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Toronto Star Sun May 17 2015

At last, Ontario Health Minister Eric Hoskins seems to get it. After nearly a year of insisting Ontario's much-criticized home-care system is performing just fine, Hoskins is now admitting the system is an utter mess and in desperate need of fixing. Hoskins made the concession last week in unveiling a 10-point "road map" to improve home- and community-care delivery across Ontario. The program is a small, first step in the right direction, but lacks real details and falls far short of what is required to reform a system in such disarray.

The most important step was taken by Hoskins when he adopted a new attitude toward home care, a key part of the overall health-care system that has suffered for years from severe underfunding, political neglect and too much bureaucracy. Indeed, Hoskins could actually become the new home-care champion.

Toronto Star Sun Dec 6 2015

After months of planning and false starts, Ontario Health Minister Eric Hoskins finally has all the proof he needs to push ahead at full speed with sweeping changes to the province's troubled home-care system. So what's holding him up? For weeks, Hoskins has been signalling he will release a "discussion document" outlining radical reforms, including scrapping the beleaguered 14 Community Care Access Centres (CCACs) that co-ordinate home-care delivery across the province.

He received even more evidence this past week that it's time to transform the system with the release of auditor general Bonnie Lysyk's annual report. Lysyk listed a wide range of mismanagement, poor oversight and horror cases in which patients failed to get services such as nursing, physiotherapy and personal support on time or in enough quantity to make a lasting difference in their health. In many instances patients had to wait almost a year just for an initial assessment. In recent days, Hoskins has been telling key health-sector players he will release his discussion paper "before the holidays."

Toronto Star Sun Sep 27 2015

In the wake of the latest major report that blasts the way Ontario looks after home care in this the province, it is time for Ontario Health Minister Eric Hoskins to take immediate action to fix a system that is clearly broken. The latest horror-filled report, released last week by auditor general Bonnie Lysyk, outlined a system that is utterly confusing, often mismanaged, lacking in oversight and filled with inconsistencies in how patients are treated. Lysyk took particular aim at the 14 Community Care Access Centres (CCACs), the publicly funded organizations that co-ordinate nursing, therapy and personal support services for patients outside of hospitals.

Basically, her report described a troubling situation where Queen's Park champions the huge CCAC bureaucracy that costs too much money and does nothing very well. Among her findings was the stunning revelation that more than $900 million of the $2.4 billion that CCACs receive annually to deliver for home- and community-care services actually go for administration and overhead - not direct patient care.

By almost any measure, Eric Hoskins has had a rough time over the past few months. A chorus of doctors is demanding he be fired as Ontario's health minister because their fees are being trimmed; patients are staging protest rallies over cuts at local hospitals; health-care stakeholders are resisting his plans to dramatically reform the home-care system; political opponents are attacking him for the government's handling of the suicide crisis in the remote First Nations community of Attawapiskat. The list goes on.

The reasons Canada is nowhere close to implementing such a plan are simple: stiff opposition from private insurance companies and skittish politicians who don't want anything to do with raising any taxes — even for a sensible and fiscally solid cause — for fear of voter backlash. Over the past year, Hoskins has quietly pushed the pharmacare agenda with provincial and federal health ministers. As a start, he convinced his colleagues at a meeting in January to set up a working group to look into the issue. Now he's stepping up his efforts as Ottawa turns its attention towards the coming negotiations later this year on a new federal-provincial health accord. He wants pharmacare to be a key part of the accord talks.

In July, the proposed plan will be high on the agenda when the premiers hold their annual meeting. In October, Hoskins will host the next federal-provincial meeting of health ministers, where he will again lobby hard for a national framework accord on pharmacare. His long-term goal is to have an agreement by July 1, 2017, that says at a minimum Canada will have a national plan in place within five years. To help Hoskins succeed, the public needs to become involved and tell politicians they care deeply about this issue. It will be impossible to get traction on pharmacare unless there's a sustained public call for action. A concerted public campaign would help ensure improved access to prescription drugs for all Ontario and Canadian residents, providing them with the medications they need.

