Hoskins best minister of health in decades

Barely weeks after he was appointed as Ontario health minister, Eric Hoskins attended a private dinner in Banff with his provincial counterparts and Rona Ambrose, then federal health minister.

Although it wasn’t on the agenda, the first thing Hoskins did that evening in 2014 was raise the issue of a national pharmacare program. As Ambrose listened attentively, he made a strong plea for such a plan and won the support of many of his colleagues.

It was a brash move for a rookie provincial health minister, who might normally be expected to sit quietly and listen to the wisdom of long-serving ministers.

But it also was a clear sign of the passion and aggressiveness that Hoskins, a medical doctor, would bring to what may be the toughest job these days in the Ontario cabinet.

On Monday, after almost four years in the job, Hoskins suddenly stepped down as health minister and as the MPP for the Toronto riding of St. Paul’s.

On Tuesday, he was appointed by Ottawa to head the new Advisory Council on the Implementation of National Pharmacare, which was announced in the federal budget speech. The council is to make its recommendations to Ottawa in 2019, before the next federal election.

Hoskins is the ideal choice to head the council, given his long-standing drive to see a universal pharmacare program that would provide free prescription drugs for all Canadians. That’s because Hoskins was the driving force behind Ontario’s decision to implement a limited pharmacare program that offers free drug coverage to everyone under the age of 25. The program, which went into effect on Jan. 1, is one of his major achievements and forms a key part of what is an impressive legacy for Hoskins.

Indeed, he was arguably the best Ontario health minister in decades.

Under his predecessor, Deb Matthews, the health-care system had become a true mess. It had undergone major cuts in services, most notably in rehab therapy, that affected tens of thousands of patients. Home-care services were underfunded and over-managed; local hospital beds and programs were being cut; doctors were increasingly furious over moves to trim their fees; and opposition politicians were outraged over the government’s handling of the suicide crisis in remote First Nations communities in Northern Ontario.

Slowly and steadily though, Hoskins started to effect real change in the chaotic system.

On community care, he scrapped the 14 controversial and bureaucratically heavy Community Care Access Centres, transferring much of their work to 14 Local Health Integration Networks with the goal of saving millions of dollars and using the money for more frontline care.

The initiative still is a work in progress, but there are initial signs that it’s starting to fulfil its mission.

On hospitals, he personally intervened to save some rural hospitals, emergency departments and birthing units. He understood the importance of those local hospitals to their communities, because once lost, those services would never come back.

He stopped the expansion of private clinics, put a halt to medical tourism whereby foreign patients paid big money to get fast services at Ontario hospitals, took a strong stand on high-paid medical specialists and cracked down on medical excesses, such as overuse of costly MRI tests.

At the same time, he was a doer who sometimes got his elbows up too high and clipped other ministers as he strove to promote often dramatic changes. And yes, he could have been more aware of his cabinet colleagues’ concerns, but it was in his nature to push hard on reforms he saw as necessary.

True, Hoskins has his critics, including myself at times, who say he didn’t do enough, such as on primary care reform, or who felt he was too often a captive of the bloated health ministry that he oversaw.

Still, even some of those critics praise Hoskins for the work he has done. They understood he was hamstrung by the government’s fiscal policies, but they also admired his courage and his commitment to the values of universal health care.

Not a bad legacy so far — and one that could grow even more if Ottawa ever does adopt a national pharmacare plan.