Ontario: Progress?Critique and analysis of the 2009 Progress Report from the

Government of Ontario

Who is McGuinty?The “Education Premier”

Wanted to rebuild public services after Harris government

Vowed: Education

Add $1.6 billion to school systemMove away from private school funding and invest

further in the public systemReduce class sizes

HealthMake two-tier health care illegal Stop privatizing MRI/CT clinics, and open more public

clinics

Ontario Progress ReportSixth in a series of Progress Reports updating

Ontarians on the results we have achieved together in a transparent and measurable way

From the point of view of the government of the day, can be biased or misleading

AgendaHealth Care Analysis and Critique

Education Analysis and Critique

Misleading Facts and Figures

HEALTH CARE

Ontario’s Top 5 Healthcare Problems

As quoted by Michael Decter, former chair of the Health Council of Canada and the Canadian Institute for Health Information:

1. Chronic Disease

2. Integrating Health Services

3. Smarter Systems

4. Need for More Doctor and Nurses

5. Wait Time Reductions

Dalton’s Claims: Chronic Disease

Banned smoking in vehicles with children under 16 present

Helped the growing number of Ontarians living with diabetes through a mix of prevention, technology, personal planning and access to specialized resources and health professionals, benefitting 310,202 Ontarians so far.

Banned trans fat from food and beverages sold in schools.

Offered free measles, mumps, rubella vaccines through a catch-up immunization program

Dalton’s Claims: Integrating Health Services

Helping Ontario patients get the care they need, faster

You could have your fracture set by a qualified nurse practitioner

People needing a prescription re-fill can make one trip to a pharmacist

Physiotherapist can now order an x-ray

If your nurse practitioner suspects pneumonia, she order your x-ray, she could prescribe your antibiotics.

Dalton’s Claims: Smarter Systems

Implemented e-Health (Electronic Health Record) Medication Management

Enable online prescription & medication historyProvide decision support for physicians ordering

drugs Wait Times

Enable public reporting & performance management

Dalton’s Claims: More Nurses & Doctors

That’s why we’ve provided funding to create nearly 10,000 more nursing positions. More than 900 nursing positions will be created in 2009–10.

About 800,000 more Ontarians now have access to a family doctor, compared to 2003

Over 7,700 nursing graduates have been matched to job opportunities through our Nursing Graduate Guarantee.

There has been a 23 per cent (160 students)  increase in medical school enrolment from 2005–06 to 2008–09.  

Dalton’s Claims: Wait Time Reductions

Compared to four years ago, Ontarians are getting:

cataract surgery 197 days faster

hip and knee replacements 185 days and 262 days earlier

cancer surgery 16 days sooner 

cardiac procedures up to 23 days quicker

MRI and CT scans 15 days and 34 days faster 

We have expanded the Wait Times Strategy to include general surgery. Ontarians received an additional 8,240 general surgery procedures since October 2008

Criticism: Smarter Systems Implemented the e-Health System

Used $1 Billion of Ontario taxpayers money for Electronic Health-record system

$4.8 million in no-bid contracts during first four months $50,000 to refurnish the CEO’s office Paying consultants $300/hour

Despite decades of work, Ontario still back of the pack compared to other provinces in developing electronic health-care

Auditor General Jim McCarter: “We did not get value for money for this billion dollars”

The report also linked the untendered contracts to McGuinty’s role in the hiring of eHealth Ontario’s chief executive and not providing oversight in the hiring of consultants

Criticisms: More Nurses & Doctors

Improper diagnoses of problem…

Canada has been slowly losing its doctors and would-be doctors to the USA - thanks to two main factors – The much higher salaries in America Ample and better post-graduate training

opportunities.

1 in 12 Canadian-educated physicians practiced in the United States

This is equivalent to having 2 average-sized Canadian medical schools dedicated to producing physicians for the United States.“

Criticisms: More Nurses & Doctors

Several possible causes of shortage of doctors:

The number of dissatisfied physicians leaving Canada is said to be increasing.

The baby boomer generation of doctors will soon start to retire.

