2013-06-19T13:06:23-04:00 Tim Hudak http://www.huffingtonpost.ca/author/index.php?author=tim-hudak Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Tim Hudak Good old fashioned elbow grease. tag:www.huffingtonpost.com,2013:/theblog//3.2727956 2013-02-21T12:02:36-05:00 2013-04-23T05:12:01-04:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
For the past decade, the Liberal government has tried to sustain our health care system by increasing spending six to eight per cent every year, far in excess of the economic growth that lets us pay for it. And despite all of the spending, we do not consistently get the results Ontario families expect and deserve. The Liberals' philosophy of health care has been "more of the same." But now they've run out of money -- so it's turned into less of the same.

This is why the Ontario PCs released our latest discussion paper, "Paths to Prosperity: A Healthier Ontario." It's the 10th in a series and proposes bold ideas to create a 21st-century model of care that is proactive and based on chronic disease management, health promotion and prevention.

Early in the 20th century, we achieved the biggest improvements in outcomes like life expectancy, mainly by managing infectious disease through clean water, better sanitation and advances in the health system, like vaccinations and antibiotics.

By the middle of the 20th century the biggest challenges were changing. As people lived longer we needed hospitals and more advanced acute care to manage the heart attacks, cancer, and other conditions that became the most important frontiers of health care.

Now, the biggest challenge facing our health care system is changing again. More and more people today are living with two, three, four or more chronic conditions, like heart disease and diabetes and chronic kidney disease. And just as we couldn't deal with acute conditions through cleaner water, we can't manage chronic disease with more acute hospital care. As a result, we need to build a system that treats chronic disease as the leading health care challenge of our time, not as an afterthought in a system designed around acute care.

Currently, the medical profession is mainly set up around diseases -- one doctor to deal with kidney disease and another to deal with diabetes. Even clinical trials typically screen out patients with multiple conditions.

This means that we often have very little evidence about what works for the patients who are the most intensive users of health care. A Healthier Ontario proposes to create one or more centres of excellence to develop new, integrated, evidence-based approaches to care that are tailored specifically to the needs of people with multiple chronic diseases.

We also know that the best care is provided close to home -- through community clinics and home care. Regrettably, people with complex chronic conditions frequently end up in acute care hospitals. Waiting in an emergency room is not only inconvenient and disruptive for these patients, but it is also expensive for the system. By providing community and home-based care options to help patients with complex chronic conditions live better at home, we can reduce the cost and the strain that unnecessary acute hospital visits put on our system.

Lastly, since care is often fragmented, patients with complex conditions often do not have a comprehensive care plan that covers all of the different specialists and all of the different sources of care they access. We must support health professionals to work together to develop integrated care plans for patients that need to see multiple doctors and use multiple sources of care. And for patients with the highest needs, we must provide a dedicated care navigator -- most often a nurse -- who can actively coordinate the plan. This will ensure that a patient doesn't get the same test three times, and that she isn't scheduled for physiotherapy at the same time as she is supposed to be getting an x-ray across town.

We cannot say today that our health care system is the best in the world -- but it can be -- and it starts by building an integrated system that treats a person with as many as three chronic conditions - diabetes, Alzheimer's and heart disease - like one patient, not three.

]]> tag:www.huffingtonpost.com,2012:/theblog//3.2333599 2012-12-20T12:00:55-05:00 2013-02-19T05:12:01-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/ A New Deal for the Public Sector. It's the latest in our series of Paths to Prosperity papers on boosting Ontario's competitiveness for job creation. And its focus is on setting clear goals, doing fewer things but doing them better, measuring success and rewarding performance.

For those in Ontario's civil service, we propose to measure productivity and service quality, just like the private sector does. Those who deliver outstanding service should be rewarded through a tightly managed system of performance pay. What we won't do is hand out bonuses for 98% of government managers simply for showing up, as the current government has done. Those who under-perform, or whose jobs are redundant, won't be on our payroll any more.

A New Deal is premised on the idea that many government workers have lost sight of core priorities through a 20th-century mindset that's completely out of step with a 21st-century economy. Take teaching, which is much in the news these days. It requires remarkable effort, limitless patience and great skill to nurture our children -- all unique individuals with different aptitudes. That's part of the job. But if a truly outstanding teacher performs minor miracles in, say, helping someone who always struggled to read learn the joy of a book, then we should recognize this with pay based not solely on seniority.

But how to create a workplace environment that encourages public servants to do the best job possible, while celebrating the very finest among them?

It starts with breaking down barriers to a career in the public service in the first place, by opening eligibility for government jobs to everyone -- not just those already on the public sector payroll. It will also require putting an end to compulsory union membership and mandatory dues, so if you don't like what your union leadership is doing with your money, you can opt out.

Above all, A New Deal for the Public Sector is about recognizing that there are no easy choices when it comes to creating a government that delivers value for taxpayers and fosters a new emphasis on customer service. A PC government I lead will reduce spending so we can break free of a debt trap that today is swallowing vast sums of taxpayer money that should be going to the things Ontarians care the most about -- education, health care and good bridges, roads and transportation networks. Doing that will mean taking steps that people are going to notice, and won't always like. But we're no longer going to measure a government's performance by the number of people on the payroll, the number of programs delivered or the amount of money spent. Or by the number of fancy stores the government runs or the quantities of roulette wheels it buys.

So here's my offer: We will be clear and honest about what our priorities are. And then we will deliver on them. That's the kind of government Ontarians deserve: one that doesn't just preserve what's best about our province, but builds on it -- to be even better. Under PC leadership, it's exactly what you'll get.






]]> tag:www.huffingtonpost.com,2012:/theblog//3.2259835 2012-12-10T00:00:44-05:00 2013-02-08T05:12:01-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
But today, all these things are at risk. Ontario is in a deep fiscal hole. Without urgent action, we're staring at a $30 billion deficit and a $411 billion debt in just a couple of years. So if we really care about a stronger Ontario we've also got to care about our public debt -- and then do something about it. No more throwing money we don't have at things we don't need, and at every problem that moves. Because the money's run out.