Toronto Star Sun Nov 29 2015

When high-flying politicians or senior executives come crashing down to earth it is often because their outrageous spending habits or sky-high salaries have been exposed to the public. That's what happened, for example, to Bev Oda in 2012 when the federal Conservative cabinet minister resigned her seat in the House of Commons after it was revealed she had ordered a $16 glass of orange juice at a London hotel and made taxpayers foot the bill.

As first revealed three weeks ago by Toronto Star reporter Theresa Boyle, Health Minister Eric Hoskins is signalling that Queen's Park will scrap the CCACs and transfer much of their duties to the province's 14 Local Health Integration Networks (LHINs), which oversee regional health planning. Hoskins will unveil the changes in a "discussion document" to be released in the coming weeks. For years, patients have complained that the $2.5-billion-a-year home-care system was a mess, with too much bureaucracy, a drastic shortage of funds for face-to-face care, mismanagement, lack of oversight, uneven treatment and a culture of fear.

Toronto Star Wed Oct 19 2016

Provincial and territorial health ministers are imploring Ottawa not to diminish its role as a funding partner in health care any further. Ontario Health Minister Eric Hoskins, who co-chaired a meeting of his counterparts from across the country on Tuesday, said funding from Ottawa will be "inadequate" if the federal government proceeds with its plans to cut the annual increase in health transfers next year.

"(It) will result in a declining partnership," he told a news conference at the King Edward Hotel in Toronto. "What we are asking as provinces and territories is that the federal government ... not withdraw further, that we want them to sustain the level of partnership that traditionally has been there," he said. Canadians have seen that partnership "very seriously erode" since medicare was created about a half century ago when the federal government footed half the bill, Hoskins said. Today, Ottawa is paying only 20 per cent of the tab, a share that will decrease further if Ottawa next year cuts the annual increase in the Canada Health Transfer to 3 per cent from 6 per cent.

Hamilton Spectator Mon Feb 2 2015

Reaching that goal requires integrating health-care delivery to break silos, but it also needs a push. He believes he can achieve faster results through greater accountability, by putting the accent on transparency, collaboration and innovation. Hoskins stresses the value of "open data and transparency" in helping people identify problems and achieve best practices: "Having it in the public domain builds confidence in the health-care system ... Our default is we disclose and reveal and share and are transparent." In trying to transform the ministry, Hoskins also seems transformed himself as minister. The first physician to helm the health portfolio in decades, he is back in his comfort zone trying to shake things up - more in control than as minister of economic development, where he had limited success nursing Ontario's ailing economy back to health. Hoskins concedes that being a doctor helps him "get up to speed faster," but insists he retains a healthy dose of humility

He is also pitching for a national pharmacare program to complete the unfinished business of medicare. A long overdue idea (pharmaceuticals play a greater role than ever in managing disease), Hoskins believes with a federal election looming, Ontario can help push it onto the national agenda. Whether it's the dream of national pharmacare or the reality of provincial medicare, Hoskins needs willing partners at ground level. A natural loner in the world of wheeling-and-dealing politicians, he is now without allies among his fellow physicians. An ambitious plan to claw back payments to doctors and reallocate it to community care has alienated the powerful OMA, whose members act as gatekeepers for most health-care spending, which consumes 42 per cent of the provincial budget. Talks to reform an outdated fee-for-service model have been put on hold by the OMA. Hoskins still belongs to the OMA. And he makes a point of practising family medicine several days a year (pro bono, to avoid any conflict over the minister billing his own ministry). Seeing patients is a useful reminder that a lone doctor can only help one person at a time, while as minister he can improve the health of an entire province. And as the most visionary physicians quickly learn, you can't do it on your own. Martin Regg Cohn writes on provincial affairs.

The most expensive doctor in Ontario, an eye specialist, billed the province for $6.6 million last year. We don’t know his or her name or where he or she practices, but we know how much that work costs taxpayers each year thanks to a release Friday by the Ontario government of the billing information of the province’s most expensive doctors. Getty Images/ThinkstockThe Ontario Medical Association says physicians have already seen a 6.9 per cent cut over the last year, but the province wants to rein in fees for radiologists and other specialists. Over the 2014 to 2015 time period, more than 500 doctors billed the province for more than $1 million in fees. They represent just two per cent of all doctors, but cost $677 million a year, or over six per cent of the more than $11-billion Ontario spends each year on physician compensation. And many of them charge much more than $1 million, the government’s release shows. Thirty-six billed more than $2 million.

