At last, a champion for Ontario patients
When it comes to power and influence in health-care circles, doctors rank first, hospitals second, government bureaucrats third and nurses fourth.
Far down the list are patients and caregivers.
At last, though, that’s about to start changing in Ontario.
In a welcome and long-overdue move, Health Minister Eric Hoskins has appointed Christine Elliott, the former Conservative deputy leader, as Ontario’s first patient ombudsman.
Her main role will be to act as a powerful champion for patients, giving a voice to people who feel the health-care system has failed them.
Elliott is a good choice for the job and the Liberal government deserves praise for creating the post. But there is still more that Queen’s Park can do to ensure that patients’ concerns, needs and input are given true consideration when it comes to helping shape health care in the years ahead.
For decades, the Ontario healthcare system has been planned, operated and overseen by doctors, hospital administrators, health ministry bureaucrats and executives in agencies such as the Local Health Integration Networks and Community Care Access Centres (CCACs) responsible for home care.
What’s been missing is the voice of patients and caregivers.
That’s inexcusable, given that some 400,000 people are employed in the Ontario health system and several million patients are treated in hospitals, at home and in community settings each year.
Until now, those patients have had few places to turn when they ran into roadblocks in the system, or have been frustrated trying to find their way through the layers of bureaucracy and in getting anyone in authority to deal with their issues.
As health ombudsman, Elliott is to work with patients and caregivers to resolve complaints about their health-care experience. She will also investigate health-sector organizations on her own initiative, make recommendations for improvements and make annual reports to the minister.
Although her five-year appointment doesn’t come into effect officially until July 1, 2016, she will start preliminary work on recruiting a staff of 12-15 people early next year. She will earn about $220,000 a year. Elliott quit provincial politics in August, three months after losing the Tory leadership race to Patrick Brown.
Hoskins said Elliott was chosen from more than 400 candidates. Her “advocacy for vulnerable people, extensive knowledge of the health-care system and commitment to the betterment of this province make her the perfect choice for Ontario’s first patient ombudsman,” he said.
While some people question the ombudsman’s independence because the post reports to the minister, patient advocate groups are delighted with Elliott’s appointment, suggesting she will be taken seriously at Queen’s Park. As an MPP, she fought for better treatment for stroke victims and people with disabilities, and was a driving force behind a legislative committee’s push for the auditor general to review the operations of the troubled CCACs.
“There is much to be done in alerting the public and the minister to where patients fall through the cracks and get bad outcomes,” says Michael Decter, a former Ontario deputy health minister and chair of Patients Canada, a national advocacy group. “For example, transitions from hospital to home are a major area of problems for patients.”
As encouraging as this move is, there is still more the government can do to give patients a true voice in health care.
One suggestion circulating in the upper levels of the health ministry is to appoint an assistant deputy minister for patient experience. The proposal was first revealed in a blog by Steve Paikin, host of The Agenda on TVO.
The health ministry now has 16 assistant deputy ministers or their equivalents. Their areas of responsibilities range from provider agencies to doctors and pharmaceuticals. Although they may not realize, such bureaucrats can sometimes get captured by and become advocates for those interests over time.
None of them, however, have prime responsibility for patients. That means there is no voice for patients or caregivers around the table when the top bureaucrats meet to formulate future policies and procedures or to assess how existing programs are working.
It’s a stunning absence, given that many universities, such as the University of Toronto, have created positions in recent years to deal specifically with student experiences.
Also, some hospitals have established jobs to deal with patient experience and many private companies have executives assigned to customer care.
Naming a health ombudsman is a positive first step in giving patients a voice.
Appointing such an assistant deputy minister, though, could be exactly what’s needed to shake up the health ministry and focus its attention laser-like on where it should be — the patients and caregivers of Ontario.