AGENCY REVIEW
MANITOULIN-SUDBURY DISTRICT HEALTH COUNCIL
INTENDED
APPOINTMENT
MICHAEL O'KEEFE
CONTENTS
Wednesday 15 May 1996
Agency review
Manitoulin-Sudbury District Health Council
Ken Ferguson, Chair
Bob Knight, Executive director
Intended appointment
Michael O'Keefe
Subcommittee report
STANDING COMMITTEE ON GOVERNMENT AGENCIES
Chair / Président: Laughren, Floyd (Nickel Belt ND)
Vice-Chair / Vice-Président: Martin, Tony (Sault Ste Marie ND)
*Bartolucci, Rick (Sudbury L)
*Crozier, Bruce (Essex South / -Sud L)
Ford, Douglas B. (Etobicoke-Humber PC)
Fox, Gary (Prince Edward-Lennox-South Hastings / Prince Edward-Lennox-Hastings-Sud PC)
Gravelle, Michael (Port Arthur L)
*Johnson, Bert (Perth PC)
*Kormos, Peter (Welland-Thorold ND)
*Laughren, Floyd (Nickel Belt ND)
*Leadston, Gary L. (Kitchener-Wilmot PC)
*Martin, Tony (Sault Ste Marie ND)
Newman, Dan (Scarborough Centre / -Centre PC)
*Preston, Peter L. (Brant-Haldimand PC)
Ross, Lillian (Hamilton West / -Ouest PC)
*Wood, Bob (London South / -Sud PC)
*In attendance / présents
Substitutions present / Membres remplaçants présents:
Doyle, Ed (Wentworth East / -Est PC) for Mr Ford
Brown, Michael A. (Algoma-Manitoulin L) for Mr Gravelle
Brown, Jim (Scarborough West / -Ouest PC) for Mr Newman
Pettit, Trevor (Hamilton Mountain PC) for Mrs Ross
Also taking part / Autre participants et participantes:
Dwight Duncan (Windsor-Walkerville L)
Paul Boniferro, Special Assistant - Policy, Office of the Minister of Labour
Clerk / Greffière: Tannis Manikel
Staff / Personnel: David Pond, research officer, Legislative Research Service
The committee met at 1005 in room 228.
The Chair (Mr Floyd Laughren): We have a number of items before us this morning. First is the review of the operations of the Manitoulin-Sudbury District Health Council, followed by review of an intended appointment and a motion for concurrence in one appointment and then a report of the subcommittee.
AGENCY REVIEW
MANITOULIN-SUDBURY DISTRICT HEALTH COUNCIL
The Chair: Let us proceed forthwith to the Manitoulin-Sudbury District Health Council. With us this morning are Bob Knight, who's the executive director, and Ken Ferguson, who's the chair of the Manitoulin-Sudbury District Health Council. There also is in the room Jeff Wilbee, who's a member of the Association of District Health Councils of Ontario, in case there are questions that go beyond the Manitoulin-Sudbury District Health Council. Let us begin. Did you wish to make some opening remarks, Mr Ferguson?
Mr Ken Ferguson: Yes, thank you. Mr Laughren, other committee members, good morning. My name is Ken Ferguson. I'm the chair of the Manitoulin-Sudbury District Health Council. With me today, as the Chair has indicated, is our executive director, Bob Knight. We appreciate this opportunity to meet with the standing committee to discuss our agency.
I will begin with a brief overview of district health councils in general. I will then provide some background on our own agency and describe for you some current issues facing our council. Generally speaking, the theme of my remarks will be the question, what does the future hold for district health councils?
District health councils are volunteer boards. Members are appointed by the Lieutenant Governor on the advice of our Minister of Health. The minister's authority for establishing councils and appointing their members is in the Ministry of Health Act. The first council was formed back in 1974. Today, there are 33 district health councils and every part of Ontario falls within a planning boundary of one of these councils.
The mandate of the DHCs is described in subsection 8.1(4) of the Ministry of Health Act:
"8.1(4)(a) to advise the minister on health needs and other health matters in the council's geographic area;
"(b) to make recommendations on the allocation of resources to meet health needs in the council's geographic area;
"(c) to make plans for the development and implementation of a balanced and integrated health care system in the council's geographic area; and
"(d) to perform any other duties assigned to it under this or any other act or by the minister."
Our district health council was established in 1976. We serve the districts of Manitoulin and Sudbury, which have a combined population of about 200,000 people.
As is the case with all councils, our organization has been committed to providing the best possible advice to the ministers of health of over the years. We fully understand the role and the power of the provincial government in establishing and implementing health policy. At the same time, we believe communities have a strong and legitimate interest in the development of local health services and programs in the identification of local health priorities, all within the context established by the provincial government. The kind of planning carried out by DHCs is important so that provincial policy can be implemented successfully at the local level and in a way that is sensitive to local needs and circumstances.
On page 28 of our package you will find a list of our publications, which will give you an idea of the scope of our work over the years.
The 33 DHCs across Ontario engage thousands of volunteers in their work. These volunteers generally are dedicated to a reformed health system that preserves the quality of and access to health services in Ontario.
The large majority of DHC members across Ontario want to ensure the continuation of the neutral, objective role for DHCs in health planning until such time as councils may be replaced by another model for this province. To successfully fulfil that role, councils endeavour to ensure that there is a balance of perspectives from across the communities they serve.
It is also important that people serving on councils do not represent specific groups or organizations, as this would detract from the neutrality and objectivity of councils' decisions. The presence of constituency representatives on a council would give the impression that the council is dominated by vested interests. No particular interest group should have a position of privilege as compared to other community groups through having a seat on a district health council.
A number of factors seem to be converging to influence the future of councils.
The current Minister of Health, the Honourable Jim Wilson, has stated that DHCs will return to their original role of being the eyes, ears and conscience of the community. It is not yet clear how this statement might modify or define differently the DHC mandate.
Undoubtedly, the way councils function will be significantly affected by the financial restraint measures undertaken by the provincial government. Councils, if they continue to exist, face financial cutbacks, the same as other public sector organizations, over the next several years. In response to these cutbacks, district health councils are now examining options for working together more effectively than in the past.
It may be that the review of agencies, boards and commissions being headed by Mr Bob Wood will have a significant impact on DHCs.
There have been various recommendations from a number of sources, such as health care organizations, academic organizations and district health councils themselves, about a different way of planning and managing the health system.
All these factors point to significant change on the horizon for DHCs and raise some fundamental questions about our future. Will the Minister of Health continue to keep the DHC system with some restructuring, or will a brand-new kind of model be introduced in Ontario? Hopefully this will become clear in the next 12 to 24 months.
Some recent events with respect to council appointments are causing DHC volunteers and staff to have deep concerns about the impact on their organizations. Some of our members share these concerns. To be specific, appointments are being made to some councils without those councils having had the opportunity for involvement in the recruitment process. I will refer here to our own recent experience because it is the clearest example of the politicization of district health councils that seems to be under way.
There have been eight recent appointments to our council. None of these people was recruited or recommended by the council. There appears to be a one-issue agenda among the new appointees, that being hospital restructuring in Sudbury. All eight appointees appear to be of a single mind about what should happen with hospital restructuring. All eight appear to be supportive of the position of one health care organization in our community. All eight apparently seem to be well briefed by persons not related to our council. There appears to be limited interest among the new appointees in our health system reform planning projects. There appears to be an agenda among the eight new members to "clean up the council's house."
This has serious ramifications for the future of DHCs if they are to remain a part of the landscape in Ontario's health care system.
The undermining of the order-in-council appointment process, and in particular the DHC role in recruitment, creates a perceived conflict of interest and undermines the neutral objective role of councils in health planning.
The balance of perspectives on the council is disrupted.
It appears as though the minister lacks confidence in his local advisers to recruit non-partisan and objective new members.
People perceive damage to the accountability councils have to their communities.
The decision-making function of our council has been seriously disrupted.
Appointees who have not had the benefit of going through our recruitment process are joining council without knowing fully the magnitude of the commitment they have made. Because they have not experienced the face-to-face interview with experienced council members, they are not properly advised of the workload of a council member before taking their seat.
Experienced members of council feel the DHC appointment process is being corrupted in order to manufacture a false consensus on hospital restructuring issues on our council.
Experienced members also feel that the new appointments seem punitive, that it is being punished for giving advice to the minister who has challenged the status quo with respect to hospital governance.
I refer to our letter to Mr Wilson dated November 22, 1995, on page 52 of the package we have provided to you, and also our presentation to the standing committee on general governance made in January with respect to Bill 26.
It is our council's position that in Sudbury a hospital governance solution should precede major clinical program restructuring in the hospital sector. In our Bill 26 presentation, we took the position that denominational and non-denominational hospitals should be treated equally by the Health Services Restructuring Commission in major restructuring projects.
