Chapter 1: We hear you, Ontario

The Premier’s Council has heard from over 1,500 patients, caregivers, families, health care professionals and organizations on the future of health care in the province. In addition to drawing from their own professional experience, Council members gathered a wide range of perspectives and ideas from Ontarians through:  

  • Ten regional engagement sessions with over 650 participants from the following communities: London, Kingston, Ottawa, Toronto (Central and West), Sault Ste. Marie, Sudbury, Kenora, Thunder Bay and Sioux Lookout;
  • A virtual engagement session with over 250 Francophone stakeholders and participants in 16 sites across the province;
  • Initial dialogue with Indigenous communities and partners;
  • Ongoing input from over 80 health sector leaders participating in six Premier’s Council Sub-Committees; and,
  • Over 500 written survey responses and emails. 

Many Ontarians read the first report and responded by sharing their own personal experiences through the email address: There were over 50 formal submissions from individual health care professionals or associations, and many people took the time to meet with us, providing research and helpful perspectives on how to improve the health care system and end the problem of hallway health care.

Ontarians are encouraged by the speed of progress and change and want to make sure the quality and availability of care won’t be impacted while the sector transforms. All of the feedback received through these engagement activities was reviewed and considered in the development of this report. The Premier’s Council is grateful to Ontarians for their interest in and commitment to modernizing health care in the province.

Common feedback across Ontario

Although the province is home to many unique communities – large and small, rural and urban, a wide range of cultures – Ontarians generally spoke with a common voice on very clear themes. 

For the most part, Ontarians want the same from their health care system: publicly available services that are easy to understand and access. Patients want more options and flexibility in how they access health care, and they want to know that the system is supporting them throughout the process, ensuring they are engaged and empowered throughout their health care journey. Ontarians would feel more confident in a health care system knowing their primary care provider was acting as a quarterback for them: championing their needs, guiding them through a complex system and providing leadership they can count on.

Patients across the province also have a broad understanding of what “health care” should mean in Ontario. They want to see closer partnerships between housing, social services and health care. They want to have more choices in how they connect with their care providers; if they can video-chat with friends and family, why can’t they do the same with a health care professional? Although not every patient wants to – or is able to – use more digital solutions, there was broad support for improving options for connecting with care while maintaining patient choice.

We know that these perspectives from patients are echoed by the friends and family members who care for them. Research from The Change Foundation on the experience of caregivers in Ontario has uncovered concerns with accessing and navigating services across the province. Family caregivers are frustrated that health care providers do not always communicate with one another, resulting in caregivers having to re-tell a patient’s story, and spend unnecessary time clarifying information. In fact, caregivers and health care providers are both looking for one clear point of contact that ensures patients’ needs are met at every segment of their health care journey.

Caregivers are also looking for improved scheduling and timing of appointments. A report from 2016, titled Ontario’s Family Caregivers / The Caring Experience called attention to the fact that primary care appointments and home care visits can cause significant stress for a caregiver who must shift their personal commitments to accommodate a disjointed schedule of health care appointments. For family caregivers supporting patients with dementia, extended hours for respite or additional access to support overnight would help make it possible to keep their family member at home longer rather than moving them to a long-term care home. These examples point to areas where the health care system can redesign and re-orient services to better support the day-to-day realities facing patients, their families and caregivers.

Personal health information and a patient’s health record should be digitally available and easily shared at the discretion of the patient.

Patients want to be partners in their health care. They view health care as a shared responsibility between patients and providers. Patients are doing their best to keep track of appointments, follow medication and rehabilitation instructions, and provide helpful updates to their primary care providers. Patients and providers would both prefer a health care system where health information was easily shared across providers working in different parts of the system, and more readily available to patients.

The health care system should deliver a better patient experience, ensuring patients are treated with respect and dignity at all times.

Ontarians are proud of being able to access publicly-funded health care services; however, there is room to improve how this care is delivered and navigated. The Premier’s Council received strong feedback throughout the province about the need to create a better experience for patients and families accessing care. If the patient is at the centre of the health care system, certain decisions should change to improve interactions and information sharing between patients and providers. For example, patients want information about publicly-funded care options, and conversations with providers that are respectful, proactive and easy to understand. Patients should be confident that the system is paying attention to their unique health care needs and should be comfortable asking questions at any time along their health care journey.

There are already many good examples of local integration and digital solutions – build on these models rather than starting from scratch.

The public strongly believes that existing partnerships throughout the health care system should be maintained and protected – especially now, during a time of significant transformation. The Premier’s Council heard clearly that patients and providers like the care that’s currently delivered through integrated primary care teams, and they appreciate creative solutions and partnerships that already exist between care settings in their local communities. Patients believe that when they receive care, it is generally of high quality. Despite the positive feedback from patients about the quality of care, access remains a challenge. In many instances, access to care is delayed and the system continues to struggle with transitions in care due to a lack of system-wide integration. 

There are many examples of digital health services already working across the province. In the current system, telemedicine has been a critical tool in improving access to care in remote, rural, Francophone and Indigenous communities that do not always have sufficient in-person capacity to meet local health care needs. Both remote patient monitoring and digital self-care, such as monitoring blood pressure at home, enable a small number of providers to coach a large number of patients. The province can and should continue to build on these successes by ensuring technology continues to supplement health care resources.

The current mix of health care and related services are not meeting local needs.

Even though hallway health care occurs in hospitals, part of the problem can be addressed by improving access to quality health care in other care settings – especially home and community care, and mental health and addictions services.Ontarians want more flexible home care services that respond to their individual needs and easier access to mental health and addictions services and supports in community settings. Some communities have access to a range of assisted living, supportive housing or other congregate care models, but these are not consistently available across the province. As innovative approaches emerge throughout the province, patients expect the system to encourage this kind of health care.