How premier’s health-care adviser can earn his $348K
If Rueben Devlin can prepare Ontario’s health-care system for the rest of the 21st century, he’ll be worth every nickel of the $348,000 the provincial government is paying him.
The former chief executive of the Humber River Hospital in Toronto is chairing Premier Doug Ford’s Council on Improving Healthcare and Ending Hallway Medicine, charged with, well, fixing hospitals. It’s the Progressive Conservatives’ most important and most difficult promise. Cutting gasoline taxes is dead easy. So is lowering income taxes. Getting Ontario out of the international carbon market involves more paperwork, but it’s also pretty simple: ministers give orders and it happens.
Health Minister Christine Elliott can’t order patients off stretchers and into hospital rooms that don’t exist. Every person stuck on a hallway gurney is there because of a lack of physical hospital space; a shortage of nursing-home beds, of doctors and of nurses; inefficiencies in how hospitals treat and track cases; a lack of primary and preventive care; lifestyle choices the government can’t directly control. Medicine’s very success in prolonging life by monitoring and treating chronic conditions has given us more years in which we need monitoring and treating.
Ford could hardly speak about health care during the campaign without talking Devlin up. What a whiz he is, how he’d help a Tory government get health care sorted out. He got his new post as soon as the new government was in place, while the Tories were firing equivalent advisers hired by the Liberals to help with things like industrial subsidies and science policy.
Devlin’s a former president of the Progressive Conservative Party of Ontario and Humber River is the Fords’ go-to hospital. Devlin personally stood with Ford as he announced his brother Rob’s severe illness there in 2014. Hiring friends for government gigs was supposed to be done with now.
But orthopedic surgeons with serious hospital-administration experience and outlooks simpatico with the premier’s are not sitting around Ontario with nothing to do. Turns out expertise costs money. Let’s point out the petty hypocrisy and move on.
Humber River Hospital might be a model for hospital care. Built just off Highway 401 on the west side of Toronto, it bills itself as North America’s “first fully digital hospital,” designed from the ground up with equipment and workflows to gather and transfer key information electronically — quickly, accurately, traceably. Devlin was its boss for 17 years and oversaw the creation of the new facility to replace three old ones.
After leaving the top post at Humber River, Devlin became a consultant and told his story at other institutions. In one talk at Windsor Regional Hospital, he took a question about whether Humber River has room for expansion. His answer noted what a problem hospitals have with patients who really need nursing-home care but can’t get rooms to move into.
“We have patients who we term ‘alternate-level-of-care — ALC’ — and if we ever solve that problem, then we probably don’t need to expand in the near future,” he said, with a little smile to acknowledge what a big challenge that would be for someone a comfortable distance from him.
Throwing money at more and bigger hospitals to hire more staff and provide more treatments is the one thing this particular government really can’t do: the health budget is already set to reach $61.3 billion this year, and any increase big enough to make a difference would torpedo any possibility of balancing Ontario’s books. (Ford has an ambitious promise to add 30,000 new long-term-care beds over 10 years, which will just keep pace with expected demand and the funding ’s got to come from somewhere.)
The new Humber River Hospital cost $1.75 billion and has 700 more workers than its predecessors. In 2014, the institution spent $355 million; last year, $483 million. It’s a very advanced hospital, arguably a very good hospital. It is not a cheaper hospital. How ever talented Rueben Devlin is, he isn’t a wizard.
The changes to the health system need to be massive, they need to start quickly, they need the co-operation of Ontario’s fractious doctors, its well-organized nurses and non-medical staff and patients. They’ll be things the Liberals never thought of or couldn’t pull off. And they have to be either free or come with extremely short payback periods — saving so much money so fast that the upfront costs don’t matter.
The opposition New Democrats attacked Devlin’s appointment in the most by-the-numbers way possible. Devlin’s job is “cushy” and “a patronage appointment,” apparently.
It’s certainly not cushy. Ontarians’ experiences with the health system will depend on what Devlin tells the premier. People will live or they will die. Almost as much is at stake for Ford’s government.