. Now, Canada's doctors have selected one of the country's most prominent private providers to lead them.

The CMA is an organization whose mission statement declares it to be "the national advocate, in partnership with the people of Canada, for the highest standards of health and health care."

This is an organization that was created just three months after Canada was born and for most of its history its values have evolved in lockstep with the country's. Since the early 1960s, it has been a staunch supporter of the public health care system that helps define this country.

But they have just elected a guy who runs a private surgery clinic, is an advocate for private care, and is one of those who believes in a system where well-off Canadians can pay to get faster treatment.

Ladies and gentlemen, the first thing I'm here today to tell you is that I believe the public health care system that most people in this country cherish is under threat.

Under threat from those who pretend that you and I will somehow have enhanced access to care as soon as more doctors leave the public system to treat people who are better off.

So it is time to take sides.

Our government leads the side that champions innovation in the context of universal access.

Innovation that is producing tangible results for Ontarians.

We need more doctors to start fighting for that side. Doctors like Robert Bell at UHN, who wrote such an eloquent piece in the Star a few weeks ago about the difference between Canadian and American health care…

…differences that underscore the current competitive advantage we enjoy. He pointed out that in the US, General Motors is forced to spend more money on health care than it does on steel.

That's the same General Motors that just announced they're going to be building the much anticipated Camaros in Oshawa – just one site where Ontario's impressive investment pattern in automobile manufacturing is producing tangible results.

We need more nurses to fight for our health care system and we especially need their unions to balance their criticisms with honest acknowledgment that thousands more nurses have been hired since we took office and many more of them are working full time.

We need public sector unions to help fight for our health care system by honestly acknowledging that there are more of their workers providing care and support to Ontarians and that their wages are secure and rising.

So I have to say to them, by all means hold me and my government to account for what we're doing in health care, but do so in context.

That elephant I identified requires that those of us who profess the greatest love for our health care system step up and be heard.

Because really, who exactly do you think is going to defend public health care if it's not us?

British Columbia? Quebec? Alberta?

The Conservatives in Ottawa, and Tony Clement?

I don't think so.

Is John Tory going to defend public health care?

I don't think so.

Last time I checked, he was promising to take $2.4 billion out of the system.

So, at a time when Medicare is under the kind of threat that it is today, from people who think nothing of giving priority access to people on the strength and thickness of their wallet, with whom will you stand?

Our government stands alongside great Canadians like Roy Romanow, whose commitment to this country is unsurpassed.

Many of you will have read Mr. Romanow's recent article in the Walrus magazine. It was also excerpted in the Globe and Mail. This is part of what he said :

"In health care, the provinces need to do the heavy lifting involved in properly re-engineering the universal system: using new money to buy real change…and telling their electorates that it will take seven years to achieve these goals, not seven months."

I call that continuous quality improvement. He went on to say :

"Playing around with private-delivery health-care options is the default position of those governments that have not had the courage to innovate within the public model."

Couldn't have said it better myself, which is why I didn't try.

When my Premier honoured me with this job three years ago, I took it believing that it could be done. That it must be done.

I took it believing that if we were more honest with our patients – the shareholders who own this public health care system – we could gain their confidence through an unabashed dedication to renewal within the context of our established values.

And thankfully, each and every one of the 1000 days since I took the job, there have been leaders – many of them heretofore unknown except to those who have benefited from their loving care – who have stepped up to the plate and said count me in.

Doctors, nurses, administrators…all over the province, have stepped up.

So to those who haven't yet…what's that expression? "You're either wid us, or agin us"

People are going to have to choose. Where do you stand?

My task today is clear – to expand the number of believers.

Ontario's option is about better access.

And that's what I want to talk about today.

I want to demonstrate to you that we are on the right track, measured for once on the quality of our results, not simply on the quality of our rhetoric.

And the results I am going to show you today demonstrate very clearly that we are improving access to health care in Ontario, by innovating on the foundations laid by Tommy Douglas and Lester Pearson nearly 50 years ago.

And so to the numbers. You might imagine that a $35 billion operation produces a lot of them. Today I'm going to use about 15. They are noted on the handy scorecard that I trust has been placed at your table.

Let's start with nursing.

From the compassion epitomized by Florence Nightingale to the skill on evidence every day in hospitals and long-term care homes across this province, nurses have long earned the loving esteem in which they are held.

And from this government, they are also getting the respect they deserve.

The fact is, Ontario's nurses enjoy some of the most advanced practice opportunities anywhere.

And yes, there are more of them.

To date, our initiatives have created and funded 4,299 new nursing jobs in Ontario, and further program growth over the next 12 months will add 2,500 more.

That's new nurses working in communities, hospitals, long-term-care homes and public health units throughout this province.

We have worked hard to increase the number of nurses working fulltime by nine percent and we've invested millions to install more than 15,000 bedlifts to literally lighten their load.

