Good morning.

I feel as if I’m among friends.  And that’s not just because we’ve accomplished so much together.  It’s also because I’ve become pretty comfortable with you folks.  We “have a history,” as they say!

When our party assumed power in October of 2003, and Premier McGuinty tapped me to serve as Minister of Health and Long-Term Care, my first big speech was to the Ontario Hospital Association. 

I’m sure a lot of you who were in the audience that day in 2003 are here today; in fact, a lot of you are starting to look very familiar.  Four speeches later, I’m still here!  And you know what?  I’m hoping and wishing and planning to stick around for a good little while longer yet!

It’s particularly nice, this year, not to see any notable Republicans on your agenda!  I guess a lot of them are busy today...  preparing resumes and scanning the want ads.

In my speech today, I’m going to talk about a lot of good things that we’ve accomplished together. But right at the start, I want to acknowledge some people without whom very little of it would have been possible.  I’m talking about Ontario’s Deputy Minister of Health, Ron Sapsford, and the remarkable team he was working with him at the Ministry. 

I know everyone in this room joins me in thanking you, Ron -- not only for the work you do, but for putting up with me day in and day out.

Before I charge ahead with my remarks, let me also take a moment to congratulate Ruthe Anne Conyngham.

And, while I’m acknowleding people, let me say a word to Gary Cardiff, outgoing OHA Chair.  We all wish Gary a swift recovery from recent procedures and we thank him for his dedication.

As I said a moment ago, I’ve had the opportunity to speak to the OHA four times now, more often than any of my known predecessors.  And I’m very proud of that. 

For me, these four speeches to the OHA represent more than just a recurring gig on my calendar.  They represent a partnership that I’m very proud of.  A partnership that our government values very highly.  And most importantly, a partnership that has served the people of Ontario very, very well.

For that, I want to thank you -- on behalf of my Premier and on behalf of the people we represent.

I think it’s also fair to say that our partnership, our “relationship”, has evolved over this time.  Our relationship inherited a lingering fear of hospital closures, uncertainty about funding, labour issues.  I also think there was a certain skepticism, perhaps even occasional animosity, that permeated the relationship between Ontario’s hospitals, the Ministry of Health and Long-Term Care, and on occasion even the Minister.

When the Premier handed me the health portfolio, I knew I was being given a lot of responsibility.  But I don’t think I realized what an incredible amount of work there was to be done. 

And now, three years later, it’s incredible what we’ve achieved.

The successes that we’ve achieved are a big part of the reason why I’m so optimistic about the future of health care. 

I’m also optimistic because I’m a Liberal -- both big “L” and small “L”.  I believe in the importance of moving forward;  I believe in progressing beyond the status quo;  I believe that we have the power to make positive changes and I’m restless to do my part to bring these changes about, to serve as an agent of change. 

And, as a Liberal, I also know, each and every day, who it is that I work for... who all of us work for... namely, the patients we serve.  The people of Ontario.  The ones who have entrusted their health care system to us.

Yes, our successes during the past three years have been remarkable.  But before I talk about what we’ve achieved, let me talk a little bit about how we’ve achieved it.

On literally hundreds of occasions, I’ve championed the notion that “we are all in this together.”  We occupy a privileged role as health care providers, but it’s a role which dictates that our system perform as one.  Because we all know that’s the only way to deliver real results for our patients.

And the good news is that we have been working together.  Every one of our successes is the result of co-operation, of collaboration, of teamwork.  And I’m enormously gratified by this.

Now, I’ve already talked a lot about the great successes we’ve had and the things we’ve achieved... which leads me to believe I may have reached the part of the speech where skeptics in the audience may feel compelled to turn to the person sitting beside them and murmur, “Doesn’t he realize that serious challenges remain -- for our hospitals and for our health care system?” I do know that.  I couldn’t agree more.

But to you I issue the following challenge.  Tempting as it might be to contribute to the typically cynical reporting of the health care system by the media, I would encourage you to reject it.  To reject it and, in place of this cynicism, to adopt a more honest posture.

A posture that recognizes that the improvements we seek must be realized, and that the only way to realize them is through a relentless dedication to the theme of continuous quality improvement.

Those who pretend -- like John Tory -- that all that ails us in health care can be solved with just a few more Minister’s letters, written in haste and sent overnight, not only miss the point, they mislead the public.

Roy Romanow -- a man for who I have enormous respect and who I’m proud to call a friend and mentor -- recently observed that “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.”

Those who promise quick-fix solutions may as well be selling snake oil.  And those who promise to fix the system by clawing $2.4 billion out of health care -- as our friend John Tory says he’ll do -- are selling something even more dishonest.

I’m a big boy and I understand that I work in an environment where large numbers of people plan their days with no objective other than to discredit the achievements of government.  I understand this;  in fact, I thrive in this kind of environment.

But to the cynics and critics and skeptics I say this: be careful.  Be careful that your negativity doesn’t short-change our front line health providers.  Be careful that you don’t do more harm than good, as you throw barriers and abuse at those who dedicate their careers to the pursuit of excellence. 

Be careful that you do not deprive our patients of the influence of pride, innovation, of continuous quality improvement.

