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Ontario Health Minister Deb Matthews photographed in her office on Feb. 8, 2012. (Peter Power/The Globe and Mail/Peter Power/The Globe and Mail)
Ontario Health Minister Deb Matthews photographed in her office on Feb. 8, 2012. (Peter Power/The Globe and Mail/Peter Power/The Globe and Mail)

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Poised under fire, Deb Matthews tackles Ontario's ailing health-care system Add to ...

Another encounter involved an elderly man with a sick wife. “He was heartbroken,” she said, because it was costing so much more to keep his wife in hospital than to give him the help he needed, but the system wouldn’t let him bring her home. That experience “absolutely guides the work I am doing right now,” she said, adding “you would never hear those stories anywhere else than going door to door.”

By the time the votes were counted on Oct. 2, 2003, in London North Centre, Ms. Matthews had not only called the minister to account, she had trounced her by nearly 7,000 votes. A month shy of her 50th birthday, she had finally embarked on the career she was meant to have.

Tough road ahead

Eight years later, no one questions that Ms. Matthews is tough enough for that career. She’s demonstrated her mettle by holding the line in a showdown with generic-drug manufacturers, getting them to agree to a cost reduction that will save the province about $500-million annually. (“That is five medium-sized hospitals,” she said, proudly.) And she can be expected to be equally hard-nosed when it comes to her next fight: the upcoming negotiations with the Ontario Medical Association over doctors’ compensation.

There is nothing simple about health care in Ontario, or anywhere else in the country. Our federal forebears promised us universal health care, but it is the job of provincial and territorial governments to implement it. How Ms. Matthews does that in formerly fat cat Ontario is of keen interest to other jurisdictions, for the cat is now scrawny, howling for food and battling a projected $30.2-billion deficit by 2017-18. Once the engine of growth, prosperity and transfer payments, Ontario may well be asking for handouts from richer provinces if Ms. Matthews fails to deliver her agenda of cutting costs and implementing real change while improving care.

One of those changes includes making private-public partnerships and selling home-grown expertise and medical knowledge internationally with the revenues benefitting the people of Ontario. That was the idea behind moving Ornge out of direct ownership and into a stewardship arrangement with the government back in 2005. Over the years, Ornge began creating spin-offs that appear to have been much more about profit than medical service.

Ms. Matthews has acted swiftly in the last two months, severing ties with Ornge principals without severance, appointing new leadership, calling in forensic auditors, and launching a criminal probe late Thursday afternoon – but questions remain about what she knew and when.

The minister’s usually chipper voice grows distressed when she discusses the file. “When I sent in the forensic team, I specifically said, ‘Follow the public money,’ because we had been assured by Ornge and by their lawyers that there was no intermingling of private and public funds.”

As the Health Minister, she said, she doesn’t have the luxury of saying whether Ornge officials deliberately set out to obscure transparency and thwart oversight in the score of spin-offs they created. That’s why she called in the OPP: to find out.

“I see patients who are desperate for more care, shorter wait times, more drugs to be covered, and people who are working very hard every day,” she said. So when she discovers “a handful of people” who were given huge responsibilities and opportunities to improve the system and who have “lost sight of who it is they are there to serve. … I struggle to find the words, but I think it is a betrayal of that trust.”

Will she resign when the legislature resumes on Tuesday as the opposition is already demanding? Emphatically not. “The Premier has confidence in me, he has expressed that many different times,” she said. “I have demonstrated my ability to make tough decisions, I have demonstrated my ability to stand firm when the going gets tough. And I think that is the kind of leadership we need right now.”

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