The release intends to debunk a recent ad campaign from the Ontario Medical Association (OMA) arguingthe province’s efforts to rein in certain types of doctors’ fees is hurting patient care. It’s all part of a years-long dispute over doctor fees that’s pitted MDs against the province in a war over patients’ (and voters) hearts and minds. Yet, it’s not family doctors’ fees and their practices that Health Minister Eric Hoskins wants to see reduced, but the most costly specialists’ billings.

“It’s not our neurosurgeons who are billing over $1 million,” Hoskins said, “It’s a very narrow category of specialists. The data released shows three specialties tend to bill the most of the 506 doctors who topped $1 million: 154 diagnostic radiologists made the list, 85 opthamologists (eye surgeons) and 57 cardiologists. Twenty-five of the highest billing doctors specialize in addictions and prescribing methadone. 

Toronto Star Sun Mar 15 2015

Patients are being discharged from hospitals without any home care or are being cut off from services they desperately need due to a lack of adequate funding for home and community care, says Natalie Mehra, the coalition's executive director. The government spends just $4.3 billion a year of its overall $50-billion health budget for care at home and in the community. In its report, the Donner panel made 16 recommendations ranging from developing a system that focuses on patient needs instead of those of service providers to putting more money into the system. Importantly, though, the expert panel has opened the door for Premier Kathleen Wynne and new Health Minister Eric Hoskins to completely overhaul the entire structure of the home-care system.

Such an overhaul could mean the demise of much-criticized Community Care Access Centres (CCACs), which co-ordinate home and community care for patients who are discharged from hospitals, and increase the role of Local Health Integration Networks (LHINs), which oversee health-care planning in regions across the province. Many health-care experts contend that former health minister Deb Matthews spent years making the CCACs the centre of power for home care, despite mounting evidence they were ineffective and obstructionist. Under Matthews, the CCACs operated with little oversight, creating fiefdoms where private-service providers who were critical of their practices saw their contracts not renewed or their funding reduced.

Toronto Star Wed Oct 21 2015

Health Minister Eric Hoskins says he wants to create a task force to tackle the thorny issue of how doctors get paid. He met with the Ontario Medical Association on Tuesday and urged that the organization representing the province's 28,000 doctors take part in the proposal. The idea to create a task force was first proposed last December by Ontario's former chief Justice Warren Winkler who served as a conciliator during contract negotiations between the province and its doctors. The two sides never reached an agreement and the province has since imposed two rounds of unilateral fee cuts on doctors. The OMA says that, in total, physician fees have been slashed by 6.9 per cent this year.

Hoskins says he needs to divert the money from the $11.6-billion physician services budget into home care. He maintains that Ontario doctors are the best paid in Canada, earning an average of $368,000 before expenses. (Some doctors, for example, family physicians get much less than that while specialists, for example, ophthalmologists, get much more.) In his report, Winker warned that the two sides were on a "collision course" unless significant reforms were made.

Toronto Star Wed Jul 1 2015

A controversial law allowing Ontario hospitals to investigate medical errors in secrecy is about to be overhauled by the government. The act will no longer grant hospitals the power to leave grieving families in the dark over what went wrong with their loved ones' care, Health and Long Term Care Minister Dr. Eric Hoskins told the Star on Tuesday. Changes to the Quality of Care Information Protection Act (QCIPA) include involving families in reviews of medical errors, giving families the right to call for an independent investigation into a medical mistake, and creating a public registry of all critical-care incidents that occur in Ontario hospitals.

