Commission on the Reform of Ontario's Public Services

Recommendation 5-2: Evaluate all proposals for change that include efficiencies and
cost savings within the vision and plan developed above.
Chapter 5: Health
Recommendation 5-3: Divert all patients not requiring acute care from hospitals and into a
more appropriate form of care that will be less expensive, improve the patient experience and
reduce the patient’s exposure to new health risks.
Such services could be provided by private, for-profit entities, but operated within the public
payer system. Government would continue to determine what services are offered and set the
fees paid by OHIP. The patient experience would, however, remain the same: upon
presentation of a health card, the government will pay for the services rendered.
Recommendation 5-4: Increase the use of home-based care where appropriate to reduce
costs without compromising excellent care. For example, home-based care should be used
more extensively for recovery from procedures such as hip and knee surgery.
Recommendation 5-5: To improve the co-ordination of patient care, all health services in a
region must be integrated.
This includes primary care physicians, acute care hospitals, long-term care, CCACs, home
care, public health, walk-in clinics, FHTs (which for the purposes of this chapter includes
Family Health Organizations [FHOs], groups and networks), community health centres and
Nurse Practitioner-Led Clinics (NPLCs).
Cancer Care Ontario, which has recently begun to apply the expertise it built in addressing
cancer to renal disease, is a good model for better co-ordinating chronic care services along a
continuum of providers.
Exceptions to the regional system are specialized health facilities that have provincewide
responsibilities for service co-ordination and system building. Facilities such as the Hospital
for Sick Children, Princess Margaret Hospital and Centre for Addiction and Mental Health
have quite unique roles and relationships with the provincial government as well as their local
health authorities.
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