He said he could not grasp why he suddenly became a pariah. “Until November, 2011, I was being incentivized, told I was doing grand things. Not just by my board and by investors, but by deputy and assistant deputy ministers. They cheered me on, constantly. My premier cheered me on.”
As evidence, he proffered a handwritten letter from Premier Dalton McGuinty written in March of 2009, congratulating him on, as Mr. McGuinty wrote, “the success at Ornge. You are doing a lot of good for a lot of people. Proud of ya!”
“So in November, 2011, I’m great,” Dr. Mazza concluded, “and in December, pardon me, I’m a piece of shit. What changed?”
The rise and fall of Chris Mazza began at Toronto’s Sunnybrook Health Sciences Centre in the mid-1990s. A trauma-team leader known for his brilliance and his take-no-prisoners manner, he was named medical director of the hospital’s air-ambulance program in 1996. He came to see transportation as the Achilles heel of the province’s multibillion-dollar health system.
“Nobody thought about it,” Dr. Mazza said. “You created these big wonderful hospitals and centres of excellence and when you asked, ‘How are you going to connect all of this?’ it was an afterthought. Because if you are sick north of Newmarket, trust me, that’s a very different risk profile than if you live south of Newmarket” (a town at the northern edge of the Greater Toronto Area).
Dr. Mazza then became involved in integrating a fragmented patchwork of 50 municipally run land-ambulance agencies and one provincial air-ambulance service into one not-for-profit, independent entity, which he was appointed to run when it was founded in 2005. Then known as the Ontario Air Ambulance Services Co., it was burdened with obsolete aircraft, antiquated communications systems, moribund morale and diffused accountability.
Re-engineering Ornge was a Herculean challenge. It meant confronting the lucrative Northern Ontario power base of private corporations that owned the aircraft leased by the province. When he announced plans for Ornge to cut excesses from their fees and to acquire some of its own planes and helicopters, he said, they told him, “ ‘You can’t do this. You won’t last. We will get you.’ ”
Dr. Mazza resolved to persevere. In the process, though, he said, he created an atmosphere in which he sometimes failed to communicate his ideas fully to employees, even as they tried to match his frenetic pace. “The converse of ‘I don’t want to disappoint him’ is ‘I hate that son of a bitch.’ I didn’t understand that dynamic. I should have been more paternalistic.”
He pleads mea culpa, as well, on the subject of his salary. Provoking perhaps the sharpest censure he faced, it climbed from about $240,000 in 2005 to – with bonuses – $1.4-million in 2011, making him the province’s highest publicly paid employee. “I didn’t perceive our salaries would be compared to other public-sector agencies” rather than private ones, he said. “That was an error. It’s embarrassing for me. It’s ruined my life.”
At the same time, he noted that all senior executive salaries and bonuses were determined solely by the board of directors, based on increased responsibility (the organization grew from 20 employees to almost 600) and performance targets.
If he underestimated the need for transparency, it may have been because of the anomalous zone that Ornge occupied. Every province has medical air transport, but only Ornge was a public/private hybrid. Though it received taxpayer funding ($150-million a year by 2011), it was an autonomous corporation, run without political interference.
Because Ontario health dollars were tight, the pursuit of extra money was part of Ornge’s founding vision. “I was told, ‘Generate revenue outside of the taxpayer base,’ ” Dr. Mazza said. That was precisely why Ornge had been set up at arm’s length.
Meanwhile, in 2010, independent consultants confirmed that up to 10,000 patients a year – 25 per cent of them emergency cases – were being missed, falling through the cracks in Ornge’s service profile. “Well, 10,000 was not just a number for me,” Dr. Mazza said. “Those were faces. … I was obsessed with that, maybe too much.”