Following a series of Star investigations into hospital secrecy under QCIPA, Hoskins last August called on an expert panel to review the act. The panel highlighted serious holes in the system and called for significant legislative changes. On Tuesday, Hoskins told the Star the government would be implementing "every one of the 12 recommendations" made by the panel. "I can't imagine what individuals and their loved ones go through when a critical incident occurs in a hospital environment," Hoskins said. "If this government can help them understand what did happen, if we can respect them by involving them in the process, if we can do the absolute maximum in terms of sharing information to give them confidence that hopefully it will never happen again to anyone else, that's the least we should be able to do for people in such tragic circumstances."

The Sudbury Star Fri Oct 16 2015

A bill of almost $6,400 for an air ambulance transfer from one Alberta hospital to another is keeping a 77-year-old Garson grandmother awake at night. Jean Wright simply cannot afford to pay it. The last thing Wright thought she had to worry about when she returned from Alberta after an unexpected hospital stay was a bill for an air ambulance transfer, ordered by a physician.

It was a small facility and, while staff treated her well, a doctor there decided the elderly woman should be transferred to a larger hospital in Edmonton for more complex treatment. She was to be taken by land ambulance, but the vehicle didn't have a connection for the medical support she needed for the two-hour journey. When the doctor ordered an air ambulance, Wright and her daughters asked if the cost of the flight would be covered by provincial health insurance and they were told it would be. Wright, who also has kidney problems, was so ill in Vermillion, she didn't know where she was when she was at the small hospital. When the doctor said he was going to transfer her to "the city," she asked: "Where's the city?" Wright spent seven days in an Edmonton hospital being treated for fluid around her heart, a condition similar to congestive heart failure. Her daughters drove back to Sudbury while she was in hospital. Wright has a son who lives in Edmonton and she stayed with him for several days after being released from hospital before flying home.

The Globe and Mail Thu May 14 2015

n a bid to respond to a blistering report on home care in Ontario, the provincial government is promising a series of minor fixes to the system, including a Canadian-first pilot project that would give patients or their caregivers money to spend on the home health services of their choosing. Details were scant on the government's plans for experimenting with "self-directed care," an approach that Health Minister Eric Hoskins said is already working well for some parents of autistic children who have been given the flexibility to spend public funds on the programs they believe are best for their children. Dr. Hoskins said that although it was too early to say where the pilot programs would be located, who would qualify or how much they would cost, he was excited about eventually offering more choice to patients as they heal or age at home.

"We will provide them with the funds to effectively purchase their own home care under terms where they will have even greater control," he told reporters Wednesday at The Second Mile Club, a seniors' day program in Toronto. "We'll start, obviously, at a smaller scale to allow us the opportunity to make sure we get it right." The minister also announced some other changes to the home-care system, including $5-million for funding 80,000 more hours of at-home nursing care by raising the cap to 150 visits per month from the current limit of 120; developing a "statement of values" for the system; and making it clear which services are available to patients in their homes, no matter where in the province they live. He rehashed some old promises, too, including the extension of 5-per-cent annual increases in funding for home and community care and the phasing in of a $4-an-hour raise for home-care personal support workers, which The Globe and Mail reported has been delayed this year because of problems with the rollout last year.

The Globe and Mail Mon May 11 2015

INTO THE HOME The cost of moving health care out of hospitals It was one of the showpiece promises that Ontario's Liberals made before their government fell last year: a $4-an-hour wage hike for the personal support workers who are critical to the government's plans to shift health care out of expensive hospitals and into the home. More than a year and an election victory later, the PSW "wage enhancement" program is beset by so many complexities that the government has delayed indefinitely the second phase of the pay hike - a $1.50-an-hour raise that was due April 1 - while it works to mop up the problems on the ground, a Globe and Mail investigation has found.

Twenty-seven mostly non-profit health-care agencies across the province are refusing to accept the government-funded increase and pass it on to their workers, while one of the largest privatesector employers of PSWs in Ontario cut what it pays in mileage and travel time just after the first phase of the raise kicked in last fall, leaving some employees worse off than they were before the wage-enhancement program began. The PSW raise was also more expensive than expected, costing the province at least $77.8-million in 2014-15, 56 per cent more than the $50-million earmarked for the first year of the pledge.