These positions appear to have so challenged certain people that our agency is being completely transformed through the appointment process.
To conclude my remarks, the neutral and objective planning and advisory role of DHCs is at risk. The continuation of appointments in a political vein with little regard to the traditional recruitment process followed until recently by DHCs and ministers of health will mean an end to the traditional role of DHCs and convert them into nothing but political instruments of the government.
Thank you for listening. We would be pleased to answer any questions you may have at this time.
The Chair: Thank you, Mr Ferguson. We have about an hour and 10 minutes, I think until about 11:30. I would propose, if members wish to use the time equally, that we do it that way unless one party decides not to use the time. Can we start with the government members, please.
Mr Bob Wood (London South): I'd like to start the questioning. I'd like to go through the history of this to make sure I have the facts right, Mr Ferguson. My understanding is that funding was approved for this study of restructuring in April 1993. Am I right in saying that?
Mr Ferguson: That's correct.
Mr Bob Wood: I gather that in April 1995 your council gave a report that indicated it felt the sole governance issue was the first step in restructuring.
Mr Ferguson: That's correct.
Mr Bob Wood: I have copies of this correspondence, so I would be glad to give you copies of any of it if you have to refer to it. I understand that on August 8, 1995, the Ministry of Health wrote and indicated that it supported you in certain specific areas and that the changes should proceed but it felt that the governance issue should be done at the end of the other issues.
Mr Ferguson: I believe that's right. I'm not sure of the date. I believe it was probably referred to as "concurrently" -- the governance and restructuring -- in that letter.
Mr Bob Wood: We have the letter if you want to review it. I might say, and I don't want to get hung up on this point, on August 17 the ministry wrote you and said it didn't reject sole governance. Do you recall them having indicated that to you?
Mr Ferguson: They didn't reject sole governance?
Mr Bob Wood: They indicated to you on August 17, 1995, in a letter that they didn't reject sole governance. Do you recall them having indicated that position to you in August of last year?
Mr Ferguson: That was not, as I understand, indicated to us.
Mr Bob Wood: Perhaps I should give you a copy of the letter and you can read the letter and see what it says.
Mr Ferguson: Who is it addressed to, sir?
Mr Bob Wood: It was addressed to Mr Ronald Marr, executive director, Catholic Health Association of Ontario, if I've got the right letter here myself.
Mr Ferguson: Thank you. It wasn't to us, I understand.
Mr Bob Wood: That never came to your attention?
Mr Ferguson: It was copied to us later, yes.
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Mr Bob Wood: It did come to your attention. Maybe I can read this to you. This may refresh your memory. If not, we'll give you a copy of this. This is the letter of August 17 to Mr Marr from Gabrielle Monaghan of the Ministry of Health.
"The ministry has not rejected the notion of sole governance for Sudbury. Rather, it has indicated that many positive changes can occur independently of the deliberations on governance. The ministry acknowledges that deliberations on governance may require a great deal of time and that necessary improvements in the efficiency and quality of hospital services can move forward immediately, independently of such deliberations."
I gather you received a copy of this letter.
Mr Ferguson: Yes.
Mr Bob Wood: I understand that on October 4, 1995, the Ministry of Health wrote and advised you that they wanted a consultative model of governance. Do you recall having received that message?
Mr Ferguson: What was the word?
Mr Bob Wood: A consultative model of governance. Do you recall being made aware of that in October of last year?
Mr Ferguson: Yes.
Mr Bob Wood: In the Sudbury Star of October 7, 1995, it said: "DHC spokespersons" -- referring to your DHC -- "acknowledged they were aware that the minister had already indicated his opposition to any sole governance model not acceptable to Sudbury General Hospital." No doubt you are aware that was in the Sudbury Star?
Mr Ferguson: I believe I got a copy of it, yes.
Mr Bob Wood: Was that report in fact accurate? Obviously it was, because you were aware of it.
Mr Ferguson: I believe it was.
Mr Bob Wood: In January 1996, as I understand it, the Ministry of Health accepted the program service recommendations of your DHC and requested implementation.
Mr Ferguson: Requested the DHC to implement it?
Mr Bob Wood: Yes.
Mr Ferguson: What date?
Mr Bob Wood: In January of this year.
Mr Ferguson: I believe it wasn't in January.
Mr Bob Wood: When do you think it was?
Mr Ferguson: Who was the letter addressed to again, please?
Mr Bob Wood: I don't know whether I have a letter to support that or not, but we'll see. Apparently it was from Mr Andrew Szende. You do or don't recall having been advised of that position?
Mr Ferguson: Was the letter to the Laurentian board and to the Sudbury Memorial board?
Mr Bob Wood: Unfortunately, I don't seem to have a copy of the letter, so I'm afraid I can't -- apparently it was from Mr Szende. I don't have a copy of it, unless we can produce one.
Mr Ferguson: I believe there was a letter that went to those two facilities.
The Chair: Excuse me, he is with the Ministry of Health? He's the assistant deputy minister, is he?
Mr Bob Wood: That's my understanding, yes.
Interjection: Do you know of the letter?
Mr Ferguson: We saw a letter to those boards, yes.
Mr Bob Wood: Did you take a conclusion different from what I said a couple of minutes ago from that letter? What did you think? Did you think the ministry was saying something different than what I thought they were saying?
Mr Ferguson: No.
Mr Bob Wood: So you accept that the message I thought you got was the message you thought you got.
Mr Ferguson: From the ministry.
Mr Michael A. Brown (Algoma-Manitoulin): Mr Chair, on a point of order: The opposition seems to be at a great disadvantage here in that Mr Wood is listing off quite a number of letters and information that we are not privy to. I wonder if the opposition could have the same information the government members appear to be using, just so we can understand.
Mr Bob Wood: I have no problem other than the fact that I've only got one copy of these and I need them. I think as soon as I finish my questioning, or at least when we have a break in the questioning, I'd be happy to give them to any members who want copies.
Mr Michael Brown: We would appreciate that. It's just for our information.
The Chair: If you give them to the clerk, we can get those copied.
Mr Bob Wood: Yes. I think I'm through with the letters anyway right now, but just in case I'm not, I want to hold on to them until I finish my questions.
In the Sudbury Star of January 6, 1996, you were quoted as saying you noted that "Mr Wilson did not support the council's proposal" -- that being re the sole governance -- "and indicated that the DHC would not continue to press the concept on the minister as this was inappropriate for an advisory body such as the DHC." Did you see that story in the Sudbury Star?
Mr Ferguson: Yes indeed. I made those comments, sir. Would you like them expanded on?
Mr Bob Wood: No. We'll get to that in a minute. I was interested that today, in the submission on page 5, you have said at the bottom of the page, "It is our council's position that, in Sudbury, a hospital governance solution should precede major clinical program restructuring in the hospital sector."
Mr Ferguson: Yes.
Mr Bob Wood: You understand, and have understood for some months, that the minister doesn't agree with that.
Mr Ferguson: Yes, that's true.
Mr Bob Wood: I gather you've changed your mind since January of this year in continuing to press the minister on something you know he has rejected?
Mr Ferguson: On the contrary, sir. In January we'd already issued our stand and our recommendations and, being an advisory body, my comments were in the order that we get on with business, because we'd already advised and we'd turned it to the community for its direction. If they wanted to pursue sole governance, that was in their court. Our role as an advisory body was to get on with our work. We're not a lobbying agency as such with the minister, I guess, after the fact.
Our belief is that sole governance is the key to the restructuring of hospital services in Sudbury. Our position hasn't changed, but our action, our role carries on as a planning body.
Mr Bob Wood: I'm a little surprised, when you said what you said in January, you would then come to a legislative committee in May and try and press the same position. Why will you not accept the minister's position that he doesn't agree with that?
Mr Ferguson: We're not pressing the position. We're stating what we believe to be the best advice that we are able to give to the minister of the day, and as such, sir, with all due respect, that's what we're doing. We're not lobbying here today. We're here to state where we stand. In January we said we'd completed our role in making that recommendation. However, while we made that recommendation and we want to get on with other issues, because our work is not static -- it's ongoing, and we need to concentrate our energies and efforts on those other items. Having said that, we still recommend that position. It hasn't been turned or dropped, as it were, so I can reiterate without any qualms that is the position at this time.
Mr Bob Wood: I think some of us who are just new to this situation would see that as an example of poor judgement and naïveté on the part of the district health council -- they can't get a message from the minister. I would have to share with you that some of us think that's part of the problem here.
Mr Peter Kormos (Welland-Thorold): Poor judgement and what?
Mr Bob Wood: And naïveté. I know Mr Kormos doesn't like long words, but I like to put the odd one in just to keep him awake.
Mr Kormos: Could have been a dialect problem.
Mr Bob Wood: You're from southern Ontario too, so you could explain that later.
Is the health council working with all hospitals in the Sudbury area now on the restructuring?