It's time for government to return to balanced budgets, re-focus on its basic responsibilities, and exit the distracting and unnecessary business of being in business: things like designing and selling lottery tickets and putting wine bottles on shelves. Honestly, what's more important: Designer lighting in swanky liquor stores and roulette wheels for shiny new casinos -- or more MRI scans and cancer-beating drugs on the formulary?

This is where the sixth in our Paths to Prosperity discussion papers comes in. It's called "A New Deal for the Public Sector." A New Deal rejects the premise that government success is measured by its number of employees, the amount of money it spends, the number of programs it delivers or the stores and businesses it owns. That's the old way of thinking, and it's helped get Ontario into the mess we're in today.

The problem isn't our civil servants. It's a political leadership that has no vision for government -- other than to make it bigger. By contrast, A New Deal serves as a framework for a leaner government that delivers better priority services for less money, and creates a new culture of customer service. It does so by giving our public servants the specific objectives, measurements and incentives they'll need to help us achieve it.

We'll measure productivity, just like the private sector. Once our planned across-the-board two-year wage freeze is over, we'll reward public servants who deliver superior outcomes through a tightly-managed system of performance pay. We will recognize hard work when it's earned by producing measurable results.

Those who don't perform will no longer be on the government payroll -- again, just like the private sector. We'll end compulsory union membership for people like managers, program supervisors and senior policy advisors, and allow them to bargain individually for their compensation if they choose. And we'll ensure all Ontarians can apply for government job openings, not only those already on the government payroll.

By laying out these goals, expectations and incentives, an Ontario PC government will bring the size and cost of the public sector back into line with our ability to pay. We'll create a more innovative public service that's answerable to taxpayers for the money it spends. The result will be a government that can once again safeguard the things Ontarians truly care about.

But more than that, A New Deal is founded on the simple idea that tough choices are always the right choices. The problem with spending beyond our means is it cuts off our capacity to pay for the things we care about. This is the great irony of those who will oppose the difficult decisions and bold ideas of my leadership. The current government, for example, talks about the need for compassion. But their reckless overspending has robbed us of the ability to be compassionate in the first place.

Compassion is something you are able to do, not just promise. It's an act of love to help those in need, not an excuse for inaction. A New Deal for the Public Sector is a summons to principled action, for an Ontario that can lead Canada again in job creation, quality of life and value for taxpayers' money.

]]> tag:www.huffingtonpost.com,2012:/theblog//3.2103968 2012-11-12T00:00:01-05:00 2013-01-11T05:12:01-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
In our latest discussion paper, "Paths to Prosperity: An Agenda for Growth," my party put this forward as one of our key proposals to kick start our economy.

Experts believe that GTHA gridlock costs Ontario's economy $6 billion a year in lost productivity -- and that figure could double by 2015. In practice, this lost productivity means lower wages and prolonged unemployment. And we all know the effects of this gridlock on our families -- missed dinners, soccer games and school plays.

As the Ontario PC Leader and a Niagara MPP, I'm constantly travelling on GTHA highways. I understand how bad they've gotten. I know firsthand the frustration of cancelled appointments and missed time with family. While some commuters are able to rely on the province's GO Train network and TTC subways, these systems have not kept pace with the population growth of the surrounding regions.

Commuters and businesses in the GTHA deserve a world-class integrated transportation system. Instead of seeing solutions from their elected leaders though, GTHA residents have had to endure endless bureaucratic infighting. People and goods are stuck in traffic while political bickering thwarts real accountability and prevents new projects from moving forward. If politicians' words were dollars, we'd have solved the gridlock problem.

Solving this problem requires leadership with a clear vision and a plan of action. Simply put, there are too many transit agencies and politicians responsible for our region's transportation assets, and no single authority we can hold accountable for operating those assets efficiently. We can't solve traffic gridlock without ending the political gridlock.

It's time for the province to seize the wheel. In our discussion paper, the Ontario PC Caucus put forward three ways to streamline the system that moves people and goods across the region.

Our first proposal is to transfer the TTC's current subway and future LRT operations to Metrolinx, the provincial agency already responsible for coordinating transportation across the GTHA. Our vision is to create a seamless experience for commuters by integrating the region's rail infrastructure into a single network. Commuters deserve that simplicity.

The second step would be to expand the regional transportation network by investing in new public transit and better highways.

In the City of Toronto, our expansion priority starts with subways. While some propose surface-level LRTs, this solution would rip up streets and permanently remove car lanes, making congestion worse. Subways, on the other hand, are a once-in-a-generation investment and offer the best long-term return when it comes to speed, quality and value. It's true anywhere you go: world-class cities build subways.

In the 905, we would improve our highway infrastructure, prioritize expanding the regional rail network and support rapid transit projects that feed that network.

Third, we would fully integrate regional transportation assets under the authority of Metrolinx. The GTHA needs a single body accountable for all rail, highways and regional bus routes. Highways like the 427, 404 and Gardiner Expressway are core transportation routes, but some of these highways are managed by the Province, while others are managed municipally. It only makes sense that one authority has the mandate to plan, maintain, and expand these highways.

There will still be a vital role for local transportation authorities in the GTHA. Our vision is that Metrolinx will focus on fixing regional gridlock, while local municipalities continue to be responsible for buses and streetcars. This allows for smarter community planning: if you need a new local bus stop, you shouldn't have to go to Queen's Park to get it.

In the past, governments tended to look at our transit problems in isolation: regional transit, separate from rail, separate from from roads and highways. We know now that we can only solve our gridlock problems by looking at the problem holistically.

