September 23, 2016

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

Dear Minister Hoskins:

Welcome back to your role as Minister of Health and Long-Term Care. As we mark the mid-point of our mandate, we have a strong and new Cabinet, and are poised to redouble our efforts to deliver on our top priority — creating jobs and growth. Guided by our balanced plan to build Ontario up for everyone, we will continue to work together to deliver real benefits and more inclusive growth that will help people in their everyday lives.

We embark on this important part of our mandate knowing that our four-part economic plan is working — we are making the largest investment in public infrastructure in Ontario’s history, making postsecondary education more affordable and accessible, leading the transition to a low-carbon economy and the fight against climate change, and building retirement security for workers.

Building on our ambitious and activist agenda, and with a focus on implementing our economic plan, we will continue to forge partnerships with businesses, educators, labour, communities, the not-for-profit sector and with all Ontarians to foster economic growth and to make a genuine, positive difference in people’s lives. Collaboration and active listening remain at the heart of the work we undertake on behalf of the people of Ontario — these are values that ensure a common purpose, stimulate positive change and help achieve desired outcomes. With this in mind, I ask that you work closely with your Cabinet colleagues to deliver positive results on initiatives that cut across several ministries, such as our Climate Change Action Plan, Business Growth Initiative, and the Highly Skilled Workforce Strategy. I also ask you to collaborate with the Minister Responsible for Digital Government to drive digital transformation across government and modernize public service delivery.

We have made tangible progress, and we have achieved the following key results:

  • Delivered Patients First: Action Plan for Health Care: the next phase of Ontario’s plan for building a health care system that puts patients first, enabling us to deliver better, easier access to care.
  • Introduced new legislation that would, if passed, provide Local Health Integration Networks an expanded role including in primary care, home and community care and public health in order to improve access and integrated service for patients.
  • Launched a Roadmap to Strengthen Home and Community Care to help keep Ontarians safe and healthy in their communities as they age, including an investment of $750 million over three years that supports improved access to care and better consistency and quality of care.
  • Improved access to fertility treatments for Ontario families and to sex reassignment surgery for transgender people.
  • Completed a series of provincial stakeholder engagement sessions as part of a palliative care consultation and announced a new investment of $75 million over three years to improve access to community-based hospice and palliative care.
  • Increased safety in long-term care homes with continued investments for resident care, specialized investments for behavioural supports, and an ongoing commitment to annual inspections of every long-term care home in the province.
  • Worked with patients, patient advocacy groups and hospitals to develop a provincial approach to hospital parking pricing that is making hospital parking more affordable.
  • Launched the next phase of the Mental Health and Addictions Strategy in collaboration with the Ministry of Children and Youth Services.
  • Announced an investment of $222 million over the next three years for the First Nations Health Action Plan and, as part of Ontario’s response to the Truth and Reconciliation Commission, announced investments to expand access to Indigenous Mental Health and Addictions Treatment and Healing Centres and mental health and wellness programs.
  • Launched key initiatives to support public health and health promotion such as the Smoking Cessation Action Plan, expansion of Ontario’s publicly funded vaccine program to include shingles coverage for eligible seniors and HPV coverage for boys and the passage of the Healthy Menu Choices Act, 2015.
  • Provided support and stability to the health care workforce, including funding to improve primary care recruitment and retention of nurses and other interdisciplinary team members, as well as personal support worker (PSW) wage increases.
  • Passed the Health Information Protection Act to improve the privacy, transparency and accountability of the health care system.

Your mandate is to provide leadership for the health care system. This leadership is focused on implementation of the Patients First Action Plan through delivery of integrated and comprehensive health services across primary and specialist care, home and community care, hospitals, and other health care settings. Your specific priorities include:

Access: Providing Timely Access to the Right Care

  • Ensuring that patients who want a primary care provider have one.
  • Implementing a publicly available performance report to track and report on primary care access, including attachment, same day/next day, after hours and weekend access.
  • Improving availability of same-day, next-day, after-hours and weekend care by primary care providers to improve care and help reduce unnecessary emergency department visits.
  • Bringing down wait times for specialists by improving the referrals process, better co-ordinating care, improving access to the right providers and making capital investments where appropriate.
  • Implementing the expanded scope of practice of registered nurses to allow them to prescribe some medications directly to patients.
  • Implementing the First Nations Health Action Plan to improve access to service and culturally appropriate care for Indigenous people in collaboration with the Ministry of Indigenous Relations and Reconciliation and Indigenous partners.
  • Working with the Minister Responsible for Accessibility to establish a Standards Development Committee in fall 2016 to begin work on developing a health standard under the Accessibility for Ontarians with Disabilities Act.
  • Ensuring, as you work to improve access to services, that a focus on equity of access is reflected in solutions.