Mr Ferguson: I think it's going to the restructuring commission, or it's sitting with it, to take on the task. We've done our part as such. We're willing and able, but at this point it's understood that the hospital restructuring commission is taking on that role. Is that not your impression?
Mr Bob Wood: Well, it's your impression we're interested in at the moment. Are you working with anyone right at the moment or have you simply withdrawn from this issue for the time being?
Mr Ferguson: We're sitting waiting to be a player in it, but at this point I don't think we're actively --
Mr Bob Wood: Are you prepared to work with all hospitals in the area, regardless of their position on the governance issue?
Mr Ferguson: As a planning body, that's our role, yes, advisory body.
Mr Bob Wood: Do you have any perception as to why the minister rejected your position on sole governance? Would you be inclined to think that was because he thought it was bad advice?
Mr Ferguson: I guess I can't comment on that. That was his decision.
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Mr Bob Wood: You've given no thought as to why the minister rejected your advice? You don't think that was significant and something you should think about?
Mr Ferguson: It's something to think about, yes.
Mr Bob Wood: What conclusions have you drawn so far about that?
Mr Ferguson: I've concluded that's the way he wanted to go and that's the route he's taking.
Mr Bob Wood: Did you have any perception as to why he would do that? Would you not think it was because he thought it was bad advice?
Mr Ferguson: I guess I can't comment on that issue.
Mr Bob Wood: You've given no thought to that issue?
Mr Ferguson: What he thinks is good for the Sudbury basin and what we believe is the best advice, there's a difference.
Mr Bob Wood: He thought you gave him bad advice.
Mr Ferguson: That's your interpretation of it.
Mr Bob Wood: I'm asking what yours is. Do you not agree with that? Why do you think he rejected it?
Mr Michael Brown: Are we going to allow the continual badgering of the witness, Mr Chair?
Mr Bob Wood: I think I'm entitled to ask the questions and I'm entitled to an answer from the witness, who hasn't given one yet.
Mr Ferguson: I did give you an answer, sir. I believe it was his decision and whether he considered it good or bad, that's I guess with him.
Mr Bob Wood: You don't think it's important for you to consider why your advice was rejected?
Mr Ferguson: I think we did a lot of soul-searching when we were making our recommendations and we believe it to be the best advice we had, and that's where we stood and where we stand yet.
Mr Bob Wood: Do you have any perception of what position the people you recommended to the minister had on the issue of sole governance?
Mr Ferguson: I'm sorry, come again?
Mr Bob Wood: Do you have any idea where the people you recommended to the minister for appointment stood on sole governance?
Mr Ferguson: Not really, no.
Mr Bob Wood: You never discussed that with any of them?
Mr Ferguson: No.
Mr Bob Wood: Okay. Now, you rightly pointed out in your submission that the minister has the final decision on who's appointed to these councils.
Mr Ferguson: That's correct.
Mr Bob Wood: Do you think that's a good law or do you think that law should be changed?
Mr Ferguson: As long as it's his DHC, it's his call, yes. I think it has --
Mr Bob Wood: So you have no problem with the provincial laws as now drafted?
Mr Ferguson: That's right.
Mr Bob Wood: You may not have thought about this either, but let me ask you and see if you have. Do you think an advisory council can continue to give advice to the minister that he rejects and not expect changes in the composition of the council?
Mr Ferguson: I believe that should be possible. Given that we're giving advice, that doesn't mean the minister of the day has to abide by it, but it is our advice and what we see as in the best interests of our area and the province.
Mr Bob Wood: If you had someone advising you and you rejected their advice, you'd continue with them as an adviser?
Mr Ferguson: I'd have to think about that.
Mr Bob Wood: Yes, I would think you would too. To clarify this whole issue of how these appointments are done -- and I'm sharing this with you just so you folks are aware of what my thinking is, and I'm of course only one of 130 MPPs here -- I think the minister is going to consider advice from the district health councils. I think he's going to then appoint those who support the government's agenda and in whom he has confidence. He's elected by the people and he's accountable to the Legislature and the people. I think that's how it's going to work. I hope today that you'll get some useful thoughts on how you might make your council more effective.
Those are my questions. We'll reserve the balance of our time.
Mr Ferguson: Thank you, Mr Wood.
The Chair: Okay. The government party has used 16 minutes so far. Do you want to move on and then come back?
Mr Bob Wood: We'll reserve the rest of our time.
The Chair: Okay. Can we move to the official opposition, please?
Mr Rick Bartolucci (Sudbury): I'll start. Bob, Ken, welcome. We'll try to phrase our questions in such a way as there's as much knowledge exchanged so that the government members can see some of the complexities with which we visit on a daily basis in Sudbury, in the region, with regard to hospital restructuring.
I want to start off with the method of appointments. I'd like in a capsulized way for you to explain to the committee what the process is in Sudbury, adopted by a consensus of the council that this was the fairest way to go, with regard to the interviewing or the screening process for appointments. Having said that, I'll come back and talk a little bit about the recent appointments in a very general way. So, first, could you just outline what the process is very quickly, so that these people on the government side understand there is a process.
Mr Ferguson: Briefly, it is a process that was developed in coordination and consultation with the Minister of Health of the day and approved by the Minister of Health, the policy and method of selecting council members.
It begins by a vacancy within the council. That vacancy is advertised in local papers, as a rule. It's stated whether it's a consumer or a provider that is needed to sit on council, and people are invited to apply. The applications come in, and after a period of time the applications are short-listed by the nominating committee of council, who then decide to interview and choose those they would like to interview.
From there, the ones who provide a favourable interview and so on then are recommended to council at an open meeting and council then gets to recommend names to put forward to the minister. For every position that needs to be filled at the council table, two names have been submitted to the minister with the recommendation of district health council for appointment to that board.
From there, it goes through the various offices down here. I'm not too familiar with the offices down here, but I believe it goes to the minister, and the minister decides on his choice. It is referred to a committee -- I believe it's this committee here -- that looks at those names and those people and decides to interview them or not and, further, to recommend them for signing by the Lieutenant Governor as an order in council. After they have achieved an order in council, they become a bona fide member of that particular district health council that they were selected for.
Mr Bartolucci: In response to one of Mr Wood's questions, because I wouldn't want anyone here to feel that those who support the government agenda would be excluded from their names being presented by the DHC screening committee, in fact that could happen, could it not?
Mr Ferguson: Yes. I might add that those candidates the ministry or minister or other related organizations refer to the minister for appointment to the board which bypass the normal route -- normally those names would come back to the district health council for a review as a courtesy. In these cases they did not.
Mr Bartolucci: Good. Maybe we can talk about the recent appointments now to the DHC. I know there are different sectors that our DHC requires be represented. How are these recent appointments either reflective or not reflective of the different sectors? You might want to outline that first of all.
Mr Ferguson: Reflective of the positions that were open?
Mr Bartolucci: Yes.
Mr Ferguson: At the outset there didn't seem to be a correlation with what we needed in the vacancies as they were specified, consumer, provider, language orientation or other. It's coming closer now with the latter appointees, but it did not seem to follow our guidelines.
Mr Bartolucci: I guess what I'm asking is, do you feel that the new appointees can contribute to this particular DHC's mandate, given the complexities of the issues found in the Sudbury region?
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Mr Ferguson: I believe they can, but at the same time we need to get up to speed, because they are very new at the health council table and broad experience or broad information absorption takes a while. It will take a little while for that to happen.
Mr Bartolucci: Maybe you can outline how you feel they can contribute most positively to the process. Let me explain to you, because you probably aren't aware, that I was very, very critical of a particular appointee to the DHC and argued rather strenuously that this particular person shouldn't be appointed. There were several that I concurred with because I think they are good appointees, but I felt that one wasn't and argued against it.
In a very general way, because I don't want to get involved in personalities, what do you feel are the characteristics that are most essential for a DHC appointee to have, given the complex situation in Sudbury? How do you feel the new appointees can fulfil your expectations of them?
Mr Ferguson: The first point would be that I'd like to see them be neutral and objective in caring and being interested in the betterment of health care services in the districts of Manitoulin and Sudbury particularly. That would be my main goal. Any other aspect, other than fitting the ethnic sectors that make up our population, linguistic and so on, I'd like to see those areas of the spectrum fairly well covered. In broad strokes, that's what I'd like to see.
Mr Bartolucci: There has been already some press that is disturbing in the Sudbury region with regard to the DHCs. By and large, do you feel the board that in its present makeup -- we have some more appointments to make, but presently --
The Chair: The council.
Mr Bartolucci: The council, I should say. I'm sorry. Do you think the council can get along and be a productive group as it sits right now?
Mr Ferguson: There is quite a divergence of opinion. It's going to be difficult.
Mr Bartolucci: Let's deal with a little bit about the hospital servicing review report etc, without getting into particulars because it becomes very complex. Since it was completed, what's your council done to try to facilitate some of the patient care improvements that were contained in the report, and how do you focus on the hospital services or the health services report as a council?