These are achievable goals that will help kick start the economy to create jobs and improve the quality of life for Ontarians. Real leadership is needed to improve transit for our province's commuters. Our plan will move us beyond intergovernmental arguing and promote accountability to accelerate transportation decisions.]]> tag:www.huffingtonpost.com,2012:/theblog//3.2008731 2012-10-25T12:06:34-04:00 2012-12-25T05:12:01-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
In fact we can't accept anything less. We need a thriving and dynamic private-sector economy if we want to invest in core public services like top quality health care, first-class education and new transit infrastructure to break gridlock.

These two aspirations -- to be the engine of Canadian jobs again and to have world-leading public services -- are interdependent, not separate, goals. We can't have one without the other. And Ontarians deserve both.

But we need to be clear-eyed about where those new jobs and resultant tax revenues will come from: a growing private-sector economy. We've tried the alternative -- continuous government borrowing, taxing and spending -- and it hasn't led to either private-sector job creation or sustainable public services.

The Ontario PCs' Paths to Prosperity: An Agenda for Growth -- the fourth in a series -- proposes a very different approach of smaller, more focused government and a level playing field for all to succeed through freer trade, less government interference and broad-based, substantial tax relief. To read all our Paths to Prosperity papers and share your own ideas, visit our site.

Instead of grants and handouts to the politically connected, I believe tax cuts create jobs. This idea is central to An Agenda for Growth. Tax cuts spur economic activity and expand the economy wherever they're tried. The result is more government revenue, not less.

Here in Ontario, this was our experience. I'm proud to have been part of a government that substantially cut taxes on both people and businesses and carried through other pro-growth policies like balancing the budget and eliminating smothering red tape. The result was over a million net new jobs, credit rating upgrades and a 35 per cent increase in tax revenues.

I can tell you from talking to people and businesses during my town halls and the For Jobs and Our Economy tour across the province, there's a consensus taxes must be lower in Ontario.

Tax cuts lead to more tax revenue, not less, while increasing taxes or cancelling a proposed tax cut often leads to far less revenue than expected. As an example, let's take business taxes.

When the Ministry of Finance talks about the "cost" of a proposed tax cut, it accounts for this on a line-item basis by forecasting business profits and then multiplying these by the change in tax rate. The "cost" is another way of saying "revenue loss." It assumes income is stagnant and that it doesn't change as a result of the tax cut, which is what economists call profit shifting.

For example, being sensitive to tax rates, a global corporation might shift operations elsewhere in response to a tax increase, or a local business might scale back expansions and hiring. And while economists argue about the degree of profit shifting that takes place, there's a consensus that higher taxes hold back jobs and growth, and government tax revenue as a result.

When internationally respected economist Jack Mintz of the University of Calgary looked at Ontario's business tax levels, he wrote a Financial Post editorial arguing that while the Liberals claimed the scheduled tax cut from 11.5 to 10 per cent would "cost" $700 million, they ignored $600 million worth of new economic activity that would be generated from this much needed relief.

Why would Professor Mintz say the tax cut cost $100 million and Ministry of Finance say $700 million? It's because you have to account for the economic activity induced by the tax cut, and the effect on government revenues over the long term.

Tax relief creates jobs, grows the economy, and stimulates new business investments. This means more jobs for the unemployed, a rising standard of living and increased tax revenue for the provincial treasury.

Put simply, cutting taxes helps clear the path to economic prosperity.

]]> tag:www.huffingtonpost.com,2012:/theblog//3.1900893 2012-09-21T12:10:27-04:00 2012-11-21T05:12:01-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/ This is the fourth part in a three-part series on health care reform.

Ontario is moving far too slowly in adopting a patient-centred approach to funding health care -- a model that most developed countries have been using for years.

There are two principles behind patient-centred funding.

The first is making sure health care dollars follow patients as they travel through the health system. The second is making sure that health funding reflects a community's health-based needs.

Patient-centred funding doesn't mean less money for hospitals and hubs -- it simply means they'll get the right amount of money.

Here's just one example: historically, Ontario hospitals have received a lump sum of money for the entire year. This had the unfortunate and unintended consequence of turning patients into a drain on hospital budgets. Under this model, every time a patient walked into a hospital for care, the hospital had less money. The province also uses the same funding model for the Community Care Access Centres (CCACs).

When patients are viewed as a drain, the patient-centred approach takes a back seat. Funding needs to follow patients and not the other way around.

We're proposing to reverse this. Under the new system, hospitals would get money for every service they perform. This simple policy change turns patients into valued customers, not drains on hospital budgets. They would be treated like human beings, and get better customer service. It would create the potential for healthy competition between hospitals and independent health facilities, such as Kensington Eye Institute. It would also reduce variations in rates now being paid.

The health hubs I outlined in my previous post would also be funded on a patient-centred basis. Nearly all of the money they get from the province would be based on a hub's community health needs.

Hubs would have total control and responsibility for this funding. For example, a hub might choose to locate a nurse practitioner-led clinic adjacent to a hospital emergency room, so that people with less urgent problems can be seen quickly.

The key idea here is for hubs to have the capacity to pursue more locally-appropriate improvements, based on local conditions -- rather than feel they have to plead with higher authorities for permission, or for resources to pursue these improvements.

What's really exciting about this is that, over time, local initiatives would result in more innovations by frontline staff that can then be circulated throughout the system, to ensure a better use of resources. No matter where someone is in the province they can walk into any hospital for care. Some hubs will chose to offer a particular service regionally, provincially, or even nationally.

So where would all this leave the Ministry of Health?

Under our health hub plan, a smaller, streamlined ministry would shift to a position of strategic advisor with responsibility for provincial health system priorities, regulation, funding, and performance measurement through Health Quality Ontario. This is significant work, but we don't need hundreds of health bureaucrats to do it.

The Ministry would set the policy structure for the hubs, but they would allow these regional health organizations the freedom to design programming to meet patient needs. The Ministry would ensure accountability for quality, either directly or through Health Quality Ontario, and financially through audits.

The main challenge for the Ministry would be capacity planning, and determining the province's future health needs. The last such plan in Ontario was created in 1998.

