Commission on the Reform of Ontario's Public Services

Recommendation 3-11: Boundaries between public- and private-sector activities should be
shifted and, in many cases, removed. For the most part, policy development needs to remain
in the realm of the government, though various stakeholders and community groups could and
should be more involved. External groups should even be involved in advising the most senior
government decision-making bodies, including the Cabinet.
� Ministries, and in some cases particular programs, should be informed by external advice.
Advisory panels of executives who have led reform/restraint exercises in their own
organization, both public and private, could share their experience. Ministries should also
seek expert input at a more technical level to help assess options for making their
operations more efficient.
� Service delivery should be moved as close and convenient as possible to the clients.
It need not always be solely in the public domain. Services can often be delivered more
efficiently by the private sector, or through a separate agency of government (such as
ServiceOntario), but clear objectives and accountability mechanisms are needed. In many
cases, public-private partnerships could deliver services, as is done with alternative
financing for infrastructure. This could be extended to operations requiring capital for
information technology; private-sector entities could provide some of the capital and
assume some of the risks in return for which they would get a stake in the revenue or
savings flows. For example, the private sector could be asked to participate in the
management of difficult files, such as the heavy concentration of health costs in a small
portion of the population, in return for a share of any cost savings. In all cases, the choice
between public- and private-sector delivery should be driven not by ideology but by
considerations of quality-adjusted cost.
Recommendation 3-12: Within their operations, public-sector service providers should
assign people to jobs where they are most effective, efficient and affordable. Physicians
should not perform tasks that could be done more efficiently and at a lower cost by physician
assistants, registered nurses, nurse practitioners or pharmacists. Case workers need not deal
with all aspects of social assistance, employment or training matters when some clients are
willing and able to receive services by telephone or through the Internet. In the policing sector,
non-core services such as data entry could be done by clerical staff rather than officers whose
time and training are better deployed elsewhere.
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