Mr Ferguson: We participated in the work group that was active early in the year, gave our point of view and our feelings in that arena. We stand ready to advise on other issues as they come up. Currently we're reviewing the hospital operating plans as part of the restructuring in Sudbury. Those are a couple of them. We're also involved in other studies around health care in the Sudbury basin, the Manitoulin-Sudbury area. We touch it in a lot of ways and advise as we find that we can give advice.
Mr Bartolucci: The Chair will know that the DHC and I differ fundamentally on sole governance etc, denominational, non-denominational, hospital structures etc. That's given, but there's been dialogue; a very productive dialogue, I suggest.
Because you fundamentally differ from the minister's position and the ministry's position, how do you feel you reconcile the two points of view to bring a positive resolution to the dilemma we have in Sudbury?
Mr Ferguson: How do we reconcile our two points of view? With some difficulty, as you can imagine. We've given what we believe is the best advice. I'm not sure we want to give second-best advice.
Whatever the minister decides to implement, we will help facilitate and plan to do and advise on that, but at the same time our cornerstone to restructuring has been the model of sole governance as being the best for health care.
It initially doesn't appear to save a lot of dollars as a method of going, but in the long run health care planning and health care services won't have in-fighting, won't have structural problems as such. You decide where you want a program; it'll be there. There won't be any vying for that space or campaigns which cost money and time and probably delay programs interminably. Sole governance avoids all that. The only thing you have to do is find the money to do things.
Mr Bartolucci: Yes, that's a dilemma. The minister has established a Health Services Restructuring Commission. We all know that. How do you see your role fitting into the commission's mandate?
Mr Ferguson: I believe we will still be planner and advisory in function and purpose to them, albeit we'll be directed through the ministry on what role we play.
Mr Bartolucci: If you had your druthers, would you like Sudbury to be a high priority for the Health Services Restructuring Commission or a lower priority for the restructuring commission to visit Sudbury for implementation purposes? If you had your choice, would you rather it be a very high priority for the commission or something other than a high priority?
Mr Ferguson: I'd say high priority actually, given that the further down the road we go, the tougher it's going to be.
Mr Bartolucci: Have you made the minister aware of that, that you feel, as a DHC, the restructuring commission should visit Sudbury as quickly as possible?
Mr Ferguson: Not as the DHC. That was my comment, but I get that impression.
Mr Bartolucci: As a DHC, though --
Mr Ferguson: They haven't made that determination yet.
Mr Bartolucci: Could you give the committee an idea about the attitude of the committee, given that it has new components attached to it and that it is a new DHC, by and large? Do you think that would be a recommendation coming from a meeting very soon, that Sudbury be placed very high on the commission's agenda?
Mr Ferguson: I'm sorry, but I can't give you a good feeling for that at this time.
Mr Bartolucci: It's still pretty new with the new board. I can understand that and appreciate that.
I'm going to pass to Mike. I'll come back.
Mr Michael Brown: Welcome. I really appreciate the trouble you've gone to come from God's country down here today. As members might know, Ken is a prominent resident of the district of Manitoulin and it must be troublesome to come to the big city on a fine day like today.
What I would like to ask you about is a question that Mr Wood asked, only I'm going to ask in another way. Did the Minister of Health give you reasons why he decided that sole governance was a bad idea? Mr Wood seemed to say, "Why do you think he did it?" What I want to know is, what did the minister tell you?
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Mr Ferguson: The only indication I can recall is that he suggested it would take a long time to implement sole governance.
Mr Michael Brown: The Minister of Health, in responding to you, did not give you reasons by way of correspondence that (a), (b), (c), (d), these are the reasons we do not believe sole governance to be an option?
Mr Ferguson: He also indicated that he wanted it to be a voluntary process. He mentioned the length of time, and I think that's basic to it.
Mr Michael Brown: There is a letter around or correspondence or something around that would outline the minister's particular reasons for rejecting the advice?
Mr Ferguson: Yes.
Mr Michael Brown: I think that's a fair question to ask.
Mr Ferguson: The October 4 letter back to us is the indication of that.
Mr Michael Brown: I'm troubled by what I'm hearing today, and the issue is not really as important as what I'm hearing today: that a local health council, a body that is there to give advice, has rendered advice the minister didn't like. The minister has said, "I don't like that advice so I'm rejecting it," which is fair enough. I don't see a problem with that.
What I see a problem with is that if a community board that is ostensibly, as I understand your mandate, to reflect the views of the community and then has to be restructured by the minister so that it reflects the minister's view and not necessarily the community's view, then, "The heck with the community; we will change the view of the community by changing the people who are on it." That's what I think you're saying today: "If you don't give the advice the minister wants to hear, then to heck with you. It's not just that we reject the advice, but we will change the board."
Mr Ferguson: Thanks, Mike. That's the indication your colleague gave us earlier on and that's the feeling we have, that if we don't give advice the minister wants to hear, then, "We'll change the advisory voice to accommodate."
Over the years that the district health council has been in operation, this is I think the first the minister has not accepted and went by the advice of district health councils.
Mr Michael Brown: How long has this appointment process that you described earlier been in place?
Mr Ferguson: Very early in the life of a DHC, but I'm not certain of the date.
Mr Michael Brown: Would it be fair to say the process you outlined has been in place for 10 to 15 years?
Mr Ferguson: That long, if not longer.
Mr Michael Brown: Therefore, it was not partisan in the Liberal, Conservative, New Democratic sort of process, that the ministers of health had appointed people regardless of their political affiliation? As a matter of fact that wasn't a real consideration?
Mr Ferguson: As I understand it, in the past there have been some political appointees, but by and large, the process was used to find and recruit new members to councils.
Mr Michael Brown: As an opposition member, I'm obliged to ask this question of you: Do you belong to one of the provincial political parties?
Mr Ferguson: I'm not paid up, but yes.
Mr Michael Brown: Which political party would that be? I think the government members might be interested in this.
Mr Ferguson: I do belong to the PCs.
Mr Michael Brown: Yes. As a matter of fact you're a rather well-known Progressive Conservative in the constituency of Algoma-Manitoulin.
Mr Ferguson: Yes.
The Chair: How well known?
Mr Michael Brown: Fairly well known. Mr Ferguson, for your information, carried the blue standard in 1990. I'm just trying to suggest to the government that certainly I believe Ken's a good appointment. He's an example of somebody who was obviously appointed by governments that weren't terribly interested in what political stripe they were.
I'm interested in some of the other issues. I think the question here is, how can a board that is structured so that the minister only gets the advice he wants to hear affect major issues other than hospital restructuring in our area? For example, what advice did you give or were you asked for before the government decided to implement CCACs, the community-based home support programs?
Mr Ferguson: What advice did they give to us?
Mr Michael Brown: What advice were you asked for before they announced this was the direction they were going?
Mr Ferguson: I don't recall a request for any advice. My colleague says we didn't get any advice, and I can't recall any. I just questioned Bob and he doesn't recall any advice.
Mr Michael Brown: Just so I understand this, the government moved with this initiative unilaterally without asking for community advice.
Mr Ferguson: That's my understanding.
Mr Kormos: Thank you for this correspondence. I'm looking at this October 4, 1995, correspondence from Jim Wilson. I can understand that he, like every other minister, doesn't sit down and dictate these letters. These are handed down to mere functionaries and then the minister sits down at his leisure, in the back of his car or sometimes when he's in the House doing House duty, just signs these things and hopes that nobody screwed up in drafting them.
Mr Ferguson: I'd like to know him better, but I don't know.
Mr Kormos: On October 4, 1995, on the second page -- have you got a copy of that?
Mr Ferguson: Yes, I do.
Mr Kormos: "Although you are aware of my government's position on governance, I would like to reiterate that an acceptable model of governance will respect religious and linguistic roles," etc. Then he goes on to say, "It is not this government's intention to undermine local discussion on governance." I trust that latter statement gave you some relief, knowing that the minister had no intention of undermining your role -- I'm speaking of you collectively as the district health council -- in discussing issues of governance.
Mr Ferguson: That's correct.
Mr Kormos: In contrast to a condemnation of what you had been doing, that's something of a green light, isn't it?
Mr Ferguson: It was a green light, yes.
Mr Kormos: In terms of your board -- I'm looking at the bylaw here that talks about the makeup of the board, that there shall be at least one member from each of the four respective areas.
Mr Ferguson: I believe so.
Mr Kormos: I trust that the current makeup of the board provides for at least one.
Mr Ferguson: Yes.
Mr Kormos: Are these areas equally represented?
Mr Ferguson: Currently, Sudbury east is represented by a municipal sector representative. Albeit the lady is not a municipally elected person, she's appointed by their municipal association. Manitoulin has appointed me as a representative. However, Sudbury west, which takes in Espanola, is vacant, and Sudbury north, which takes in the community of Chapleau, is vacant as well.
