Commission on the Reform of Ontario's Public Services

Appendix: <strong>Commission</strong> Recommendations
Recommendation 5-25: Hospital capital plans that extend out-of-hospital services such
as those for outpatients should not be entertained by Local Health Integration Networks.
Hospitals should conduct affairs largely within hospitals, and others, such as Community
Care Access Centres (CCACs) and private health care operators, should be responsible
for providing out-of-hospital services. The CCACs and private health care operators have
demonstrated that they are capable of doing this work for less than hospitals.
Recommendation 5-26: Resist the natural temptation to build many more long-term care
facilities for an aging population until the government can assess what can be done by
emphasizing to a greater extent the use of home-based care that is supported by community
services. Home-based care is less expensive and should generate greater population
satisfaction.
Recommendation 5-27: Grant Local Health Integration Networks the authority,
accountabilities and resources necessary to oversee health within the region, including
allocating budgets, holding stakeholders accountable and setting incentive systems.
Recommendation 5-28: Tie compensation for CEOs and senior executives in all parts of the
health care system to strategically targeted health outcomes, not the number of interventions
performed, through a performance pay framework. Mirror this performance pay approach
throughout each hospital, Community Care Access Centre, long-term care facility, etc., at the
physician and health care worker levels.
Recommendation 5-29: Support transparency in senior executive and CEO salaries
throughout the health care system by publicly posting comprehensive compensation
information in a timely fashion.
Recommendation 5-30: Allocate funding based on meeting the needs of the patient as they
move through the continuum of care.
Recommendation 5-31: Some regions have developed roles for “clerical system navigators”
that co-ordinate appointments and assist patients with required forms and paperwork.
Local Health Integration Networks should ensure that a sufficient number of people in this
role are put in place across the entire health care system.
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