Without a detailed assessment of our needs and how to meet them, the health care system is on a journey without a map. This broad guidance is the kind of role that is appropriate for government.

The Health Ministry would continue to play an important role in Ontario's revamped health system, but that role would be fact-based planning -- not bureaucratic micromanagement of the system.

This will be my last post on health care in this series tied to our new white paper. We want to make sure to get the health care foundation right and then we can deal with "wiring" of program delivery. We will address other aspects of health care improvement in the near future.

Let me close with some final thoughts on some of the issues I've tried to explore in previous posts.

Health care is the Ontario government's most costly service, and the one most vital to the welfare of all Ontarians.

The problems that patients have in accessing health care today are not due to lack of money in the system, or any shortcomings of our medical professionals or others on the front lines.
No, these problems stem from the way we've organized health care. The system is hard to understand, and the pieces don't interact well enough. For patients' sake, we simply have to do better.

With the bold new ideas we suggest in Patient-Centred Health Care www.ontariopc.com/paths-to-prosperity, we will succeed.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1897797 2012-09-20T08:50:58-04:00 2012-11-20T05:12:01-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
Common sense tells us there ought to be a tight connection among all these entry points, but they're run under separate systems. All you've got is a Local Health Integration Network (LHIN) as the loose glue that tries to hold them all together. It's up to patients to understand how all this works, and try to connect the spokes. That's not right. And it's not fair.

So we propose a stronger central axis. In "Paths to Prosperity: Patient-Centred Care" we propose having 30 to 40 existing hospital corporations take over the functions of the LHINs and Community Care Access Centres (CCACs). Hospitals are already in place, and hubs can emerge from the health care infrastructure in our communities -- more locally focused, with fewer bureaucrats, offering better care.

The health hub is a straightforward concept: they would take over the LHINs' roles of local health care planning, funding and performance. These are jobs the LHINs have measurably failed at doing, despite huge outlays of tax dollars. They would also take on the CCACs' job of connecting people with government-funded home and community care and long-term care.

Most importantly, they would be required to integrate acute care with primary care, home and community care and long-term care -- into a seamless partnership. And all of this happens at the local level.

Health hubs would provide the administrative expertise that this new system requires. They have strong performance and accountability mechanisms already in place. Ontario has the most efficient hospitals in Canada, according to the Canadian Institute for Health Information. They have a long history of success and are a visible centre of care in the community.

Let's be clear: This does not amount to letting hospitals make all the decisions. This will be a partnership among equals. In our proposed model, the people who actually manage and deliver your health care today would run the system, without costly bureaucracies that impede flexibility and innovation.

Local health care shouldn't be run by people appointed by the provincial Cabinet, as is the case with the LHINs. The health hubs would have board members who are up to the task of managing the new system. These people will bring professional expertise and knowledge of their own communities. For physicians, the rise of health hubs will mean an important leadership role in planning primary care, as well as new accountability for results. This will be driven through physician-led Primary Care Committees.

These hubs would have formal authority for integrating primary care physicians into local health care planning and scrutinizing their ongoing performance in quality of care and patient experience.

We see major gains from the integration of primary and acute care with the other two large parts of the health care system, home and long-term care. This would lead to more rational decisions about how money is spent and what volume of services are available.

With a $15 billion deficit, Ontario can't afford to keep throwing money at health care. We need to be smarter about how we spend what we have, and to always put patients' needs first. That's the context in which we offer our ideas for restructuring health care.

But here's the most important thing: The next time a loved one needs some combination of hospital care, home care and the attention of their physician, and you want to help guide them along from one stage to another, you'll both know just where to go, and when. No more run-around.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1885305 2012-09-17T00:00:46-04:00 2012-11-16T05:12:02-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
Common sense tells us there is ought to be a tight connection among all these entry points, but they're run under separate systems. All you've got is a Local Health Integration Network (LHIN) as the loose glue that tries to hold them all together. It's up to patients to understand how all this works, and try to connect the spokes. That's not right. And it's not fair.

So we propose a stronger central axis. In "Paths to Prosperity: Patient-Centred Care" we propose having 30 to 40 existing hospital corporations take over the functions of the LHINs and Community Care Access Centres (CCACs). Hospitals are already in place, and hubs can emerge from the health care infrastructure in our communities -- more locally focused, with fewer bureaucrats, offering better care.

The health hub is a straightforward concept: they would take over the LHINs' roles of local health care planning, funding and performance. These are jobs the LHINs have measurably failed at doing, despite huge outlays of tax dollars. They would also take on the CCACs' job of connecting people with government-funded home and community care and long-term care.
Most importantly, they would be required to integrate acute care with primary care, home and community care and long-term care -- into a seamless partnership. And all of this happens at the local level.

Health hubs would provide the administrative expertise that this new system requires. They have strong performance and accountability mechanisms already in place. Ontario has the most efficient hospitals in Canada, according to the Canadian Institute for Health Information.

They have a long history of success and are a visible centre of care in the community.
Let's be clear: This does not amount to letting hospitals make all the decisions. This will be a partnership among equals. In our proposed model, the people who actually manage and deliver your health care today would run the system, without costly bureaucracies that impede flexibility and innovation.

Local health care shouldn't be run by people appointed by the provincial Cabinet, as is the case with the LHINs. The health hubs would have board members who are up to the task of managing the new system. These people will bring professional expertise and knowledge of their own communities. For physicians, the rise of health hubs will mean an important leadership role in planning primary care, as well as new accountability for results. This will be driven through physician-led Primary Care Committees.

These hubs would have formal authority for integrating primary care physicians into local health care planning and scrutinizing their ongoing performance in quality of care and patient experience.

We see major gains from the integration of primary and acute care with the other two large parts of the health care system, home and long-term care. This would lead to more rational decisions about how money is spent and what volume of services are available.