And the improvements are there for all to see. 

Let me begin with one that it know to all of you:  wait times. 

Is it working?  Of course it is.  The evidence is clear; the numbers are irrefutable.  And if any further proof is required that our wait times strategy is working, just look at the long list of those clamouring to come aboard.

An ever-expanding information system and fantastic innovations championed by thousands of front line staff expand our capacity to broaden the wait times reach.  That’s continuous improvement! 

But I also believe that it’s necessary to conduct this wait times debate in a more honest way.

In the 2003 election campaign, our party promised aggressive action to reduce wait times.  In fact, this promise was a central part of our health care platform.

And it wasn’t just Ontario that embraced wait times;  it’s now on the agenda in every province and in Ottawa -- and it was Dalton McGuinty who put it there.

And make no mistake:  wait times are down.  Significantly.

When I hear misinformed journalists or opposition politicians trying to accuse of cannibalizing existing services, or shuffling funding in order to score political points, I shrug.  But when I hear people within the medical community level these kinds of accusations, I shudder. 

When I hear doctors, or hospitals, accuse us of “cherry-picking”, or of shifting money from one pocket to another, I ask myself why those who claim evidence as their touchstone would use surveys of their membership to perpetuate such a myth.

Consider, together we’ve performed 657,000 new procedures.  And I emphasize:  new procedures.  And every single one of these 657,000 was paid for with new money.  At full price.  And let me add, this money was received by hospitals with the express understanding that all other levels of service be maintained.

For those of you with a commitment to public health care... those of you who have worked to achieve good results, I invite you to share in the pride of this achievement, and to celebrate it. 

And the real winners, of course, aren’t my colleagues in the Hepburn Block, or those of you who run our hospitals;  the real winners are the patients we serve, and those patients who will benefit from an array of innovations our efforts have cultivated.

Shorter wait times are a key element of our commitment to the people of Ontario.  And, together, we’ve delivered well and taught ourselves many lessons about how we can do our work better.

A second area where the successes are apparent is with respect to hospital stability.

I’ve traveled to every corner of this province.  And this summer, during my travels, I made a decision to spend as little time as possible on 400 series highways.  It gives you a very different perspective on our province.  And one thing I learned is this: as important as our big hospitals are to our major urban centres, our small and rural hospitals are even more important to their communities.

They are a matter of confidence.

Our government has been very clear in its commitment to these hospitals serving our rural communities.  And our commitment isn’t just rhetorical, it’s backed up with decisions and with dollars.

We’ve teamed many up with Family Health Teams, enhanced their funding related to diagnostic imaging, Emergency Room and Health Infrastructure Renewal Fund dollars. 

I make no apologies for the fact that small and rural hospitals receive more, relative to their size, than larger hospitals.  That’s because larger hospitals have greater opportunities to achieve efficiencies. 

We’re also champions of multi-site hospitals, especially the smaller sites within these multi-site corporations, and we’re taking steps to ensure that they’re not treated as the “poor cousins.” 

Far too often, the allocation of resources within these multi-site institutions has seen the smaller sites receive less than their fair share.  And, yes, I know it’s a difficult job to efficiently administer a sprawling, multi-site entity like, for example, Quinte Health Care, with sites miles and miles apart, in Bancroft, Picton, Trenton, and Belleville.  But Quinte Health Care has met the governance challenge and has made good strides forward.

Still though we all have more work to do in order to ensure that these smaller communities have greater confidence in their health care futures.  I’ve often said, we’re in the confidence business.  And that’s what we’re working to build.

One of the challenges in ensuring the ongoing viability of small and rural hospitals is governance.  Another is a lack of clarity about what kinds of core services we expect small hospitals to be able to deliver.

On this front, I’ve tasked the Joint Planning and Policy Committee to help define “core hospital services” for small hospitals.

Patient centred innovation invites us to be open to change.  But constant change sure can feel like a slippery slope sometimes.  We need to provide a foundation of core services for each of our small hospitals.

And confidence is the best platform for patient centred innovation.

Today, hospitals in Ontario are enjoying a renaissance, a blossoming of creativity, imaginative thinking, and inspired problem-solving. 

Barely a day goes by when I don’t have an encounter with a hospital administrator, a researcher, or a front-line caregiver, who tells me another remarkable success story of how a patient has been helped or system outcome has been improved. 

On every front, teams of people are exploring new ways of doing things.  And the result is a stronger, more productive health care system;  a system that is improving its capacity to care for its people.

Together we are the leading jurisdiction in Canada to advance innovation within the context of our much loved medicare.

Let’s continue with some more good news, shall we?

One of the things I’m most proud of is our government’s track record when it comes to new hospital capital funding.  As I said a moment ago, we’re keeping existing hospitals open -- all of them -- and we’re also putting shovels in the ground all across this province to build newer ones.

Is there anyone here in the audience from:  Mississauga, Sudbury, Sarnia, Sault Ste. Marie, London, Ajax, Hamilton, Ottawa, Ingersoll, Woodstock, Belleville, or North Bay?