Mr Kormos: You've written to the minister on two occasions, February 1996 and April 1996, both on the 15th of those respective months, and you expressed concern about the process of appointments to the council.
Mr Ferguson: That's correct.
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Mr Kormos: Was this a personal concern or was it one that was shared by the members of the district health council?
Mr Ferguson: The district health council's executive expressed the concern that the process as we understand it that we tried to adhere to carefully did not appear to be followed. The second letter, if you would, refers to the same issue, but it continues that the process was not followed.
We're concerned, and rightly so. We thought we'd recommended some very fine candidates, plus, being that it wasn't followed and we'd already corresponded with our minister previously, this time we wished to know whether or not there's a new process, and if there is, we'd like to know about it because the advertising costs quite a bit of money and the short-listing takes volunteers' time. We don't mind that if the process is going to work. Also, the interviews take time. People and volunteers have to come in. I sit through eight or 10 hours of interviews myself, and some of my colleagues on council sit through a number of hours beyond that because the process had been going on before I got involved with the nominating committee. To what end, if our recommendations aren't being noticed or looked at?
If there's a new process, we'd like to know about it because we'd like to adjust so that we can deal with it and try to do what the minister would like us to do. We really are keen on looking after recommending the best interests of our community to our minister.
Mr Kormos: Really, if it were just a matter of doing what the minister wanted you to do, there wouldn't be much need for you, would there? The minister, he or she, could make those decisions all by its tiny little self, and district health councils would become pretty irrelevant if district health councils only did what the minister wanted them to do, wouldn't they?
Mr Ferguson: That's our contention. We're there to recommend what we believe is in the best interests of our communities.
Mr Kormos: Yes, and I trust you'd been following the guide to agencies, boards and commission for district health councils, which indicates that the Lieutenant Governor in Council appoints the members and a chair selected from a list of nominees submitted by the district health council.
Mr Ferguson: That's correct.
Mr Kormos: That's what was driving your concern in the February 15, 1996, letter and in the April 15, 1996, letter, because you'd been doing that to no avail.
Mr Ferguson: It appears that way.
Mr Kormos: Were any of the people whose names you submitted in turn submitted by the government for approval?
Mr Ferguson: No. That's correct.
Mr Kormos: How many names did you submit?
Mr Ferguson: There were 16 names in total that we've recommended for those positions.
Mr Kormos: These are people whose application had been solicited by virtue of ads in local papers --
Mr Ferguson: That's correct.
Mr Kormos: -- and who had been considered and interviewed by at least a committee of the health council in compliance with the guidelines set out.
Mr Ferguson: Yes.
Mr Kormos: And yet there have been a number of appointments. Most recently, was that Mr Poratto? Was that Mr Poratto who was here last? Is that the one we voted on a couple of weeks ago, Chair?
The Chair: Yes, it is.
Mr Kormos: His approval wasn't unanimous by this committee. The record would show that in any event. Mr Poratto came here and seemed to suggest that -- if I'm wrong, somebody's going to jump up quick as a boo and indicate it because they take great pleasure in that -- somehow you had been involved in his application for a position on the district health council.
Mr Ferguson: As near as I can determine, there was a letter to the editor of the Sudbury Star in January. That was the first indication we have. I don't know Mr Poratto. Mind you, I must clarify that there have been a number of rather large meetings in Sudbury over hospital services restructuring and related district health council business. I don't recall the chap introducing himself to me.
Mr Kormos: Huh? You mean he never talked to you?
Mr Ferguson: He may have talked to me, but without introducing himself.
Mr Kormos: Without identifying himself. The executive director wants to say something.
Mr Bob Knight: Mr Poratto called me in the late fall of 1995 and had a conversation which closely reflected the kind of statements he made at this meeting here and in his letter to the editor. But he did not at any time in his conversation with me indicate, to my recollection, that he was interested in serving on the district health council, and we have nothing in document form from him indicating such interest. In fact, we have nothing in documentary form from any of the eight people who were appointed other than the résumés that were sent to us by the minister's office after the fact.
Mr Kormos: And in the little ad you put in the paper, soliciting applications for membership on the council, does it indicate how those people are to apply?
Mr Ferguson: There's an address, yes, an invitation to apply to the district health council office, and the address is there, yes.
Mr Kormos: To your district health council office?
Mr Ferguson: Yes.
Mr Kormos: Not to some other district?
Mr Ferguson: That's correct.
Mr Kormos: So that would have been the ad that Mr Poratto saw?
Mr Ferguson: Presumably he'd see it if he got the local papers, yes.
Mr Kormos: And it would have directed him, if he was interested, to submit an application or a résumé, a CV, what have you, to the district health council?
Mr Ferguson: That's correct.
Mr Kormos: And you never received one from him?
Mr Ferguson: Not that I'm aware of, no.
Mr Kormos: Maybe the executive director could help.
Mr Knight: No, we never received one. Of the eight people who were appointed recently, one of those people did actually submit an application in response to our ad, but was not interviewed or recommended by council. I would say that people in the community are starting to get mixed signals about how they should apply to the district health council. In fact, we received a letter from someone two weeks ago who indicated that she had applied through the local Progressive Conservative Party office.
Mr Kormos: And how did that go across?
Mr Knight: Well, basically I advised her that we were unsure at this point what the process is for recruitment, but that was probably a positive move on her part.
Mr Kormos: In view of the recent history of appointments?
Mr Knight: That's correct.
Mr Kormos: You can only rely on what you see and what you hear, huh? You can't start looking into people's heads, and that seems to be the way it's done up there. You call the local Tory office.
There was a disturbing article on May 14 -- and I don't want to embarrass you, Mr Knight, but you've been with the health council, what, for five years?
Mr Knight: Yes.
Mr Kormos: I might ask the chair, the health council's been pleased -- I say "been pleased" -- with Mr Knight's work? They've kept him for five years.
Mr Ferguson: Up to quite recently, yes.
Mr Kormos: And he obviously came to the health council with strong qualifications?
Mr Ferguson: I believe so. I must admit I wasn't on council when Bob did come into the employ of the Manitoulin-Sudbury DHC. I've only been on a couple of years myself.
Mr Kormos: The article, and it's written by a Star staff writer, one Denise St Pierre: "A rift within the Manitoulin-Sudbury District Health Council could soon cost the agency's top administrator his job," referring to Mr Knight. One of the new appointments says, "`We don't want to be unfair to Mr Knight. We know he has a family, and we would offer him a good severance package,'" which is small comfort.
What the hell's going on? How is it that Mr Knight -- and I appreciate you can't discuss personnel matters -- right? -- because that's done in camera. I understand that. Am I right that the vote was a 7-7 vote? Is that what it was? That's what the newspaper --
Mr Ferguson: I'm sorry, that was an in camera meeting, and I cannot discuss that at this point.
Mr Kormos: Okay. No minutes or notes from the meeting -- I appreciate you can't discuss this, Mr Ferguson, but members who attended confirmed a vote of non-confidence was taken. The vote was split 7-7, meaning the non-confidence motion was lost. I appreciate you can't discuss what's going on in an in camera meeting, but you can certainly indicate whether there had ever been any previous concern prior to these new government appointees about Mr Knight's performance as executive director.
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Mr Ferguson: No. As a matter of fact --
Interjection: What's the question again?
Mr Ferguson: Could you repeat it, but I think I got it.
Mr Kormos: Yes. Please help me along because I'm grappling with this. I'm just trying to get a handle on it.
Mr Ferguson: He's received several great reports as interviewed or as assessed by our executive committee who did a performance report on him.
Mr Kormos: So if there was a vote of non-confidence, which of course you can't talk about because it was in camera --
Mr Ferguson: That's right.
Mr Kormos: But if there was a vote of non-confidence like the newspaper reports, obviously some of those district health council members aren't as respectful of in cameras -- unless the press made this up. But if there was, this would have been a novel thing with respect to Mr Knight because you're indicating that until these new provincial appointees appeared on the scene, there was never any question about his ability.
Mr Ferguson: Not from district health councils.
Mr Kormos: Quite right. There were critics from outside the health council.
Mr Ferguson: Oh, yes.
Mr Kormos: I trust you're satisfied that Mr Knight understands that as an executive director his job is to convey the message as determined by the appointed members of the council.
Mr Ferguson: That's right.
Mr Kormos: You've never had any quarrel with Mr Knight doing anything other than that, have you?
Mr Ferguson: No, sir, we haven't.
Mr Kormos: He's been consistent in understanding what his role is as executive director.
Mr Ferguson: Explicitly.
Mr Kormos: Mind you, he may or may not give advice to the members of the council. That's part of his job description, isn't it?
Mr Ferguson: That's correct.