With a $15 billion deficit, Ontario can't afford to keep throwing money at health care. We need to be smarter about how we spend what we have, and to always put patients' needs first. That's the context in which we offer our ideas for restructuring health care.

But here's the most important thing: The next time a loved one needs some combination of hospital care, home care and the attention of their physician, and you want to help guide them along from one stage to another, you'll both know just where to go, and when. No more run-around.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1885253 2012-09-14T15:52:31-04:00 2012-11-14T05:12:01-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
Consider an older person with a chronic illness. She might need support in her home from a nurse -- say, to ensure she's following her drug regimen or to change bandages. Or primary care from her doctor. Or help at the hospital. Maybe all three, at varying times. It's up to the patient to navigate this complex journey through the system, which, as too many Ontarians know too well, often means being bounced from pillar-to-post to get the right support, in the right order, at the right times -- where everyone involved is talking to everyone else. Too often, if you have a loved one somewhere in the system you have to fight like hell to get anything done.

How to integrate the many disconnected pieces of the system is the chief focus of "Paths to Prosperity: Patient Centred Health Care" -- the Ontario PCs' latest white paper. It was released Monday and is already generating debate, just like the prior two PC papers on affordable energy and modernizing Ontario's labour laws. In it, we've gone looking for the best ideas to "de-layer" middle management and empower local health professionals to treat people -- not push paper.

It proposes to give patients a single pathway through the system -- not a run-around through multiple layers of bureaucracy. And its goal is to deliver on the Triple Aim approach, as defined by the Institute for Healthcare Improvement: to enhance patient quality and satisfaction, improve the health of the population and reduce the per capita cost of health care.

To do all these things, we need to build off what already works -- and avoid institutionalizing weaknesses in the system by just tinkering with underperforming Local Health Integration Networks, or "LHINs." These regional bureaucracies were created by the current government in the hopes of coordinating and integrating the various parts of our health care system in different parts of the province.

Six years on, they have precious little to show for it. On the contrary, there is overwhelming evidence that they are a costly failure: reports were released in July on the performance of all 14 LHINs. Each one of them fails to attain provincially-set targets. The numbers add up to a 77 per cent failure rate across the network. And the government says it's making progress?

The fact is, continuing to tinker with this system is like shoring up a crumbling foundation with a two-by-four: It may hang together for a while, but it's bound to collapse eventually. Instead, we propose bold change, through the creation of hospital-based health hubs. Instead of more bureaucracy, these hubs would build off of what's already working in our system, high-performing hospital infrastructure and expertise. The hubs would be governed by volunteer, skills-based boards, directly linked to physicians.

The reason hubs would be able to better integrate care is because, for the first time, there would be a single platform for planning, procurement and performance at the local level, instead of carrying on with the current, fragmented system. For example, given some room to innovate based on local circumstances, a hub might locate a nurse-practitioner clinic beside a hospital emergency room, so people with less urgent problems could be seen more quickly.

Similarly, one in six hospital beds are filled by people who don't need that costly level of care, and could be in home or long-term care, which are better settings for them. But a lack of coordination prevents this from happening. Our reforms would empower front line health workers to deal with this issue in new ways "on the ground."

We need to break down these barriers and eliminate middle management like LHINs, clearing away the separate layers patients now have to deal with, to give them access to a seamless array of services in their communities. We must also remember that our health care system is for providing care, not for creating or sustaining well-paid managerial jobs for its own sake

Ontario can again have confidence in a world-class health care system, but only if we build on its existing strengths while closing down costly bureaucracies and using the money to directly serve patient needs.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1861863 2012-09-06T13:53:55-04:00 2012-11-06T05:12:01-05:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
The cause is nine years of reckless overspending. The effect is that we've run out of money, which puts everything we value at risk. Compounding the problem is a government that's adrift and out of gas. In the year since the last election, Dalton McGuinty has utterly failed to grasp the seriousness of our situation: not a nickel shaved off his $16 billion deficit, and no action to reduce the cost of our bloated public sector.

In fact, he made things worse -- with a budget that increased taxes and spending, more costly commitments like a home reno tax credit and a tuition grant, and doubling down on a failed green energy program that has pushed electricity costs through the roof. We just can't afford more of the same.

But this government has no plan to turn things around: nothing to rein in overspending, to boost our competiveness and attract investment, or to get our economic fundamentals right to create jobs. They spent years throwing money at their problems. But now, there's nothing left to throw.

In fact, all we have to show for the so-called "emergency session" of the Legislature is exactly one partial wage freeze for one group of government employees. There are 3,999 still to go. We just don't have time for an endless "bargaining-go-round" of the kind we've seen the past several weeks with teachers alone.

This may explain something disturbingly false about the Premier's recent statements: He wants you to forget the huge raises he gave the public sector unions over nine years, and believe what he is saying now. In the next breath, he wants public sector workers to forget what he is saying now, and remember the raises he gave them over nine years.

We need urgent action. So we've tabled a bold package of ideas called "Freeze, Fix, Review." We need an immediate, across-the board wage freeze for the entire public sector, and have a bill on the shelf that's ready to go. We first tabled this legislation last May, which the government promptly voted down. If they are truly serious, this time, about a broad-based wage freeze -- including an end to "performance" bonuses doled out recently to 98 per cent of public sector managers who simply showed up for work -- they'll run with it.

Other perks that have to go include unsustainable benefits the private sector got rid of years ago, like being able to store up sick days and turn them over for money on retirement. Sick days are for being sick, not for cashing out like so many poker chips.

Next, we'll push to halt planned spending increases in no fewer than 14 of 24 Ministries (representing over 80 per cent of total spending, incidentally), which will buy time to get down into fundamental, structural change to fix the way the government works and spends. And as a third step back toward fiscal sanity, we'll need a Fall Economic Statement that actually begins to reduce government spending on a permanent basis.

