It will put Ontario’s dire fiscal situation into sharper focus. It will poke and provoke. It will even provide a few fresh ideas.
What economist Don Drummond’s long-awaited report won’t do, when it’s finally released on Wednesday, is help Dalton McGuinty’s government overcome its biggest obstacle to saving Canada’s largest province from financial collapse.
In about 400 government-commissioned recommendations, including more than 100 on health care alone, the economist will tell Mr. McGuinty’s Liberals where they need to go on public-service reform. But contrary to popular belief, they already have a pretty good sense of that. What they don’t know, and what Mr. Drummond mostly won’t tell them, is how to get there.
In conversations with those who have seen the full report, or at least large chunks of it, a word comes up repeatedly: “compendium.”
It’s a way of saying the report is basically a laundry list of reforms Mr. Drummond thinks government should consider. Some of those ideas are entirely original. But most, while not getting much public attention, have been floating around for years in government departments and sectors and research papers (including some written by Mr. Drummond himself).
Putting them all in one place is useful in forcing an overdue debate about the tough choices ahead. So, too, is framing them in the context of Mr. Drummond’s grim economic forecast. While some will be rejected out of hand – there’s no way Mr. McGuinty will abandon signature education policies of smaller class sizes and full-day kindergarten – others will gain legitimacy and momentum. And the exercise has compelled the Liberals to start publicly laying out their plans, including in a speech that Finance Minister Dwight Duncan will make two days before the report drops.
Where the report will fall short, in terms of the government’s needs if not reasonable expectations, is in terms of implementation.
With the odd exception – aside from the flashier stuff, the education section seems to contain some unusually detailed proposals for how to reap savings from different staffing models – it’s been described as largely “aspirational.” It will be specific in telling government what to strive for, without delving into the nitty-gritty of how to achieve it.
For evidence that it’s nitty-gritty that’s missing, consider the “action plan” delivered in a recent speech by Health Minister Deb Matthews.
To her credit, Ms. Matthews promised to expand the mandate of controversial Local Health Integration Networks to include oversight of primary care – a move that risks a backlash, but one Liberals believe is necessary to make the system more efficient. But when pressed for details on how exactly the LHINs will interact with family doctors, and how they’ll overcome the general toothlessness that has impeded regionalization to date, government officials hedged. They are looking at many different delivery models, and haven’t settled on one yet.
Much the same answer could have been given on any number of files, particularly with regard to health care. The Liberals know they want fewer procedures done in hospitals that could be done elsewhere, and fewer “bed blockers” in hospitals who could be at home, and a shift toward “evidence-based medicine,” all of which will be raised in Mr. Drumond’s report. But they can’t just snap their fingers and make it happen.
The barrier, as much as lack of will, is absence of infrastructure. There are very smart senior political staff and bureaucrats. But those familiar with the inner workings of government suggest there just aren’t enough willing or able bodies to drive dozens of reforms at once, let alone 400 of them.
None of this is Mr. Drummond’s problem. Sources say his report includes a chapter on how the Premier’s Office and Cabinet Office could be reorganized to drive change more efficiently. Otherwise, having had less than a year to study reforms, he could hardly have been expected to come up with a detailed road map for each one, nor is that the expertise he offered.
In that regard, the Liberals dropped the ball. Amid last year’s focus on getting re-elected, little time seems to have been spent on a transition plan to turn promises into reality.
To listen to much of the hype, Ontario will never be the same after Wednesday. That may be true, in terms of public perceptions. But within government, the reality won’t have changed much at all.