Mr Kormos: There probably were times when council adopted a position that was consistent with Mr Knight's advice. Is that fair to say?
Mr Ferguson: That's fair.
Mr Kormos: Is it fair to say that there may well have been times when council, in its judgement, heard the advice, but made a decision that wasn't necessarily totally consistent with what Mr Knight --
Mr Peter L. Preston (Brant-Haldimand): Point of order, Mr Chairman: I believe these are proceedings that took place in camera and I don't see how they're adding to this discussion here today. It's a matter that is personal to these two gentlemen and I don't believe it adds or detracts from today and I don't believe it should be pursued.
The Chair: Mr Preston, I think that Mr Ferguson and Mr Knight are able to separate out in their responses what they would view to be appropriate and inappropriate. So I think we should let the questioning continue and I think Mr Ferguson and Mr Knight both understand what in camera means and will not discuss that here at the committee.
I understand your point and I don't disagree with it totally, but I don't think that the questioning is inappropriate because I think that Mr Ferguson and Mr Knight know full well how fulsome their answers can be.
Mr Preston: Mr Kormos, in his way, is going to lead to a conclusion by innuendo and I don't believe that's going to be helpful to either case.
The Chair: All right. I've made the ruling, so continue, Mr Kormos.
Mr Kormos: Thank you, Chair. Mr Ferguson, you're satisfied that Mr Knight understands his role as executive director?
Mr Ferguson: Quite well, yes.
Mr Kormos: Again, I don't want you to talk about what happened in camera.
Mr Ferguson: No, I haven't been talking about anything in camera.
Mr Kormos: And I wouldn't think of asking you about that, either getting in the back door or the front door. But is there concern among council members that this sort of report would appear in the paper? I'm talking about the report of a 7-7 vote on a non-confidence motion on Mr Knight.
Mr Ferguson: I've had a number of council members call me expressing grave concerns about it, exasperation. I've had residents from the catchment area, Manitoulin-Sudbury district, expressing concern. I talked to my son last night and my answering machine has got a number of calls from people very upset about that article in particular and what it says.
Mr Kormos: So if there was an attack on Mr Knight -- if there was, because of course you can't indicate whether there was or not because that's in camera -- folks in the communities that your health council serves are not pleased.
Mr Ferguson: Yes, you could say that.
Mr Kormos: Is that an understatement?
Mr Ferguson: Quite.
Mr Kormos: They're royally ticked.
Mr Ferguson: Yes. I guess they don't want to be referred to as royal, but they're quite ticked.
Mr Kormos: And, Chair, you'll notice I've been moderate in my use of language. That's not exactly what I was thinking.
In your leadership on the council, have you encountered -- and how long have you been chair?
Mr Ferguson: A year ago this June. It's been a long year too, I might add.
Mr Kormos: I bet you it has. Look, imagine us down here at Queen's Park.
Mr Ferguson: Yes. It's not like in the Everglades. They don't have somebody with a rifle to shoot the alligators here either.
Mr Kormos: But on occasion I understand an alligator will bite off more than it can chew and it will actually choke in its own digestive process.
Mr Ferguson: Yes. That's a kind of a small consolation, though, while you watch --
Mr Kormos: Especially if you're the person being chewed on. Right?
Mr Ferguson: -- you're watching your stomach turn, yes.
Mr Kormos: Yes. Are you fearful for the integrity of the district health council?
Mr Ferguson: We have some concerns, yes, about that very issue and that's part of what my opening statement was alluding to. We see that it can play a very valuable role in advising the minister on what is appropriate and reasonable for the communities, in particular the Manitoulin-Sudbury district catchment area, and while we know very few things are status quo, we would like to know what our role is and have that made very clear to us.
The Chair: Mr Kormos, you have three minutes left.
Mr Kormos: Three minutes. Okay. I trust you can tell us whether or not there was a secret, off-the-record meeting of health council members on April 25.
Mr Ferguson: Yes, there was a meeting.
Mr Kormos: Did you call that meeting?
Mr Ferguson: Yes, I did.
Mr Kormos: Did you call it on your own initiative?
Mr Ferguson: I called it with the recommendation and request of the executive and myself, yes.
Mr Kormos: Was that in response to certain things being put to you?
Mr Ferguson: Yes.
Mr Kormos: Were those things being put to you by the new members, the new appointees?
Mr Ferguson: A combination.
Mr Kormos: Was it because of concerns on the part of the pre-existing appointees, the ones prior to the improper appointees? Was it about their concern over the direction of the new appointees?
Mr Ferguson: Perhaps I can let that question fall.
Mr Kormos: Sometimes silence speaks volumes, sir.
Mr Ferguson: I'd prefer not to comment on that question.
Mr Kormos: I understand. So there was a whole lot of concern?
Mr Ferguson: Yes.
Mr Kormos: There was concern by existing members of the board prior to these new appointees about an attack on the independence of the board?
Mr Ferguson: I'm sorry?
Mr Kormos: There was concern by the original members of the board about a seizure of control of the board by the new appointees.
Mr Ferguson: There's concern, yes.
Mr Kormos: Especially in view of the fact that these new appointees had not been appointed through the procedure outlined in the guide?
Mr Ferguson: There's concern --
Mr Kormos: Is there concern about direct political interference in the integrity and independence of the district health council?
Mr Ferguson: Yes, that's fair to say.
Mr Kormos: Are the new members of the board perceived as hatchet people for this government?
Mr Ferguson: In my comments earlier on they are perceived as being there to clear the council's house.
Mr Kormos: Are they being perceived as fifth columnists?
Mr Ferguson: I'm not sure what you're referring to as fifth columnists.
Mr Kormos: They're designed to take over the board so that the board merely is an expression of the political will of this government as compared to an expression of the interests and will of the community.
Mr Ferguson: I won't deny that that thought is there.
Mr Kormos: Is that thought there among more than a few people?
Mr Ferguson: Yes, I think so.
Mr Kormos: Do you consider that a legitimate concern by those people who do feel that way, or is it merely fanciful?
Mr Ferguson: I won't say it's fanciful, no.
Mr Kormos: You wouldn't say it's fanciful.
The Chair: Thank you, Mr Kormos. Sorry to interrupt, but we did agree to split up the time. The government members have seven minutes left if they wish to use the time.
Mr Bob Wood: Yes, we do wish to use that. I'd like to follow up on a couple of matters that have come forward. I wonder if you'd describe for me, Mr Ferguson, the current process you apply when somebody comes to you and says they want to serve on the district health council. What happens from there?
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Mr Ferguson: We ask them to fill out an application form and then it's presented to the nominating committee for consideration, and given that they would like to interview them, then the applicant is requested to come in for an interview at a mutually agreeable time. That's usually the catch because given the broad spectrum of the nominating committee and the prospective candidates, it does take a little work to coordinate times that people are mutually available for that sort of activity. That's how that happens, yes.
Mr Bob Wood: So each person who applies to you goes through that process and then is either recommended or not recommended to the minister.
Mr Ferguson: That's right.
Mr Bob Wood: Do you refer anyone directly to the ministry who applies to you before they go through that process?
Mr Ferguson: Not that I'm aware of -- there has never been that happen, no.
Mr Bob Wood: Maybe Mr Knight could help us on this. Is anyone referred directly to the ministry?
Mr Knight: In the past, no. They've all gone through the step-by-step process that Mr Ferguson has outlined, but in recent weeks we've received two applications and basically our nominating committee has decided not to use the process any more because it appears to be fruitless and so they're being referred on at this stage.
Mr Bob Wood: What's your current practice then with respect to someone who comes to you and says they want to serve on the council?
Mr Knight: It hasn't been happening very much. As I say, in the last month or so we've had only two and that is simply to refer them on to the minister's office.
Mr Bob Wood: Was that authorized by the district health council?
Mr Knight: More or less. When the nominating --
Mr Bob Wood: When you say "more or less," was it or wasn't it?
Mr Knight: When the nominating committee decided it was not going to conduct any process any more until the minister indicates whether or not he wants us to do so, then I think there's an obligation on our part --
Mr Bob Wood: Excuse me. How was it authorized by the district health council? Was it done by a bylaw? Was it done by resolution?
Mr Kormos: I'd like to hear the answer, Chair.
Mr Bob Wood: How was it authorized?
Mr Ferguson: Not by bylaw.
Mr Bob Wood: Was it done by resolution?
Mr Knight: An authorization for that sort of thing I don't think is needed. The person's applying for council --
Mr Bob Wood: Excuse me. So is it correct to say --
Interjection.
The Chair: Order.
Mr Bob Wood: Is it correct to say there was no authorization by the district health council?
The Chair: Order, please. Mr Wood, there's nothing wrong with your line of questioning, but Mr Knight really should have the opportunity to complete an answer and I don't think you're being fair to him. Go ahead, Mr Wood.
Mr Knight: Thank you, Mr Chair.