This is the kind of bold, conservative action I pledged to my party. And we're not stepping off the gas: The weeks to come will see a steady stream of provocative new "Paths to Prosperity" white papers on boosting our competitiveness to create jobs. We've already changed the debate with Affordable Energy and Flexible Labour Markets -- to bring down electricity costs for consumers and businesses alike and modernize our 1940s-era labour laws, respectively. And we're just getting started. Please check our progress for yourself.

Our immediate challenge, though, must be to send this his Premier a message: Stop the overspending and focus on job creation: It's time for straight talk -- and a real plan to get our economy moving. That's where we come in.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1653894 2012-07-06T10:14:55-04:00 2012-09-05T05:12:07-04:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
When it comes to Ontario's Workplace Safety and Insurance Board (WSIB), it's time to "fix it now." Because there's a much bigger bill in our future. Little wonder it's one of four areas for action detailed in our latest Ontario PC white paper on ideas to create jobs called Paths to Prosperity: Flexible Labour Markets.

The WSIB is the government agency that provides injury and disability benefits to workers. WSIB coverage is compulsory for most businesses and industries in Ontario. Employers fund the WSIB through payroll taxes, in the form of premiums based on the earnings of their employees. The WSIB sets these premium rates, while government sets benefits and coverage through legislation.

WSIB premiums are necessary, but they are also a tax on jobs. The objective should be to keep premiums reasonable while still meeting workers' needs. The WSIB has failed to achieve this goal. But successive governments at Queen's Park have gone the "fix it later" route. And the problem is now out of control.

The WSIB currently has an estimated unfunded liability of $14.5 billion. This means that the assets in its insurance fund are $14.5 billion less than what's needed to meet the estimated lifetime costs of all claims under the WSIB's coverage. But according to one recent analysis by the independent, not-for-profit C.D. Howe Institute, entitled "The Hole in Ontario's Budget: WSIB's Unfunded Liability," on a fair-value accounting approach, the unfunded liability could actually be closer to $20 billion. That's some hole.

Yet, despite an increasing unfunded liability, the Ontario government recently unilaterally increased WSIB benefits, making the problem worse. The WSIB can be expected to increase premiums yet again -- acting as a powerful disincentive for businesses to hire new employees.

The management of the WSIB is not a new concern. Since the early 1980s, every government of every political stripe has tried to "fix" the Board, through legislative reform and all sorts of administrative fiddling. The core problems are still there.

The hard fact is that this system was designed for the Ontario of over a century ago -- when horses delivered bottled milk and they hadn't yet painted the Titanic. It simply no longer meets the modern needs of our workers and employers. The time for thoughtful change and bold action is overdue. And that's where Paths to Prosperity comes in.

One solution to this problem is to allow the private sector to compete for providing insurance coverage for workers in Ontario. Most U.S. states already allow private insurers to compete with state insurance funds for the provision of workers' compensation. I believe that a similar model would work well for Ontario.

Right now, 70 per cent of Ontario's workforce is covered under the WSIB. Imposing a deteriorating WSIB on the 30 per cent left out makes no sense. In spite of that, next year, the Ontario government will do just that for self-employed independent construction contractors under Bill 119, called the Workplace Safety and Insurance Amendment Act. We will start our Paths to Prosperity reforms by repealing this backward step the first chance we get, while still ensuring adequate insurance protection.

Allowing private insurers into the market would provide employers with choices, not just about which company, but on the specific details of coverage. Mandatory coverage at equal or better terms would still be in place. An employer would be required to present proof of membership in an alternate plan before they would be allowed to opt out of the WSIB. Private insurance, like WSIB coverage, would remain a "no-fault" system to maintain the integrity of workplace insurance.

Under this proposal, a streamlined, more accountable WSIB governed by a competent, not political, board of directors, would continue to compete with private sector companies. The WSIB would serve as an insurer of last resort, providing coverage to those businesses that cannot obtain insurance elsewhere.

We recognize that these are bold suggestions that must be carefully and thoughtfully introduced. The unfunded liability is both the catalyst and impediment for needed reform. It's a catalyst because its persistence, over 30 years now, shows the system is often captive to short term political interference. It's an impediment because responsible reform cannot permit employers to abandon the Board's liabilities.

That's why we propose a staged reform process. We would start with the repeal of Bill 119, which forces Ontario's self-employed independent operators to join the WSIB. Instead, we would allow those entrepreneurs to opt for comparable private insurance.

Next, as individual business sectors secure an adequate level of funding, we would allow those employers to obtain suitable private insurance. Insurance choice will be respected. Third, we would immediately revamp the Board, replacing a political board of directors with a skills-based board, charged with proper corporate governance oversight.

These reforms will trigger a modernization of Ontario's workplace insurance system, which was once at the vanguard of public policy. Ontario's needs have changed. The Board hasn't. Now it must.

Our province needs bold action to become more competitive and create more jobs. Paths to Prosperity: Flexible Labour Markets shows us the way past these bureaucratic relics of the last century - and into a brighter future.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1646603 2012-07-04T07:47:44-04:00 2012-09-03T05:12:07-04:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/ examples of waste uncovered in U.S. military contracting.

We might laugh at these stories, but when rip-offs like these get close to home, they cease to be funny. Take the outrageous waste that one media outlet recently uncovered in Toronto schools. How funny does $19,000 for the installation of a sign sound? How about $3,000 for an electrical outlet in a school library? About as funny as stories about $436 hammers sold to the U.S. Army sound to Americans, I imagine.

Whether it is at the Pentagon, or the Toronto District School Board, the root of the problem is the same -- sweetheart deals made possible thanks to what's called closed tendering, allowing the well-connected to charge ridiculous rates for routine items or work. And it's a real focus in our latest, hotly-debated Ontario PC "Paths to Prosperity" series of white papers on ideas to help us create jobs. It's called "Flexible Labour Markets." And as controversial as it's turned out to be in labour circles, I think most Ontarians will find it's rooted in basic principles the rest of us can agree on.