Amongst a wide range of other initiatives, our fulltime job guarantee for 2007 nursing graduates holds much promise. And as of this month, we have more than doubled the number of nurse practitioners we can educate, fulfilling that commitment a full year ahead of schedule.

This entire array of nursing initiatives forms just part of our new leadership role in health human resources. The newly created HealthForceOntario is evolving new health care roles as we strive to make Ontario the jurisdiction of choice for health care professionals.

We created HealthForceOntario to increase the number of nurses, and doctors, and other health professionals in this province, and examples of this innovation and leadership can be found as we establish a one-stop shop for internationally educated health professionals and a marketing and recruitment centre that arms us to compete.

And nowhere is the competition more great than in the game of "physician beat the clock" made necessary by the decisions of our predecessors.

I spent this summer traveling to smaller communities in our vast province, relying as little as possible on 400-series highways.

What I found was community after community bearing the DNA of the two political parties who oppose us - political parties that bear responsibility, yet duck accountability for the patients orphaned by their action and inaction respectively.

Two parties that stood by and did essentially nothing while the number of Ontarians without a doctor grew at a simply disgraceful rate.

Now…as your Health Minister and as an accomplished former pizza driver I'd like to offer two thoughts :

First off, as I have often said, you can't make a doctor as fast as you can make a pizza.

And second, the continuous portrayal of all our foreign-trained doctors as sadly languishing in the service industry, driving cabs and delivering pizza, is inaccurate, harmful, and it robs us all.

But if we are honest we will acknowledge that not all medical schools in the world, some 5,000 across the globe, automatically produce an equal graduate - no matter how impressive-looking a certificate they can produce.

Our citizens demand that all doctors meet our very high standards - a principle that has served us well.

So while that may serve as context, it's the results that should speak loudest. When our government took office three years ago, Ontario offered 90 training and assessment positions to foreign trained doctors.

This year we surpassed our own targets of 200 by providing 218 of these positions.
And so since 2003, 750 new IMGs have begun practicing in Ontario communities, and another 470, give or take, are currently enrolled in training and assessment programs.

That's a lot of doctors.

One day soon I hope to see an above-the-fold headline in the Toronto Star :

"Taxi and pizza industries threatened by labour shortage."

But the needs of Ontarians can not be met by doctors produced on foreign soil alone. A badly-needed expansion of our own medical schools is underway, much of it into areas of the province new to the honour and responsibility of physician education.

Sudbury and Thunder Bay emerged one year ago as medical educators, as the Northern Ontario School of Medicine opened its doors to the first 56 medical students to be trained in the North.

Later this week I will have the privilege of addressing this year's crop of 56.

Windsor, Niagara, Kitchener-Waterloo and Mississauga are joining the ranks of medical education communities, while Queen's and Ottawa are expanding as well.
56 new positions in the North. 104 new positions in the South. That's a 23 percent result on what was a 15 percent campaign promise. Take that out to 2008 and you have 852 first year medical school spots.

That's a lot of new doctors coming on board, and we're awfully glad to have them.

And just when you thought you couldn't take any more good results, the renewal of primary care in Ontario has made it possible for us to increase the proportion of those doctors who will work as family medicine residency positions by a whopping 70 percent.

Health care systems the world over are striving to meet similar challenges, perhaps none more important than improving the way care is delivered at the community level.

Better managing care for the elderly and those with chronic disease stands as both a challenge and a huge opportunity to situate our resources close to people's homes and closer to our hearts - and our deep-seated inherent belief in prevention.

There should be no doubt that the single greatest contribution that we must all make to sustain our public health care system is to stay healthy in the first place.

And that's why we have been proud to put your money where that sentiment lies.

You can see that in Premier McGuinty's decision to form the Ministry of Health Promotion, and you can see it in three distinct initiatives now reaping rewards for Ontarians.

In 49 communities that are experiencing challenges with equitable access to primary health care we are creating Community Health Centres. That's a doubling of the number of CHCs in this province.

And all of the new CHCs in Toronto are in communities identified as high-risk in the City of Toronto and the United Way of Greater Toronto's Strong Neighbourhoods Report.

We are also innovating in primary care with the creation of inter-disciplinary teams of health professionals to provide comprehensive care to hundreds and hundreds of thousands of Ontarians.

We promised 150 family Health teams and we have delivered.

And our landmark agreement with Ontario's doctors has led to monumental gains in the number of Ontarians enrolled in group practice and enjoying better primary care as a result.

407 may be the designation of a highway, but it's also the percentage increase in the number of Ontarians now receiving care in a group practice since our party came to government.

Put another way…nearly seven million Ontarians can count on nurses and doctors to be there for them 24/7. For them, the emergency room is just that – for emergencies.