Mr Bob Wood: Make it a short answer, please.
Mr Knight: In the absence of any local process based in our council, we have an obligation, I believe, to pass on applications for council membership to the minister's office.
Mr Bob Wood: Please don't evade the question. Was there an authorization by the district health council to change the process, and if so, how was it done? It wasn't done by bylaw. Was it done by resolution of the district health council?
Mr Ferguson: I believe I indicated to Mr Knight to go ahead and forward them until clarification was made on the process.
Mr Bob Wood: The answer, I take it, was it was never authorized by the district health council?
Mr Knight: There's no resolution to that effect, no.
Mr Bob Wood: Was there anything they did that authorized it?
Mr Knight: I've already explained that.
Mr Bob Wood: Nothing? The answer is there was no authorization?
Mr Knight: No, that's not correct, Mr Wood. I have already explained to you that the nominating committee, which is the group which heads up the recruitment process in our council, decided to suspend its process. Now if you want to --
Mr Bob Wood: And received no authorization from the health council?
Mr Knight: If you wish to accuse me of an indiscretion --
Mr Bob Wood: I'm accusing you of nothing. I'm asking for --
Mr Kormos: Chair, I want to hear the answer.
Mr Knight: -- by construing from that that I should then just simply send the applications on to the minister's office, then you can do so.
Mr Bob Wood: I'm not interested in instruction from you in what I can or can't do. I gather -- this is the last time I'm going to ask this -- there was no authorization by the district health council to suspend the process?
Mr Knight: There was no resolution, to my recollection, to that extent. The nominating committee members indicated they didn't want to do this any more. Actually there was a resolution. When one of our members resigned from Chapleau, council passed a resolution that a letter be sent to the minister saying, "We have this new vacancy, and we await your instructions, Mr Minister, on what to do with recruitment."
Mr Bob Wood: Would you be kind enough to send us a copy of that resolution?
Mr Knight: Absolutely.
Mr Bob Wood: Thank you. I have a couple more questions but I suspect I'm out of time --
The Chair: There are two minutes left.
Mr Bob Wood: I'm going to defer to Mr Preston.
Mr Preston: I put all my notes away because I wasn't going to ask the question. The last paragraph on page 5, your position disagrees apparently with the government and with the eight people who have been appointed. Is that correct, basically?
Mr Ferguson: Yes, probably. We haven't got a definitive direction from the new people yet.
Mr Preston: All right. Your own description of the health council, "The kind of planning carried out by the DHC is important so that provincial policy can be implemented successfully...." Do you see these things running parallel or at cross-purposes?
Mr Ferguson: Sorry?
Mr Preston: Paragraphs 3 and 4 --
Mr Ferguson: Is that page 2 you're talking about?
Mr Preston: On page 4: "There have been eight recent appointments...."
Mr Ferguson: Okay.
Mr Preston: All right. You're familiar with those?
Mr Ferguson: Yes.
Mr Preston: All eight apparently seemed to be well briefed. They seem to have an opinion?
Mr Ferguson: Yes.
Mr Preston: It differs with your council's opinion or the other half of the council's opinion?
Mr Ferguson: It appears to, yes.
Mr Preston: All right. And yet your statement is that your job there "is important so that provincial policy can be implemented successfully...." Provincial policy seems to be against the last paragraph on page 5. Is that correct?
Mr Ferguson: Yes, in that hospital governance should proceed before --
Mr Preston: Regardless of what it is, the provincial opinion is different than that?
Mr Ferguson: Yes.
Mr Preston: And these people seem to be agreeing with provincial opinion, and your statement is that you're there so that provincial policy can be implemented. Do you not see that as parallel or running against each other? What do you say?
Mr Ferguson: The way you've put it, it sounds like they're opposed.
Mr Preston: They're your words, sir.
The Chair: Thank you, Mr Preston. May I thank the committee members for their adherence to the time, and we may be able to complete it by 11:30.
Mr Ferguson and Mr Knight, on behalf of the committee, I thank you for your attendance here and your forthright answers. It is customary for the committee, at a later date, to do a report on this short session today. Of course, that would be a public report and you would, of course, as well receive a copy of that. Thank you very much for your attendance here today.
Mr Kormos: If I may, in response to your last comment, there appears here to be a hijacking of what should be an independent body, and what I'm calling upon the Chair to do is to ensure that this committee prepares its report at the earliest possible opportunity.
The Chair: The subcommittee will deal with that next Tuesday as to the agenda.
Interjection.
The Chair: Okay. Not next Tuesday, the Tuesday after. Okay? Thank you, Mr Ferguson. Thank you, Mr Knight.
Mr Ferguson: I thank you all for your time and patience. We're volunteers. I'm a volunteer. I'd sooner be farming, but I thank you for the invitation to come down and share our thoughts with you. It's my belief and my intention to be the eyes and ears along with the council of our community for the minister and to do the best we can in giving advice to him, and sharing that with you and with the public any time we can. Thank you again.
Mr Preston: Thank you very much.
The Chair: Thank you again. Okay, the balance of the morning is to deal with the review of an intended appointment, Mr Michael O'Keefe. Is Mr O'Keefe here?
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INTENDED APPOINTMENT
MICHAEL O'KEEFE
Review of intended appointment, selected by the official opposition party: Michael O'Keefe, intended appointee as president, Workers' Compensation Board.
The Chair: Mr O'Keefe, thank you for coming to the committee this morning. If you wish to make any opening remarks we would welcome those, and if you'd introduce the gentleman who is with you.
Mr Michael O'Keefe: Mr Paul Boniferro, who is --
Mr Paul Boniferro: The Minister of Labour's policy assistant, and here to assist Mr O'Keefe today. If there's any issues that arise that can assist the committee members with respect to policy issues around the WCB or his appointment, I'll be happy to assist in any way.
The Chair: Okay. Mr O'Keefe, do you wish to make any opening remarks?
Mr O'Keefe: Yes, Mr Chair. I appreciate the opportunity to appear today before the standing committee on government agencies. The position of president and CEO of the Workers' Compensation Board is certainly one of the most challenging jobs in the country. It carries with it enormous responsibility, but as well an opportunity to contribute and to make a difference. It requires leadership, creativity, and a win-win attitude.
I believe my years running major hospitals have prepared me very well for this position. While WCB is a different business than hospitals, the health care sector plays an integral role to the workers' compensation system; and I know the health care sector. But, most importantly, I believe the generic challenge facing the health care sector and an institution such as WCB have many similarities.
WCB, like the Toronto Hospital, is a very large institution. WCB currently has 4,600 staff, while at the Toronto Hospital we have 6,000. WCB has an operating budget of approximately $330 million, the Toronto Hospital approximately $500 million. WCB, like hospitals, serve many different and often diverse interests: government, clients, employers, employees, service providers etc. WCB, like hospitals, operate with a board of directors and a great amount of public scrutiny, and must therefore meet very high standards of excellence.
In the health care industry, which most management gurus concede is one of the most complicated of all organizations, I have successfully met all of these challenges. My goal will be to build an organization that is devoted to both reducing the causes and minimizing the effects of workplace injuries. An organization that recognizes good service is an efficient service, doing the right things right -- an organization that is financially sound.
I feel the position requires an individual with demonstrated turnaround experience and ability to manage effectively in a high-profile, dynamic environment, financial experience, a successful track record of top-level management in a big organization, restructuring experience, experience in a union environment, and ability to work effectively with the board of directors, public relations knowhow, public policy experience and a win-win attitude; and I feel I have these attributes and experience. Thank you, Mr Chair.
The Chair: Thank you, Mr O'Keefe. Do government members have any questions?
Mr Bob Wood: One, and I think a couple of my colleagues have questions as well. I'd like to ask you, Mr O'Keefe, whether or not you think there are opportunities for improvement in the management of the WCB, and if you do think there are, where you would see those opportunities lying?
Mr O'Keefe: I have not had the opportunity to review information on productivity or client satisfaction. In fact, I have not had my foot inside the door of the WCB since I became involved in the job search.
However, I've looked at some gross indicators such as costs per claim, the reduced number of claims, no real reduction in admin costs; I've looked at staffing numbers compared to other jurisdictions, relatively speaking; looking at the turnaround time of claims compared to other jurisdictions; the fact that there have been no major re-engineering initiatives that I'm aware of that have occurred over the past while.
There has been a series of acting CEOs so it's more or less been hold the line, and leads me to believe that there are considerable opportunities to reduce cost and improve service. The whole issue of service: Everybody has an opinion on the quality and level of service being provided by WCB, and I believe there are opportunities to improve service, and it would be a priority for me upon taking up the position.
Mr Bob Wood: That's my question for the moment. I think a couple of my colleagues have questions.
Mr Bert Johnson (Perth): Mr O'Keefe, would you please tell the committee about the search and the interview process that you were involved in, how it evolved.