As a basic principle, for example, all qualified companies should be allowed to bid on government contracts. Is that a controversial idea? I hope not (although if you're in the business of selling $7,600 coffee makers you might disagree.) Closed tendering is the practice of allowing only contractors with collective agreements with unions in general, or particular unions, to bid on construction or maintenance projects.

Restrictive contracting and subcontracting clauses in union collective agreements with public institutions and municipalities -- including Ontario Power Generation, Hydro One, the City of Toronto and the City of Hamilton -- have created monopolistic bidding conditions that inflate costs and stifle job creation.

More expensive infrastructure means less of it gets built. This means fewer hospitals, fewer roads -- and ultimately, fewer jobs. For example, the City of Hamilton estimates that restrictive clauses within its collective agreement with the United Brotherhood of Carpenters and Joiners of America inflates the prices of its construction projects by up to 40 per cent.

Additionally, last year, Infrastructure Ontario revealed that the $155 million Pan Am Games construction project at Ivor Wynne Stadium would be subject to the same tendering restrictions. As a result, it's expected that the price of this project will also be inflated by up to 40 per cent -- costing Ontario taxpayers millions more.

People often assume that closed tendering affects only non-union contractors. In reality, closed tendering also prevents union contractors from bidding on some contracts as well. Again, the City of Hamilton is a perfect example. Of the 260 or so contractors registered with the City at the time, only 13 of the 260 contractors had unionized workforces with the United Brotherhood of Carpenters and Joiners of America.

Some of the contractors' workforces were unionized by other unions, some were not unionized at all. Hundreds of employers were prevented from competing, and thousands of workers were left with time on their hands.

This is yet another example of outdated government policy that hurts our economy and reduces opportunities for individual workers and businesses. As the representative of taxpayers, government ought to be getting the best price and offering opportunities to the full range of Ontario businesses, not a favoured few.

Government shouldn't be picking winners and losers, but rather ensuring all businesses have the same chance to compete for government work. Opening up tendering for all companies will increase competition, and ultimately cut infrastructure and energy construction costs across the province.

Ontario can lead Canada again in competitiveness and job creation. But first we need to clear away the economic deadwood left over from the last century, such as labour practices which date back to the 1940s and 50s. Closed tendering is one of them.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1638135 2012-07-03T08:00:48-04:00 2012-09-02T05:12:16-04:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/
So why should Ontarians have to live -- and work -- with labour laws, regulations and institutions that are decades out of date, limiting competition, workplace flexibility and job creation?

It's time to modernize our labour markets and rules, to give Ontario employees more choice and control over their own workplace needs and freedoms. Taking bold action on this front is all part of getting our economic fundamentals right, by encouraging the kind of flexible workforce Ontario businesses need to be competitive and create good jobs again.

In the Ontario PCs' new "Paths to Prosperity: Labour Flexibility" white paper, we say it's time to rethink the extraordinary powers government grants unions. While unions fight to protect existing jobs, they can't be allowed to prevent new jobs from being created. Ontario needs to focus on expanding its economy and creating jobs, not just on slowing job losses. That's not the road back to prosperity. It's the wrong path.

Over time, unions have contributed to developing Ontario's middle class and to improving safety in the workplace. These were important gains. Unions prospered in a world of large corporations, jobs-for-life and a relatively slow pace of change. But those days are gone. The world has changed. The protectionist instincts that shaped our worldview then have given rise to globalization now.

Today, workers of all ages want and take far more control over their careers, switching employers and even moving to new fields altogether. They need workplaces, pay and benefits that will make it easy for them to branch out and try new approaches and ideas. Old-fashioned workplaces where union contracts narrowly prescribe exactly how a job must be done and who will do it just aren't compatible with the 21st century-style competition we face from abroad. Neither are the grievances that usually meet efforts to adapt to customer or consumer demand, and that often result in operations grinding to a halt, resulting in lost market share.

Unfortunately, the big public sector unions don't seem to have noticed the rapid shift to a 21st century economy, which features more small and medium-sized employers, multiple careers for workers and constantly changing economic demands. They're more at home with workplace laws, rules and government agencies that date back in some cases to the 1940s.

Yet in American states with which Ontario must compete in the 21st century, far different rules apply. So far, 23 of them have adopted laws making closed union shops illegal, and which protect employees from being fired for not paying union dues.

We've studied their approach carefully to sift through for what we can adapt to our own realities. Same with the experience of Europe, Australia and New Zealand, which have all moved ahead on labour market reforms just like these. So while they may be new ideas for Canada, they're standard practices in most of the industrialized world where we do business. And for countries and markets we want to do business with -- by attracting jobs and investment here to Ontario.

The changes in the United States are critically important to our province. Why? Because our neighbour is on the verge of a manufacturing renaissance. The Boston Consulting Group projects that net labour costs for manufacturing in China and the U.S. will converge around 2015. This U.S. manufacturing renaissance is expected to take place primarily in states with voluntary unionism.

Over the last decade, more than five million Americans have moved from states where union financial support is mandatory to states where it is voluntary. Modern labour market rules create opportunity (not to mention fatter paycheques), and workers follow.

Bold changes that make union leaders accountable to their members are pro-market, pro-worker, economic reforms that take issue with the extraordinary ability of unions to levy what amounts to a tax. These changes can take a number of different forms. They can make forced union membership an unfair labour practice for unions and employers. They can also require that union dues be collected by union officials themselves -- not by the employer or the provincial government through automatic payroll deductions -- to drive more accountability.

Reforms can guarantee that all votes by secret ballot can be administered independently, for example by the Ontario Labour Relations Board or Elections Ontario. Not only should every employee have the right to a secret ballot vote to certify or not, but all strike votes and collective agreement ratification votes should be by supervised secret ballot as well.

