September 25, 2014

The Honourable Dr. Eric Hoskins
Minister of Health and Long-Term Care
Ministry of Health and Long-Term Care
80 Grosvenor Street
10th Floor, Hepburn Block
Toronto, Ontario
M7A 2C4

Dear Minister Hoskins:

I am honoured to welcome you to your role as Minister of Health and Long-Term Care. We have a strong Cabinet in place, and I am confident that together we will build Ontario up, create new opportunities and champion a secure future for people across our province. The people of Ontario have entrusted their government to be a force for good, and we will reward that trust by working every day in the best interests of every person in this province.

As we implement a balanced and comprehensive plan for Ontario, we will lead from the activist centre. We will place emphasis on partnerships with businesses, communities and people to help foster continued economic growth and make a positive impact on the lives of every Ontarian. This collaborative approach will shape all the work we do. It will ensure we engage people on the issues that matter the most to them, and that we implement meaningful solutions to our shared challenges.

Our government’s most recent Speech from the Throne outlined a number of key priorities that will guide your work as minister. Growing the economy and helping to create good jobs are fundamental to building more opportunity and security, now and in the future. That critical priority is supported by strategic investments in the talent and skills of our people, from childhood to retirement. It is supported through the building of modern infrastructure, transit and a seamless transportation network. It is supported by a dynamic business climate that thrives on innovation, creativity and partnerships to foster greater prosperity. And it is reflected across all of our government, in every area, and will extensively inform our programs and policies.

As we move forward with our plan to grow the economy and create jobs, we will do so through the lens of fiscal prudence. Our 2014 Budget reinforces our commitment to balancing the budget by 2017-18; it is essential that every area adheres to the program-spending objectives established in it. We will choose to invest wisely in initiatives that strengthen Ontario’s competitive advantage, create jobs and provide vital public services to our families. The President of the Treasury Board, collaborating with the Minister of Finance, will work closely with you and your fellow Cabinet members to ensure that our government meets its fiscal targets. The President of the Treasury Board will also lead the government’s efforts on accountability, openness and modernization as we implement new accountability measures across government.

Our government continues to deliver better access, better quality and better value for money for Ontario’s health system. As Minister of Health and Long-Term Care, you will lead the shift toward a sustainable, accountable system that provides co-ordinated quality care to people, when and where they need it. You will partner with administrators, health care providers and patients to achieve our shared commitment for a system that is there for generations.

In pursuit of our commitment, I ask that you keep in mind three key goals: people receiving the right care at the right time and the right place; an accountable, efficient and transparent system; and promoting healthier lifestyles for Ontarians through shared responsibility across government.

Delivering quality health services is a shared responsibility. You will foster collaboration across the system and make the necessary trade-offs to shift spending to where Ontario will get the best value for our health care dollars — which must be shared between our health system partners.

For example, through Health Links, we have worked with providers across the system to deliver quality care in appropriate settings, to our most complex patients, and you will continue to build on these successes. It will be a challenging transformation, but you and your health care partners will work together to protect and strengthen our health care system.

Your ministry’s specific priorities include:

Putting Patients at the Centre — the Right Care, Right Place, Right Time

  • Ensuring that patients receive timely access to the most appropriate care in the most appropriate place — and that the needs of Ontario’s patients are at the centre of the system. This means care that is appropriately co-ordinated around the person receiving it, especially for those who are transitioning through and across systems and sectors.
  • Championing the delivery of quality co-ordinated care to patients by making the best use of the skills and capacity of all our health care providers, hospitals, community clinics and organizations, long-term care homes and others. You will take the lead in ensuring that changes are informed by evidence — and that Ontario’s precious health care dollars improve quality of care and health outcomes for patients and families.
  • Continuing to expand home and community care to ensure that people receive care as close to home as possible.
  • Strengthening Ontario’s end-of-life care.
  • Improving the capacity of the health care system by making the following investments: capital grants for major hospital expansion and redevelopment projects; community infrastructure to help shift care from hospitals to community settings; and home and community care services.
  • Bringing forward a plan to ensure that every Ontarian who wants one has a primary care provider.
  • Exploring options to improve wait times for referrals to specialist care.
  • Continuing to ensure that our system has the health human resources it requires to deliver quality and efficient care. This includes exploring appropriate expanded scope of practice for providers and more models for collaborative care.
  • Building on the 2014 Budget announcement to increase wages for Personal Support Workers (PSWs) in the home and community care sector, your goal is to develop a strategy to bring stability to this workforce and ensure we meet the need for PSWs in the long term.
  • Collaborating with hospitals to jointly bring forward a plan to reduce or cap hospital parking rates for frequent visitors.
  • Exploring ways to improve dementia supports, including new memory clinics.
  • Continuing the pursuit of affordable drug access for patients in partnership with your federal, provincial and territorial colleagues. This will include a co-ordinated process for approving new and expensive drugs to minimize the wait for people who need these lifesaving medications.