Mr O'Keefe: I was contacted by Caldwell Partners, which was the recruitment firm retained to undertake the search. They asked if I was interested. I indicated I was, forwarded a résumé, met with them on a number of occasions. This then led me to be interviewed by a search advisory committee that had been set up under the chairmanship of Dr Robert Prichard, the president of the University of Toronto. It also included the CEO of Manulife, the CEO of Xerox, a senior VP with the Royal Bank of Canada and Dr Bette Stephenson.
I was interviewed by this search committee and finally recommended for appointment.
Mr Bert Johnson: What do you consider the key priorities as the intended president of WCB?
Mr O'Keefe: My immediate priority will be to implement the new government reforms. That's an obvious priority for me. These reforms are being designed to improve the financial performance and administration of services.
An essential element of the reforms will be the implementation of the mandate for prevention of workplace injuries and illness, because ultimately if we are able to prove successful in the prevention and early return to work, that will have a tremendous impact on all the issues currently facing the WCB.
Some of the specific challenges will include improving the financial position of WCB, the administration of service delivery, positioning the WCB for implementation of the reforms and, again, ensuring the new safety and prevention mandate is reflected in a new organizational structure.
Mr Bert Johnson: Thank you. Those are my questions.
Mr Bob Wood: Jim Brown has a question.
The Vice-Chair (Mr Tony Martin): Mr Brown has a question? Go ahead.
Mr Jim Brown (Scarborough West): Small business creates 80% of all new jobs, and over the past five or six years, small business has been really turned off by a host of factors, one of which is the WCB. How do you think you'll be able to address the problem of encouraging small business to create jobs and restore the economy?
Mr O'Keefe: Most certainly the service issue is a significant issue. Good service is an efficient service, so it's to improve the efficiency of the programs that are currently being delivered by WCB.
The whole issue of its overall financial stability and taking initiatives to improve the current financial position and the focus on prevention, I believe, will have a positive impact for the small businesses in the province.
The Chair: Anybody else? There's about a minute and a half left.
Mr Bob Wood: We'll reserve the balance.
The Chair: Okay, we'll move on. The official opposition.
Mr Dwight Duncan (Windsor-Walkerville): First of all, congratulations on your appointment. On behalf of the Liberal opposition, we feel it was a fair process and obviously a well-done process, in keeping with the tradition we established when we appointed Dr Robert Elgie chair of the board. We raised a number of issues prior to your appointment, hoping the focus would be done the way it was.
First of all, what percentage of current claim costs do you feel would be appropriate in terms of coverage at the WCB? Currently it's at about 37%. What do you see as an appropriate coverage level?
Mr O'Keefe: I really don't feel I've had an opportunity to get involved in the organization to make a realistic response to your question. As I said earlier, I've had no involvement with the WCB. Hopefully, tomorrow I will. I really feel I should reserve responding to that question because I don't have the information at hand.
1140
Mr Duncan: The government's discussion paper speaks to that whole issue vis-à-vis the unfunded liability, as well as the coverage rate. Let me ask you this: Do you view the unfunded liability as an issue of debt or do you view it as an issue of current claim cost coverage?
Mr O'Keefe: I believe it is a significant issue that has to be dealt with. Currently the assets are about three times the value of the annual premiums coming in. I've read some works by actuaries that have indicated a fully funded WCB system should have assets that are approximately six times the current income or premiums. The situation is somewhat reversed currently, where we have assets that are three times but liabilities that are about six times, so something obviously needs to be done if we are going to be able to sustain the system in future.
Mr Duncan: Do you think we can do that with a 5% cut in assessments in the short term?
Mr O'Keefe: I really don't wish to comment on that initiative which is being taken by government. I think that is a government policy issue. When I take up the position, I will carry out what I have to do as CEO to implement whatever direction I'm given.
Mr Duncan: What kind of advice would you render to a government, given what you've just indicated about the nature of the unfunded liability and of the accident fund? What kind of advice would you give to the government if they said to you, "What's your view on assessment cuts at this point in time?"
Mr O'Keefe: I really don't feel I'm in a position to give an opinion right now. That's a government decision that will be, I'm sure, discussed in the Legislature.
Mr Duncan: The legislation is anticipated, I believe, the first week of June. Do you think you'll be in a position at that time to share your views as the president and CEO of the board with the Legislature, the employer and the injured workers' community in the province?
Mr O'Keefe: I hope that when the government takes its position, I will be out front in respect to how I will deal with it as CEO.
Mr Duncan: Can I take your answer to mean that you neither support nor do not support the 5% assessment cut?
Mr O'Keefe: No. I would take my answer in respect of your question that I do not feel I'm in a position right now to give an opinion on that issue. It's a government policy issue.
Mr Duncan: In terms of the percentage of employers who are covered in Ontario relative to other jurisdictions, the government in its discussion paper presented a table that said roughly 70% of Ontario employers are covered. I think British Columbia was the highest with about 97%, the Canadian average being in the low to mid-80s. The government, as a matter of policy in a number of other areas, including welfare benefits, has attempted to position Ontario either at the average or slightly below the average in terms of cost. Do you have any views yet with respect to the percentage of employers who are covered by WCB, and what would your view be with respect to an appropriate level of coverage?
Mr O'Keefe: I really don't have any views right now. That is, as you know, in the discussion paper and will be discussed and debated. I don't really have a position right now.
Mr Duncan: I assume you'll be defending whatever recommendations come forward from the government with respect to those issues and the other 17 questions that are raised in the discussion paper.
Mr O'Keefe: I don't feel it will be so much defending as carrying out the implementation in a fair, equitable, sensitive manner.
Mr Duncan: Is it your intention to meet with injured workers' advocacy groups and injured workers' groups prior to the legislation being introduced? If you've yet to form an opinion on these issues which I believe are going to be introduced to the Legislature within two weeks, it would be my hope that you would be prepared to meet with injured workers' groups and advocacy groups on behalf of injured workers to hear their views on these issues as well. Would you be prepared to do that prior to the implementation?
Mr O'Keefe: I would take that under advice.
Mr Duncan: The secretariat, as you're probably no doubt aware, has received literally dozens of submissions, some of them very compelling, I might add, that I think would be well worth your perusal and then meeting with these folks so that you can see where they're coming from. Dr Elgie was very effective at that and always kept the doors open, and I think it would be in the interests of the president to begin and to maintain those contacts.
Mr Kormos: This is a candidate search process that seems unimpeachable. Obviously the background of Mr O'Keefe is such that while I may disagree -- not "may," I do disagree -- with what Ms Witmer and Mr Jackson have in mind for the WCB, it remains that Mr O'Keefe presents himself as eminently qualified as an administrator and I wish him well.
The Chair: Anything else from the other parties? Government party, do you wish to pursue anything else?
Mr Bob Wood: We do not.
The Chair: Mr O'Keefe, thank you very much for coming before the committee. I think you can get a sense from the committee that they're pleased with your appearance here and your intended appointment.
Mr O'Keefe: Thank you very much, Mr Chair.
The Chair: We have two other items of business to attend to. One is to entertain a motion of concurrence and the other is to deal with the subcommittee report.
Mr Bob Wood: I move concurrence in Mr O'Keefe's intended appointment.
The Chair: Any debate on that? No debate at all?
All those in favour? Opposed? It's carried unanimously. Thank you for that.
I think most committee members know that the appointment of Mr Kemp to the Deseronto Police Services Board has been withdrawn. Mr Bartolucci. We don't need to debate it, but --
Mr Bartolucci: I know, Mr Chair, and I don't plan on debating it. I simply plan on saying that I'm glad good sense -- perfect sense -- was used in the withdrawal of this appointment.
Mr Bob Wood: I would like to note, Mr Chair, that we try to listen to all points of view. We don't agree with all points of view at all times, but we do listen to them. We appreciate submissions made by all.
The Chair: I think the process worked in this case, if I might say so.
Mr Bartolucci: Mr Chair, we had an indication of how the eighth appointee to the DHC in Sudbury will come back to haunt the restructuring process in Sudbury very, very quickly. That's just a prophecy with regard to Mr Knight's job. You will note that there was a 7-7 tie, and the eighth appointee is Mr Poratto.
Mr Bert Johnson: Is that as in profit-sharing?
Mr Bartolucci: That is a prophecy.
Mr Kormos: I guess we had all better await the subpoenas for when Mr Knight sues the butt off the DHC for unjust dismissal, if indeed that happens. I'm prepared to testify.
SUBCOMMITTEE REPORT
The Chair: Can we move on to the report of the subcommittee.
Mr Bob Wood: I move adoption of the subcommittee's report.
The Chair: Is there any debate on Mr Wood's motion? If not, all those in favour? Opposed? None.
Thank you very much, Mr Wood. I thank the members of the committee for getting us through the morning in fine fashion. We are adjourned.
The committee adjourned at 1149.