If it had not been for a talk years ago with his adolescent son, Christopher Mazza might not have become the mystery man at the centre of Ontario's biggest political scandal of 2012 – the alleged mismanagement of the province's Ornge medical-transport service.
Dr. Mazza, the former chief executive officer of Ornge, has been accused of corruption, nepotism, extravagance, featherbedding, bullying and sexual harassment. Eventually fired, he entered Guelph's Homewood Health Centre, and was diagnosed with post-traumatic stress disorder. During his worst period, he spent several weeks living in a closet.
Although he testified last summer before the Ontario public accounts committee, Dr. Mazza has granted no face-to-face interviews – until recently, when he spoke exclusively, for four hours, to The Globe and Mail.
"I had actually wanted to quit after SARS," he said, referring the 2003 pandemic that took 44 lives in Toronto and 774 worldwide. "It was horrific. I couldn't figure out why nobody would co-operate with each other, would not make intensive-care-unit beds available or provide nurses. That's the story never told about SARS: Everyone circled the wagons."
But then, he remembered, his "weirdly mature" son Joshua persuaded him to stay. "It seems strange to have even had that kind of conversation with a 12-year-old, but he was that kind of kid," he said.
"And then Josh died."
Joshua Mazza was a careful and skilled freestyle skier who had trained with the race team at Markdale, Ont.'s Beaver Valley Ski Club. There was a new tabletop jump he wanted to try. So just after 9 a.m. on March 5, 2006, he headed for the hills. A few minutes later, on the chairlift, Dr. Mazza spotted a chalkboard message asking Josh's parents to report to the ski-patrol hut.
That is where he and his then-wife, Kathy, received the impossible news: The slope to the tabletop jump was too steep, and Josh had taken off too soon, gaining too much lift. His head injuries were catastrophic. He was dead on impact. He was 14.
Chris Mazza, it is fair to say, has not been the same since.
At home, his marriage eventually ended in divorce (he has two other children, now in their teens). At work, he fixated, he said, on gaps in the health system and mistakes that could cost someone else a loved one. "I became obsessed with perfection. I believed we had to drive harder, even harder than the private sector, because we had a higher motive. Was I hard on people? Probably. Too hard? Maybe. They said I went too fast. But nobody told me to slow down."
The loss of his son was a recurring motif in the conversation, but the wear of the scandal was also clear. At times, he showed flashes of the dynamic executive he had been – confident and in command of facts and concepts. At other moments, he stuttered, his voice choked with emotion. His handshake was firm, but he looked grey and drawn, his right knee jumping as he spoke.
Dr. Mazza mounted a vigorous defence of the hybrid public/private-enterprise model that he created at Ornge. He tried to refute each of the allegations: that Ornge had kept government regulators in the dark; that he was guilty of nepotism in hiring and promoting Kelly Long, a woman who, after his divorce, became his girlfriend (they are now engaged); that he had set up a Byzantine tapestry of for-profit ancillary businesses, to line his own and other private investors' pockets; that Ornge's $144-million purchase of 10 AgustaWestland (AW) helicopters was misguided; and that he orchestrated a multimillion-dollar kickback on the deal.
Some of these claims are now the subject of an Ontario Provincial Police probe.
"I'm not perfect," Dr. Mazza conceded. "Far from it. … But I became collateral damage in a crossfire. Do I feel betrayed? I do. But I've learned that people remember things differently when they feel threatened."
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."
Ornge was starting to jell on several fronts, he felt. Even so, "we had a sustainability problem, a service-gap problem, and we were told we couldn't use provincial grant money to capitalize for-profit initiatives. So what do we do?"
One answer was to sell Ornge's expertise to other jurisdictions. "What we had was unparalleled on a global basis," he said. "It was a moving hospital. The vast majority of other services are still mired in scoop-and-run."
He convinced AW that Ornge could help it expand in the U.S. market. But that was the limit of his role in the subsequent, controversial, allegedly self-serving agreement, he said; others negotiated the details.
As for his relationship with Kelly Long, he said, he began seeing her (and disclosed that to the company) four years after she was hired and after she had become an associate vice-president. "I was never involved in moving her forward or in hiring her. She never reported to me," he said. As for the way she was "denigrated as 'a waitress and a water-ski instructor,' " he added, those were side jobs she had had while earning her MBA and teaching.
Finally, it was reported that Dr. Mazza received three interest-free loans from Ornge Global, one of its for-profit entities. He said there was only one loan, for $450,000, and it was neither unsecured nor interest-free. The other moneys were parts of bonuses and incentive plans.
"The complexity created confusion from which I have suffered. In hindsight, with respect to the loan, I should have gone directly to the bank instead."