Toronto Star Thu Sep 3 2015

A health-care initiative that saves up to $4,000 per patient and cuts down on emergency room visits is being rolled out at dozens of hospitals and through home-care providers across the province. The "bundled care" program connects patients with a single team of clinicians who meet and care for them before, during and after surgeries, even providing services once the patient has gone home. It cuts out the confusion often associated with health-care visits because it keeps much of a patient's health-care team the same throughout the process, and often assigns a co-ordinator - usually available 24/7 by phone or iPad - to manage that team.

The program was first used at St. Joseph's Healthcare Hamilton in 2012, with tangible success, but will soon be coming to dozens of care providers, Dr. Eric Hoskins, the province's minister of health and long-term care, has announced. The pilot project, Hoskins said Wednesday, will involve six teams: One team each in the London Middlesex, Hamilton Niagara, Haldimand Brant and North York regions, focusing on chronic obstructive pulmonary disease and congestive heart failure One team in Ontario's central west area, prioritizing patient transitions from the hospital to their homes, while reducing system duplication by providing electronic visits. One team in Mississauga Halton that will allow cardiac surgery patients to go home on average three days sooner.

Toronto Star Fri Jul 3 2015

Ontario's NDP health and labour critics are calling on the government to take action following a Star report detailing the rising number of nurses reporting assaults by patients. In an open letter, labour critic Cindy Forster and health critic France Gélinas urged Health Minister Eric Hoskins and Labour Minister Kevin Flynn to improve the safety of patients and staff in Ontario's health-care system. "It is deeply disturbing that nurses and health-care professionals are facing increasing levels of workplace violence in our province," wrote Gélinas and Forster.

In an emailed statement to the Star, a spokesperson for the health minister wrote that Hoskins and Flynn are committed to ensuring Ontario's nurses have safe workplaces, but acknowledged there is room for improvement. "We recognize that there is more work to be done, which is why Minister of Labour Kevin Flynn met with the (Ontario Nurses' Association) earlier this year to discuss these very issues, and meets regularly to keep an open dialogue so we can continue working together to protect health-care workers," read the statement. On Thursday, the Star reported on the dramatic increases of reports of assaults on nurses at several Toronto-area hospitals over the past three years.

The first physician to helm the health portfolio in decades, Dr. Eric Hoskins is in his comfort zone as he tries to shake up his $52-billion ministry.

Published on Sat Jan 31 2015

The doctor is in. Now the pressure is on. As Dr. Eric Hoskins tries to chart a new course as health minister, he’s already offside with his fellow health-care professionals: Physicians walked out of pay negotiations earlier this month, while home-care workers walked off the job this week for higher wages.

Ontario wants more patients to get same-day or next-day appointments with doctors, Health Minister Eric Hoskins says.

By: Rob Ferguson Queen's Park Bureau, Published on Mon Feb 02 2015

But Hoskins, a physician, acknowledged Monday after a lunch speech on transforming the health-care system that he’ll have to get doctors on side after imposing a contract on MDs, leaving many angry. Home and community care nurses are also on strike.

The Globe and Mail Thu Jan 21 2016

Provincial and territorial health ministers have agreed to begin talks on improving access to prescription drugs, and are asking the new federal government to join the discussions. The move, which gained the support of health ministers during a meeting in Vancouver on Wednesday, is the first step toward the possible inclusion of a national pharmacare plan in a new health accord, said Ontario Health Minister Eric Hoskins, who introduced the proposal. Mr. Hoskins, who has long pushed for more equitable access to pharmaceuticals, said the current negotiations on a new health deal provide a unique opportunity for governments to consider what a Canadian pharmacare plan might look like.

Such a plan might be a combination of public and private insurance, he suggested, that could start with an agreement among governments about what prescription drugs to cover. "I like to believe we have a generational opportunity to really create a visionary document," Mr. Hoskins said in an interview on Wednesday. While there is no guarantee that Canadian governments can agree on a national drug plan, he said, they need to try. "It would be unfortunate if we didn't take advantage of the opportunity and at least do the hard work to look at the possibilities and to have the courage to dream and to think of the bigger vision." A working group set up by the provinces will look at improving "equitable and appropriate access to pharmaceuticals based on evidence," according to a release issued after the closeddoor meeting.