Connect: Delivering Co-ordinated and Integrated Care in the Community and Closer to Home

  • Developing a capacity planning framework to help support the provision of care in the most appropriate setting possible across the health care continuum — hospital, long-term care and community — by reducing the rate of Alternative Level of Care, lowering hospital readmission rates, implementing the Home and Community Care Roadmap, improving palliative care in all settings and making capital investments where appropriate.
  • Connecting and integrating the mental health and addictions system for all patients, including co-ordination with the Ministry of Children and Youth Services, to ensure patients receive high quality care wherever they access services, following advice received from the Mental Health and Addictions Leadership Advisory Council.
  • Improving the safety and quality of life for those living in long-term care homes today and in the future, by considering necessary investments, including staffing, and by advancing the Enhanced Long-Term Care Home Renewal Strategy as quickly as possible and ultimately eliminating all four bed wards in Ontario’s long-term care homes.
  • Bringing forward a plan to make Ontario a leader in digital health care, in collaboration with the Minister Responsible for Digital Government, centred on the principle of improved patient access to information and health care services.
  • Expanding culturally and ethnically appropriate continuum of care services for seniors, including in long-term care homes.

Inform: Providing Education, Information and Transparency to Support Informed Decision Making

  • Developing a one-stop website that provides information to help people make choices about their health and effectively navigate the health care system.
  • Making tangible improvements to the province’s immunization system and aim to ensure caregivers can easily access the information they need on school-aged immunization.
  • Providing education, information and targeted programs for Ontarians on responsible alcohol consumption to help people make better informed choices.
  • Exploring opportunities to enhance the environmental health of Ontarians, including supporting research and engaging key stakeholders such health care providers, public health partners, and patients on potential areas of action.

Protect: Making Decisions Based on Value and Quality to Sustain the Health Care System for Generations to Come

  • Undertaking additional initiatives that will reduce the misuse of prescription opioids across Ontario, and provide support to those with addictions.
  • Increasing low-risk birthing options and availability to improve quality of care and value for the system.
  • Working with the Minister Responsible for Women’s Issues and the Violence Against Women Roundtable to take action to protect patients from sexual abuse, based on the recommendations of the Minister’s Task Force on the Prevention of the Sexual Abuse of Patients and the Regulated Health Professions Act, 1991.

In addition to the priority activities above, I ask that you also deliver results for Ontarians by driving progress in the following areas:

  • Ensure the voices of patients, caregivers and stakeholders are heard and actively consulted through transformation of the health care system.
  • Partner with health service providers on transformation. Make efforts to support health care workers to ensure the demands we are placing on all levels of front-line workers are sustainable.
  • Support the mandate of the newly established Patient Ombudsman as well as the planned provincial Patient and Family Advisory Council.
  • Work with the Minister Responsible for Seniors Affairs on initiatives, such as the development of a dementia strategy that will especially impact seniors.
  • Continue implementation of Immunization 2020 to improve vaccine coverage at all stages of life, from newborns to seniors.
  • Continue to advance a national approach to public drug benefits that ensures equitable access to high quality prescription drugs for all Ontarians.
  • Work with the Chief Health Innovation Strategist to drive collaboration across the health care system, and champion Ontario as a leading centre for new and innovative health technologies and processes.

As you know, taking action on the recommendations contained in the Truth and Reconciliation Commission report is a priority for our government. That is why we released The Journey Together, a document that serves as a blueprint for making our government’s commitment to reconciliation with Indigenous peoples a reality. As we move forward with the implementation of the report, I ask you and your fellow Cabinet members to work together, in co-operation with our Indigenous partners, to help achieve real and measurable change for Indigenous communities.

Having made significant progress over the past year in implementing our community hubs strategy, I encourage you and your Cabinet colleagues to ensure that the Premier’s Special Advisor on Community Hubs and the Community Hubs Secretariat, at the Ministry of Infrastructure, are given the support they need to continue their vital cross-government work aimed at making better use of public properties, encouraging multi-use spaces and helping communities create financially sustainable hub models.

Responsible fiscal management remains an overarching priority for our government — a priority echoed strongly in our 2016 Budget. Thanks to our disciplined approach to the province’s finances over the past two years, we are on track to balance the budget next year, in 2017–18, which will also lower the province’s debt-to-GDP ratio. Yet this is not the moment to rest on our past accomplishments: it is essential that we work collaboratively across every sector of government to support evidence-based decision-making to ensure programs and services are effective, efficient and sustainable, in order to balance the budget by 2017–18, maintain balance in 2018–19, and position the province for longer-term fiscal sustainability.

Marathon runners will tell you that an event’s halfway mark is an opportunity to reflect on progress made — but they will also tell you that it is the ideal moment to concentrate more intently and to move decisively forward. At this halfway mark of this government’s mandate, I encourage you to build on the momentum that we have successfully achieved over the past two years, to work in tandem with your fellow ministers to advance our economic plan and to ensure that Ontario remains a great place to live, work and raise a family.

I look forward to working together with you to build opportunity and prosperity for all Ontarians.


Kathleen Wynne signature

Kathleen Wynne