If everything he did was wrong, he asked, why did his appointed successor, Ron McKerlie, say, less than four months later "that everything was wonderful at Ornge? Aviation medicine is an exceedingly complex axis. It's not something you fix in a few months if it's broken."
Despite his tribulations, Dr. Mazza said he still believes that the public impulse can be successfully married to the profit motive, though "it needs to be accepted first that government can't solve every problem.
"You can't curse government for having a deficit, vote for no tax increases, and then say 'I want my MRI next week.' That's an oxymoron."
Today, he lives in a rented Toronto apartment, remains close to his former wife and spends as much time as possible with his two children, Katie and Matthew. His recovery, he said, is focused "on the holistic healing of my mind, body and spirit," incorporating running, meditation, yoga and healthy eating.
After the past year's relentless media and political fusillade, he said, "my spirit has been crushed, my confidence shattered, my family shattered. I have to find a way to trust the world again. I did not do this alone. I had ideas. People said they were good ideas and then the wind changed.
"What's my future? I don't know. … So yeah, I guess in the end, they got me."
CHRIS MAZZA IN HIS OWN DEFENCE
On the creation of for-profit companies at Ornge:
All the equity owners signed pledge agreements gifting back all future dividends to the public side of Ornge. I would only have benefited personally from a monetization event – say, we sold a company to Oman – and only then after Ornge and the private investors had taken their share. I had no vote on any of this. I was not a director of any of the boards. Ornge would have derived additional revenues "selling" excess capacity in IT, finance and communications to the for-profit businesses. You'd be leveraging assets already paid for and charging full price, which would flow back and decrease costs to Ontario.
On Ornge's acquisition of AgustaWestland AW139 helicopters:
I resisted buying a new fleet. I didn't have a choice. If we'd gone to the private sector to change the [leased] fleet, it would have cost half a billion dollars, because they want a return. The cost of capital to them was 25 per cent. Mine, 5.7 per cent. So they were very angry. More than 25 per cent of their profits came from return on capital. We'd been paying for that fleet a long time. …
AW handily won an exhaustive procurement competition, over six rival bids. The procurement team reported to me, but I wasn't at the negotiating table. I have no knowledge of how to build helicopters or what they cost. I asked, "Is that a good price? … Yes? … Great. Let's go."
On Ornge's purchase of Canadian Helicopters Limited's fleet of 11 S-76 Sikorskys for $28-million, while it awaited the new AWs:
That decision was made only after CHL, sole bidder on our 2008 RFP for rotary service, asked for $49.5-million a year, up from $31-million in 2007. I didn't know what to do. I was terrified. The alternative was to shut down Ornge bases. The ministry was informed. "Good luck with that," they said. There was no discussion about going to cabinet [for more money]. And later, some of the Skiorskys could not be sold. Rusted tail booms. So you tell me we didn't need to replace the fleet? Really?
On criticism of the AW interior design, which could prevent CPR from being performed:
The Sikorsky S-76 was one of my biggest bugbears. You could not intubate. With the new models, we got to build an interior that made sense. I don't know what we could have done differently. But the CPR issue applied only in very limited circumstances – if you went into cardiac arrest on takeoff or landing. In the old choppers, a medic had to break the law by getting out of his seat to check the patient in flight. In the AWs, the medic's seat moves with the patient. In general, the new helicopters yielded exponential advantages.
On whether Ornge should have built a prototype before committing to an entire fleet:
Do you have any idea what that would have cost? In military procurement, it's a factor of six [times as much]. I did not have that luxury.
On the subsequent bill for more than $12-million in system upgrades:
I agreed to pay $6.7-million, almost a 50-per-cent reduction. We were going to have a 20-year relationship with Agusta. You buy their equipment and you are married. There is massive dependency. I'm running a 24/7 critical service. What if there are issues? What if a helicopter needs a part and I'm put back in line?
One the apparent extravagance of Ornge's $50,000 wakeboard speedboat and two custom-built motorcycles:
The bikes [with a value of $150,000] were gifted by AgustaWestland to boost the profile of the Ornge Foundation, our patient-care promoting charity. This is customary for hospitals and other institutions – asking for a directed gift as part of a purchase contract. We were proud of it. We wanted to get a safety message out. The boat? I never saw the boat. I never rode in the boat.
In memory of my son, Joshua, we also set up J Smarts, a charitable endeavour to teach risk-management skills to teen athletes. I'd taught Josh everything I knew and he was taught by coaches. Yet he still died. What was missing? Well, we teach children what to do and what not to do, but we don't teach them how to make decisions in circumstances they've never encountered. We were teaching physics, acceleration and de-acceleration. It's much safer to do that on water. Some 25,000 children went through the curriculum.
Note: Although the charities [and all of Ornge's for-profit businesses] were shut down by the Ministry of Health, J Smarts remains an active program at Muskoka Woods, a youth resort on Lake Rousseau.