Ontario can and should improve the health services it provides to patients without spending more money, the province's next deputy health minister says.
Robert Bell is preparing to take over the largest department at the legislature on June 2, in the midst of a hotly contested election.
But the widely respected outgoing president of Toronto's University Health Network figures he will have no trouble persuading whoever is premier to support the "apolitical" cause of making the system more efficient and more responsive to patients.
"Nobody can argue with better quality care at the same or a cost-effective rate," he told The Globe in an interview. "That's something that any political party wants to achieve. And I think there's a huge amount of enthusiasm for doing that."
Dr. Bell, a former cancer surgeon who led UHN for nine years, is the rare outsider appointed to the key post at the $50-billion health ministry. He has never worked in the public service.
He is replacing Saad Rafi, who left the job late last year to take over the problem-plagued Pan American Games organizing committee.
Dr. Bell's front-line experience has helped him spot some of the ways the health-care system could do more with as much money as it has now.
He pointed to repeated hospital readmissions for patients with chronic conditions as one obvious area for improvement.
"It's not that these people are wanting to have more resources expended on them. If anything, they're probably discouraged with the way that care is being provided," Dr. Bell said. "They're probably best described as being poorly served because the only way they can get looked after is to come back to the emergency department and get admitted to hospital multiple times. So what can we do to reduce the frequency of admissions to hospital?"
In the long run, Dr. Bell would like to see Ontario's health system achieve the same dramatic improvement as happened at Cancer Care Ontario, the provincial agency that oversees anti-cancer efforts in the province.
"Why did CCO over 10 years go from being a questionable-quality cancer system to being documented as one of the best cancer systems in the world? What were the features that allowed that to happen?" Dr. Bell said.
He suggested it was an obsession with measuring everything, then following the lead of the evidence, a model that could be applied to other parts of the system, he said.
One looming challenge for the ministry will be reaching a new contract with the province's physicians. Their last deal – which came after a bruising fight with Dalton McGuinty's government – expired at the end of March.
A recent report from the Institute for Competitiveness and Prosperity pointed to rising doctor compensation as one reason health spending is difficult to rein in.
Asked about that finding, Dr. Bell said Ontarians want their health-care providers to be well-paid. "The physician community in Ontario, I think, feels that they're well compensated. I think that's probably the best way to describe it right now."