When the mandarins at Queen's Park set out to find a new leader for Ontario's Ministry of Health and Long-Term Care, they looked around the globe for the right candidate.
In the end, they found him at the hospital down the street.
Persuading Robert Bell, the widely respected president of Toronto's University Health Network, to take a deep pay cut and move up the block to be head of the government's largest department is a coup, according to leaders in the tightly knit world of health-care management.
That means the 63-year-old former cancer surgeon likely has the latitude to make significant changes when he becomes deputy minister in June – or at least as much can be given in a notoriously complex, $50-billion department overseen by a minority government under the threat of a spring election.
"He's very aspirational. He knows what Ontario's health system could be and he knows how to get there," Health Minister Deb Matthews said in an interview. "He's going to really drive change."
Dr. Bell's background gives him some unique advantages. As the leader of the country's largest research hospital network for nine years, he has an insider's knowledge of front-line health care.
But, having never worked in the bureaucracy, he also brings a rare outsider's perspective.
"Generally speaking, it's very hard to recruit external people into the ministry of health. Yet external people can be of enormous value because of their hands-on experience in running the system," said Graham Scott, a health-care consultant and a deputy health minister in the 1980s.
"That's why I think this is a considerable coup for the ministry."
Pay disparity is part of the challenge. Dr. Bell earned a salary of $753,992.40 in 2012, the last year for which his compensation is publicly available. That will drop to $427,551.76, the same as his predecessor, Saad Rafi, who left the post late last year to take over the problem-plagued Pan Am Games organizing committee.
Dr. Bell declined an interview request, saying through a spokeswoman that he did not want to speak about his new job until he starts it.
But in an e-mail to UHN staff and supporters, Dr. Bell explained he could not refuse a chance to "ensure that the health care we have today is even better quality and more affordable for our children and grandchildren." (That would presumably include his own progeny: He is a father of six and grandfather of four.)
Educated at McGill University, the University of Toronto and Harvard, Dr. Bell was a world-renowned orthopedic oncologist before becoming chief operating officer at the Princess Margaret Hospital from 2000 to 2005.
Tom Closson, Dr. Bell's predecessor as UHN president, recalled how Dr. Bell helped expand what is now the Princess Margaret Cancer Centre and turn it into one of North America's top spots for cancer treatment and research. His gregariousness and strong communication skills were a big asset, he added.
"People don't feel threatened by Bob. They feel energized by him and engaged when they talk to him. I think those things will help him," Mr. Closson said.
Mr. Scott predicts Dr. Bell's credibility will be an important asset, especially considering the ministry is in the midst of a sweeping transformation aimed at improving care while curbing costs.
"He may be able to persuade the government to engage in some reforms that will actually substantially enhance patient care, notwithstanding they may put a few noses out of joint in the system," he said. "I'm not suggesting he's a radical, because he's not. But he's quite a focused guy on constructive change."