Executive summary

The Premier’s Council released its first report in January 2019 which identified the main challenges facing Ontario’s health care system. The first report, Hallway Health Care: A System Under Strain, explored what many Ontarians – and health system leaders – already suspected: the current health care system isn’t working as well as it could for patients, providers, families, caregivers, or taxpayers.

The Council’s first report also identified emerging themes and opportunities for ending hallway health care, such as integrating care around patients, innovating in care delivery, finding more alignment and efficiency across system goals, and planning for long-term capacity needs. Since the release of its first report, the Premier’s Council has conducted 10 regional engagement sessions in communities across the province and has heard from hundreds of individuals through its public email account. Although this is only the beginning of public engagement activities, the Premier’s Council has already received many important considerations directly from patients, providers and sector leaders about how to improve the system and end the problem of hallway health care.

The system – and Ontarians – are ready for bold change to improve and protect our publicly-funded health care system. There are many opportunities to improve the design and delivery of services in the province to ensure that the system is providing the right care, at the right time and in the right setting. This is about more than ending hallway health care, it’s about building a better health care system that works for Ontarians of all ages.  

The Council’s second report to the Premier and Ministers of Health and Long-Term Care provides advice on how to achieve that new vision for health care in Ontario: a vision for a modern, sustainable and integrated health care system that is centred on the patient.

The Council’s ten recommendations


  1. Put patients at the centre of their health care. Patients should be well-supported and treated with dignity and respect throughout all interactions with the health care system.
  2. Improve patients’ and providers’ ability to navigate the health care system, simplify the process of accessing and providing care in the community, and improve digital access to personal health information.
  3. Support patients and providers at every step of a health care journey by ensuring effective primary care is the foundation of an integrated health care system.


  1. Improve options for health care delivery, including increasing the availability and use of a variety of virtual care options.
  2. Modernize the home care sector and provide better alternatives in the community for patients who require a flexible mix of health care and other supports.

Efficiency & Alignment

  1. Data should be strategically designed, open and transparent, and actively used throughout the health care system to drive greater accountability and to improve health outcomes.
  2. Ensure Ontarians receive coordinated support by strengthening partnerships between health and social services, which are known to impact determinants of health.
  3. As the health care system transforms, design financial incentives to promote improved health outcomes for patients, population health for communities, and increased value for taxpayers. 


  1. Address short- and long-term capacity pressures including wait times for specialist and community care by maximizing existing assets and skills and making strategic new investments. Build the appropriate health care system for the future.
  2. Champion collaborative and interprofessional leadership development focused on system modernization capabilities.