Doctors are increasingly concerned about their lifestyle and may be reducing their hours of work

Aging of the population is increasing need for medical care

Facts & Figures The cost of health care in Ontario in the year 2000 was $22.2

billion; in 2011 the cost is going to be $47.4 billion

Increase has not improved the quality of service compared to what Ontarians received in the past

Ontario also has the lowest per-capita number of nurses We have 633 registered nurses per 100,000 people Compared with 983 in Newfoundland 920 in Prince Edward Island And 717 in Quebec.

We also have the lowest ratio of physicians. In Ontario, there are 85 doctors per 100,000 people Compared with 116 in Nova Scotia and 111 in Quebec National Canadian average is 98 Only Nunavut has a lower number: 26 physicians per 100,000

people.

EDUCATION

Dalton’s Claims - Early Learning

Has created more than 22,000 childcare spaces across Ontario since 2003. Ontario will start phasing in full-day learning.

Up to 35,000 kindergarten students across Ontario will be enrolled in September 2010. The goal is to have the program fully

implemented in all schools by 2015-16.

Current Reality - Early Learning

According to the Canadian Centre for Policy Alternatives: The Ontario budget includes no allocation to

implement federal recommendations . What happens to funding for 22,000 child care

spaces when federal funding expires next year?

According to the Child Care Resource and Research Unit: Ontario is considering allowing fewer staff to care

for larger groups of young children. Ontario could be the first province to lower child

care standards

Dalton’s Claims – Funding Students

In 2003–2004, one quarter of all primary classes had 25 or more students.

By 2008–2009: 90.3 % of primary classes had 20 or fewer

students. 100 % of primary classes had 23 or fewer

students.

As of 2009–2010, are funding more than 10,500 additional teaching positions

Current Reality - Funding Students

Further, according to the CCPA:

Ontario’s per student school funding places the province far behind most peer jurisdictions in North America .

The gap is most notable between Ontario and key North American cities.

In 46th place compared to American states and ninth among Canada’s 13 jurisdictions.

New York City invests twice as much per student in public education as Toronto.

Dalton’s Claims – Education Standards

Overall, 67 % of Ontario Grade 3 and 6 students are meeting or exceeding the provincial standard in reading, writing and math. A 13 % increase over 2002–2003.

Education Standards - Ontario

Steady improvement in in EQAO results over the past five years:

Since 2008, the percentage of students meeting or exceeding the provincial standard in Grade 6 reading is 69%

Grade 9 applied mathematics, the percentage meeting or exceeding the standard is 38%.

Other criticismsSome flaws in the funding formula:

Underinvestment in programs required to support students with special needs in Ontario.

A lack of funding for local priorities.

A complete lack of accountability to ensure the provincial government responds to the inadequacy of its funding to schools.

Misleading Facts and Figures (Health Care)

1,790 new international medical graduates (IMGs) entered practice in Ontario between 2003 and 2006 How many remained in Canada?

Shorter wait times What are the original wait times?

Misleading Facts and Figures (Education)

Smaller class sizesSmaller class sizes ONLY in primary schools

(JK to Grade 3)

Higher test scores5,100 new primary school teachersBut only 126 teachers for Grades 4 to 8

Misleading Facts and Figures (Education)

Good, safe places to learn3500 schools have safety audits, how many

schools in Ontario does that cover?

Reaching higher Invested $3 million in bursary support over

three years Which means only 1 million per year, divided over

800 is only $1250

Capped tuition increases — after freezing tuition for two years — at an average of 5% annuallyStill growth of 5% per year

Misleading Facts and Figures

Health Care and Education spending = +5% / year (2009 Budget) Reality

Freezing hospital funding (Healthzone)Cutting in education (Policy Alternatives)Early Learning in question (Globe and Mail)

ConclusionHealth care is close to 50% of operating budget

Education is another $19.9 billion (20%)

Combined, 70% of operating budget

Sustainability is a huge issue Demand for investment in new tech,

infrastructure, and other vital social services will increase

Deficit will only grow larger