How about Cornwall, Listowel, Almonte, Napanee, St. Catharines, Richmond Hill, Mattawa, Newmarket, Oakville, Waterloo, Sudbury, or Sioux Lookout?  Oh yeah... and Toronto?

Well, you know what I’m talking about!  There’s a new hospital, either rising out of the ground, or about to, in your community.  We’re talking about more hospitals, and more than 2,000 additional acute care beds. 

People often talk about how they want their government to deliver “results.”  Well, these are results that speak volumes.

And here’s another “result” that brings joy to my heart:  in the three years that have passed between my first speech to this audience and today, we’ve witnessed an extraordinary turn-around with respect to the financial performance of our hospitals.

I know, of course, that managing these issues requires ongoing dedication and vigilance.  And I know that all Ontarians thank you for your hard work and commitment to this effort. 

In addition to better financial performance we’re also seeing better funding.  And of course the two go hand in hand.

The reality in Ontario today is that every year, every hospital receives more money.  It’s a pretty simple equation.  And it adds up to stability -- stability that was in desperately short supply just a few short years ago. 

A few short years ago, hospitals were clamouring for predictable, stable, multi-year funding. 

Done!

And the list goes on.

• Today we have 4, 299 new nurses working in Ontario today. A year from now, with the new nursing positions already funded, that number will rise to 6, 500.  That’s new nurses working in communities, hospitals, long-term-care homes and public health units throughout this province.
• And it’s not just more nurses we’re seeing, but more nurses working full time.  In the past three years, we’ve increased the number of nurses working full time to sixty-two per cent -- a nine per cent increase. 

What else have we done?  Let’s go on!

• We have more than doubled the number of nurse practitioners we can educate;

• 750 new International Medical Graduates are sharing their skills, expertise and compassion with Ontario patients;

• We have 150 Family Health Teams up and running in every part of the province;
• There has been a renewal of primary care in Ontario, making it possible for us to increase the proportion of those doctors who will work as family medicine residency positions by a whopping 70 percent;
• We are  providing primary care to 458,081 more patients since we came into office;
• We’re helping kids be healthier through newborn screening, three new vaccinations and aggressive efforts to reduce teen smoking.

That’s an impressive list.  And I could go on.

When I look back over the way the health landscape has changed during the past three years, I take great satisfaction in the fact that hospitals today truly are a part of a health care system.   

Those of you who are lucky enough to hear me speak from time to time will know that a subject near and dear to my heart is the building of a true health care system.  Today, we’re headed in the right direction.

I’m not going to veer into my speech about Local Health Integration Networks, but LHINs are certainly a big part of the progress we’re making.  The strategic investments we’ve made have also helped to build a ‘system.’  Gone are the days when the Ministry would provide funding for just one area, at the expense of others, creating bitterness and rivalries. 

And it truly is a source of enormous satisfaction and pride for me to see hospitals working co-operatively with other elements essential to health care:  community, primary care, long-term care, home care...

I’ve often said that the best care is the care that’s offered as close to home as possible.  That’s a principle our government subscribes to.  

What it really boils down to is this:  respect.  We’ve worked hard to create a culture where we tackle problems collectively, where we work co-operatively, where we share responsibility as well as ideas and expertise.

When I announced our ER strategy at St. Joseph’s Hospital here in Toronto about two weeks ago, I was joined on stage by Dr. David Bach, Hilary Short, Camille Orridge, and Dr. Bob Bell.

That’s the President of the Ontario Medical Association, the President & CEO of the Ontario Hospital Association, the Executive Director of the Toronto Community Care Access Centre, and the President and CEO of the University Health Network -- all of them standing side by side to champion an important health care policy announcement that they all contributed to.

The symbolic value of that united front speaks volumes.  It tells our patients that we finally get what they’ve known for a long time.

It also speaks volumes about what we’ve achieved, and about what it’s possible to achieve if we work together.

Yes, our list of achievements is impressive -- impressive no matter how you look at it.  But much remains to be done.  As we prepare for the work ahead, there are decisions to be made -- and one of the most important is the decision the people of Ontario will make next October.

Our government, the McGuinty government, has a set of values, of principles, that have guided our health care reforms.  I may be a little biased, but I think we’re on the right track.

If you’re one of those who believes in public health care and wants to see it strengthened, this government has delivered.

If you’re one of those who wants to see us build a more integrated, co-operative health care system -- a true system -- this government has delivered.

If you’re one of those who want to see hospitals large and small, in big cities and in small rural and Northern communities, remain strong and viable, this government has delivered.

It’s a record of innovation, of investment, of success.  It’s a record of community based governance, of giving real power to local communities.

We’ve built a stronger health care system, and we want to make it stronger still. 

With a little luck, the people of Ontario will grant us the privilege of continuing to work on their behalf.  And, if all goes well, I’ll see you again a year from now, for what will be my fifth speech to the OHA. 

And I wonder aloud... if the first anniversary gift is a feather boa... I wonder what the fifth is?

All I know is that I’m looking forward to continuing to work with you and, hopefully, to see you again a year from now.  I’ll be fighting hard for that privilege, as I know you’ll all be working hard on behalf of our employers -- Ontario’s patients.

Thank you.