Moving Forward on Accountability and Transparency

  • We have succeeded in bringing down annual health spending growth from about six per cent in 2012 to about three per cent in 2013 – without compromising care. We did so in partnership with our health care administrators, institutions and providers. You will now work with them, as outlined below, to continue to drive accountability, transparency and quality throughout the system, while limiting expenditure growth.
  • Continuing to change Ontario’s funding system for hospitals, Community Care Access Centres and long-term care homes so that it reflects the care that people need and receive. I also ask that you explore opportunities to optimize quality and value in community laboratories and the broader laboratory sector.
  • Partnering with stakeholders to establish the patient ombudsman, who will resolve patient complaints and drive improvements in quality across the health care sectors.
  • Continuing to work toward delivering excellent air ambulance service to patients that meets the highest standards of accountability and transparency.
  • Pursuing changes to deliver more efficient and co-ordinated care to patients. This will include a review focusing on improving patient outcomes and value for money of Local Health Integration Networks (LHINs), Community Care Access Centres and Public Health Units.
  • Exploring options to further strengthen the framework for ensuring that the community sector and LHIN-funded health service providers are accountable for delivering quality patient care, including expanding the Excellent Care for All Act.
  • Continuing to respect the negotiation process with the Ontario Medical Association, which enhances our respective abilities to improve productivity, deliver quality services to patients and ensure fiscal sustainability.
  • Accelerating the adoption of new health technologies and innovations that demonstrate value and contribute to a more productive and sustainable health care system. You will do so by partnering with the ministers of Research and Innovation, and of Government and Consumer Services — and by continuing to work with the Ontario Health Innovation Council.

Collaborating on Shared Responsibilities across Government

  • Striving for a system that delivers the best quality care to meet the needs of patients and that continues our success in lowering the growth in health care spending. With support from the Associate Minister of Health and Long-Term Care (Long-Term Care and Wellness), you will continue our drive for a sustainable, accountable and quality health care system.
  • Working with the Minister Responsible for Seniors Affairs on initiatives that will especially impact seniors.
  • Working with the Minister of Aboriginal Affairs on ongoing work related to Aboriginal health and wellness.
  • Delivering on the next phase of the Mental Health and Addictions Strategy to support the delivery of co-ordinated, timely and quality services. You will lead this work — partnering with those across government and across systems — to support healthier, resilient and inclusive communities.
  • Working as part of Realizing Our Potential, Ontario’s Poverty Reduction Strategy to expand access to health benefits for children in low-income families. You will do so in collaboration with the ministers Responsible for the Poverty Reduction Strategy, of Community and Social Services, of Children and Youth Services, and others. This will build on work underway to expand access to existing dental programs to all low-income children. I also ask that you explore long-term options for a sustainable program that provides health benefits to lower-income Ontarians.
  • Helping develop a policy on community hubs that reflects the perspective of health and wellness. You will work on this in partnership with the ministers of Education and of Municipal Affairs and Housing, the Associate Minister of Health and Long-Term Care (Long-Term Care and Wellness), and others — and in consultation with stakeholders.
  • Working with the Associate Minister of Health and Long-Term Care (Long-Term Care and Wellness) to build a culture of health and community wellness, including supports and programs, to help people stay healthy. This will include encouraging Ontarians to play an active role in health care by participating in healthy living and wellness, and by taking advantage of programs that support these goals. You will work in collaboration with other ministers, including the ministers of Children and Youth Services, and of Education, and the Minister Responsible for Seniors Affairs.

We have an ambitious agenda for the next four years. I know that, by working together in partnership, we can be successful. The above list of priority initiatives is not meant to be exhaustive, as there are many other responsibilities that you and your ministry will need to carry out. To that end, this mandate letter is to be used by your ministry to develop more detailed plans for implementation of the initiatives above, in addition to other initiatives not highlighted in this letter.

I ask that you continue to build on the strong relationships we have with the Ontario Public Service, the broader public sector, other levels of government, and the private, non-profit and voluntary sectors. We want to be the most open and transparent government in the country. We want to be a government that works for the people of this province — and with them. It is of the utmost importance that we lead responsibly, act with integrity, manage spending wisely and are accountable for every action we take.

I look forward to working together with you in building opportunity today, and securing the future for all Ontarians.


Kathleen Wynne signature

Kathleen Wynne