Sometimes big challenges require big ideas. And big ideas mean big change. Ontario has bounced back before by thinking -- and acting -- with bold strokes. Ontario can again lead Canada in competitiveness and job creation by getting our economic fundamentals right. But a key step will be to open up economic opportunities for individual workers -- not old-time union bosses.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1638130 2012-07-02T00:00:03-04:00 2012-08-31T05:12:07-04:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/ dropped on Ontario. Our province lost over 31,000 full-time jobs in the previous month, making May the 65th consecutive month that Ontario has lagged Canada in job creation. Or maybe you didn't: Bad economic news here is so routine now it's usually not news at all.

With nearly 600,000 Ontarians out of work, our province is short on hope these days. Hope won't create change, though. Change requires action. And our goal, as the PC Party of Ontario, is to bring hope to our province while delivering change.

That is why I'm proposing a bold modernization of the province's outdated labour laws and workplace regulations and agencies. Big parts of this system date back to the 1940s. They need to be hauled into the 21st century -- just as Europe, Australia, New Zealand and the U.S. have done -- recognizing the fact that today's workers have much more variable workplace requirements. Our ability to compete, to innovate and develop a truly modern economy depends on it.

These new ideas are contained in the second of our "Paths to Prosperity" white papers, entitled "Flexible Labour Markets." (Our first one, the hotly-debated Affordable Energy, is available here.) "Flexible Labour Markets" recognizes that the world has changed, and that our economy has changed with it -- but that the rules governing the workplace, and the way unions are run -- have not.

The recent loss of the Caterpillar plant in London was just one example of Ontario's new reality, making increased productivity essential to attract and retain both domestic and international business operations, and the jobs that come with them. So we need to adapt, looking carefully at what works elsewhere in the world.

That means, for example, that our public sector tendering rules should be changed to open more government work up to real competition. This will ensure more roads get built and new buildings opened on time and on budget -- while creating more competition, and more jobs.

As well, our Workplace Safety and Insurance Board and the Ontario Labour Relations Board need reforms that will encourage, not discourage, job creation.

Then there's the issue of the tremendous power given to unions by governments over the years. No one should be fired from their job, or not hired for a job for which they are the best candidate, simply because they aren't a union member. We need to make it easier for workers to make this basic choice, based on what works for them and what will drive their own prosperity.

It may even be that the new ideas we're putting forward will help government in its tough relationship with public sector unions. While unions in the private sector must ultimately compete and change, or lose jobs, their public sector counterparts act like monopolies that just don't factor in economic realities and the public's ability to pay.

Bottom line: Ontario can lead Canada again in competitiveness and job creation, but only by getting our economic fundamentals right. A big one is the need to open up economic opportunities for individual workers -- not union bosses. That's what "Paths to Prosperity: Flexible Labour Markets" is all about.]]> tag:www.huffingtonpost.com,2012:/theblog//3.1539559 2012-05-24T08:48:05-04:00 2012-07-24T05:12:07-04:00

Tim Hudak http://www.huffingtonpost.com/tim-hudak/ "They own assets all over the world, including property in Manhattan, utilities
in Chile, international airports and the high-speed railway connecting London to the Channel tunnel. They have taken part in six of the top 100 leveraged buy-outs in history. They have won the attention both of Wall Street firms, which consider them rivals, and institutional investors, which aspire to be like them..."

No, the above isn't an excerpt from an article about some new class of hedge funds.

It's actually from a piece in the Economist about Canada's large public sector pension funds.

The article calls these funds "Maple Revolutionaries" for their willingness to seek out
investment opportunities overseas that offer a reasonable rate of return at an acceptable level of risk.

Many of them have their main offices in Toronto, including the Canada Pension Plan Investment Board, Ontario Teachers' Pension Plan, Healthcare of Ontario Pension Plan and Ontario Municipal Employees Retirement System.

In our recent Ontario PC Caucus policy white paper, titled "Paths to Prosperity: Affordable Energy," we propose why we think these Maple Revolutionaries have an important role to play in Ontario's energy sector.

I can see them, for example, helping shift the power sector away from its traditional reliance on government spending and public borrowing towards more private capital and investor risk.

What if, for example, Ontario Power Generation and Hydro One were opened up to investment, in the form of a partial sale to a consortium of Canadian pension funds?

The benefit for the pension funds is straightforward. They need investment opportunities
that are aligned with their long-term interest of earning stable returns, so they can continue paying pensions to retirees at reasonable cost. Ontario power sector assets could potentially be a good addition to the pension funds' infrastructure holdings.

What the pensions will provide, in return, is a strong push for OPG and Hydro One to be
managed more efficiently. In particular, the pension funds will ensure greater attention is paid to controlling costs and promoting efficiencies.

Right now, there are more than 11,000 people at OPG and Hydro One making more than $100,000 per year -- more than double the number in 2003, despite a significant drop in demand for the energy they produce and transmit across the province. A dose of scrutiny from outside investors on labour costs like these will go a long way to improving how these enterprises are run.

This would be welcome: A recent report prepared for the Ontario Energy Board (OEB), the provincial regulatory body, found that OPG's Pickering nuclear station is among the most poorly run in the world in terms of measures like overall capability and generating cost per megawatt hour.

Following the sale of an equity stake to the pension funds, we could unlock additional value through an offering of shares to other investors.

"Paths to Prosperity: Affordable Energy," emphasizes that, even with this outside investment, the government will continue to play a role in energy policy, albeit a more limited and focused one. The OEB will still be there to make sure power prices are reasonable and fair, for example.

This approach is truly win-win-win -- not only for ratepayers but for taxpayers in the broader sense. Our electricity sector will be better managed by bringing pension fund expertise and private investor discipline to the table -- which will benefit consumers by helping lower costs.

The province's credit rating will benefit, as outside capital reduces the need for Queen's Park to borrow money for energy projects, set against a looming $30 billion deficit and unsustainable $411 billion debt. And Ontario's public sector pensions will receive solid returns on their investments here at home, helping ensure a secure retirement for their hundreds of thousands of members.]]>