Now I know you've been waiting for me to talk about wait times.

The outgoing President of the CMA has described our efforts in Ontario as moving from "a laggard to a leader".

Our Premier took us there, just as he has helped take Canada there.

From our 2003 election campaign which influenced the subsequent federal election, through his role as Chair of the Council of the Federation which culminated in the 2004 First Minister's Meeting in Ottawa, Dalton McGuinty's imprint is unmistakable.

That is a result we should all take pride in for it well represents just how much we can do when we work together.

Here's a result :

If you were to take the number of procedures performed since we launched our wait times website and multiply that number by the average number of days that we have reduced wait times for each procedure, you'd get 6.4 million days.

That's 6.4 million days that somebody somewhere in Ontario has not had to spend waiting for a joint replacement, or cataract surgery, or an MRI/CT scan, or a cancer or cardiac procedure.

One example : We have increased the number of MRIs performed by 61%, and we have reduced wait times for this procedure by 28 days.

All told, that's 3,064,609 fewer days of anxiety, and undoubtedly for some a better shot at winning what might be the fight of their lives.

Expressed as a percentage, MRI waits are down 24 percent. Cataracts are down 10 percent. Angiography a whopping 44 percent.

In fact, wait times are down in all five key areas of focus including hips and knees, which to put it bluntly are wearing out under Ontarians at a rapid rate.

All cancer and cardiac wait times are lower than the national benchmarks and also meet our more aggressive access targets.

I mentioned the wait times web site – more than one million hits have been logged on that site since it was launched last summer.

Ontarians are coming to understand that they can take part in, and take charge of, their health care, and that website is helping them do it.

And perhaps the best news yet is that some of the most powerful lessons learned by our health care system are being enthusiastically applied by leaders who have stepped up to the plate and said we can and we will produce improved results for Ontarians.

While wait times tend to focus on the health care services we are providing, I hold my greatest enthusiasm for the health we are preserving in our kids.

Newborn screening, three new vaccinations and reduced rates of teen smoking all add up to healthier kids.

Surely these are exactly the kinds of initiatives Tommy Douglas had in mind when he said :

"Let's not forget that the ultimate goal of Medicare must be to keep people well, rather than just patching them up when they get sick."

What I set out to do in this speech today is to make the case that the solutions to the problems facing public health care aren't to be found in private health care.

It really ought to be a no-brainer. If you have something great and a problem develops, you don't toss the whole thing away. You fix the damn problem.

And you stay committed to the thing that was great in the first place.

Well here in Ontario, we have stayed committed to Medicare. We believe it to be the best expression of Canadian values.

The first thing we did in health care three years ago was introduce Bill 8, the Commitment to the Future of Medicare Act.

That legislation reflects our belief that the health system must be patient-centred, accountable, and respond to assessed need, not a person's ability to pay. It closed legislative loopholes that allowed queue-jumping and extra billing, and made two-tier health care illegal in Ontario.

When the American company Life Line wanted to bring mobile ultrasound diagnostic clinics into Ontario, to charge people for their services of course, Bill 8 let us stop them at the border.

When Copeman Healthcare tried to open its private clinics here in Ontario, charging people thousands of dollars in enrollment and yearly fees, Bill 8 let us stop them too.

Queue jumping is not a Canadian value.

What people who support clinics like Copeman either don't know or don't want to know is that it not only flies in the face of some pretty fundamental values to give wealthier people better access to health care, it also damages the public system - the system we collectively own.

Defenders of these clinics – and now we're back to Dr. Day at the CMA - insist they will relieve the strain on the public system.

That's untrue and the Copeman math proves it as well as I ever could. Every nine-doctor clinic proposed by Copeman would leave 3,500 more people orphaned without doctors in the public system.

Somebody want to explain to me how exacerbating the doctor shortage and creating more orphan patients is going to relieve the strain on the public system?

So no. Thanks very much. We are on a different path.

Remain true to our values, commit to excellence, act with courage and innovate as if the life of our publicly-funded, universally accessible health care system depends on it.

Because it does.

And so this call to arms come complete with a battlefield opportunity, where values and passion and ideas are the weapons of engagement.

By our own law, our government is obligated to develop a 10-year, forward-looking strategic plan. And what that is, is a roadmap to spend around 400 billion dollars.

We're going to need help with this. Help from the people whose system this is. Help from the shareholders – the people of Ontario. And that help will be sought in a hand-on process that we will be initiating shortly.

And I'm serious when I say we need help. This is about the democratization of a public asset. And it gets back to what I said at the outset :

A system we believe in and value and cherish is under threat. We need to fight for it.

We need to fight for the right of all citizens to get the health care they need, when and where they need it, regardless of how much money they have in their pocket.

Because that is our birthright, and we care about it.

The battle has been joined. And we will win.

Because we have results on our side.

Thank you.