Drummond zeroes in on health, education

Many of the recommendations contained in the Drummond report are just good common sense, and could have been made even if the province was in a good financial position, according to Laurentian University president Dominic Giroux.

The Commission on the Reform of Ontario's Public Services' mandate was to make recommendations resulting in a balanced budget by 2017-18 — a difficult task given Ontario's $16 billion deficit.

The 362 recommendations in the commission's report, released Feb. 15, suggest cuts to a variety of sectors, including health care and education.

“Yes, obviously the genesis of the commission was to provide advice to the province on how best to balance the budget by 2017-18,” Giroux, who sat on the commission, said.

“But most of the recommendations are either ideas that have been floating in government for some time, or simply good practices that have been brought to our attention that should be pursued.”

The commission, led by former TD economist Don Drummond, began its work in earnest in June, Giroux said.

Commission members were given access to the province's deputy ministers to “receive their best advice” about how provincial services can be reformed.
They also consulted with about 200 stakeholders, and collected suggestions from members of the public on a website.

“Our task was to ask the right questions to stakeholders, to governments and to government officials, and to come up with a set of recommendations that would sustain quality public services, but at a cost that could be affordable to taxpayers by 2017-2018.”

Giroux said the toughest part of sitting on the commission was the tight deadlines the group was under.

“When you look at other commissions that have been created by either the province or by the federal government, often they were given way more than six months to report on a scope that was much narrower than what we've seen with the Commission on the Reform of Ontario's Public Services.”

Drummond wrote in his report that none of the choices outlined in the report will be easy, and many of the proposals will “draw vigorous criticism.”

“But it must be kept in mind that our recommendations can deliver the needed degree of spending restraint to balance the budget by 2017-18, only if they are all implemented.”

Drummond said the deficit is expected to be $16 billion this year, and by 2017-18 it will almost double if the status quo is left in place.

A press release from the Ministry of Finance said the report will inform the 2012 budget.

“The McGuinty government remains committed to putting Ontario's finances on a long-term, sustainable path,” Dwight Duncan, the province's finance minister, said in a press release.

“I thank the commission for the hard work it has done to provide advice on how to help us achieve our goal of a balanced budget by 2017-18.”

 

Post-secondary education

Many of Drummond's recommendations focus on health and education.

In terms of post-secondary education, Giroux's area of expertise, the report recommends capping growth in post-secondary spending at 1.5 per cent each year until 2017.

This will not keep pace with the projected enrolment growth of 1.7 per cent, nor with the general rate of inflation, so the province's post-secondary institutions will have to “find efficiencies to preserve, if not enhance, quality,” the report stated.

The report also recommends the status quo be kept in terms of universities increasing tuition by a maximum of five per cent per year.

Giroux said Laurentian University's budget was prepared with this scenario in mind, so it should be able to manage with this level of funding.

“Relatively speaking, we're in a better position than most universities in the province,” he said.

The report also recommends the province consider eliminating a 30 per cent tuition rebate available to many of the province's post-secondary students. This tuition rebate program was only announced last month.

“The challenge with the 30 per cent tuition grant is that because it is allocated broadly to students, the commission’s view is that it may not be as effective as more focused programs targeting lower-income students,” Giroux said.

 

Primary and secondary education

Doreen Dewar, chair of the Rainbow District School Board, summed up her opinion of many of Drummond's recommendations this way — “short term gain for long-term pain.”

She said she doesn't think Ontario Premier Dalton McGuinty, who has touted himself as the education premier, will implement all of the recommendations.

Dewar said she hopes stakeholders will be given the chance to have their say before the province makes any decisions.

One of the recommendations is that primary and secondary education spending be capped at one per cent each year to 2017-18.

The report said over the past decade, there has been a 56 per cent increase in per-pupil funding, and at the same time, student enrolment is declining. “This is not sustainable,” the report said.

Dewar said this level of funding would be a “difficult pill to swallow.” “It's going to be really hard on small boards, more so than large boards,” she said. “It's going to impact directly on student learning. You can't hold the line that tight without a very negative impact.”

Many of the recommendations would disproportionately affect northern Ontario.

Dewar gives the example of charging parents a fee for school bus service.

“I've been to schools in southern Ontario where there's 1,200 elementary kids in one school facility, and they all walk,” she said.

In northern Ontario, school boards cover large geographic areas, meaning many students are bussed to school. Many rural schools have been closed in recent years, increasing the proportion of students who take buses even further, she said.

“Now to turn around and say 'OK we have to charge you for busing,' that would be a hardship that is unacceptable.”

Drummond's recommendation that full-day kindergarten program be cancelled, or its full implementation be delayed from 2014-15 to 2017-18, could hurt disadvantaged children if implemented, Dewar said.

“We need to get the premier to understand that this full-day early learning program is very crucial, especially to have-not families,” she said.

These are families who haven't the means to be able to provide that stimulus and necessary groundwork that we build on for student success. These are the most vulnerable students we have.”

Duncan has publicly stated that scrapping full-day kindergarten is not on the table.

But other recommendations surrounding primary and secondary education are, including suggestions that class sizes be increased and high school students be limited to taking 32 credits.

Dewar said she is disappointed Drummond didn't look at the cost savings that could come from amalgamating all of the different types of school boards in the province.

Although Catholic education is entrenched in the constitution, Dewar said there's nothing that guarantees “bricks and mortar.” She said she believes that Catholic and non-denominational education be provided in the same building.

“In northern Ontario, we have all these small communities that have half-empty buildings,” she said. “It's mind-boggling. I wish this man had taken a look at this. I can't even begin to figure out how much money we could save.”

Drummond also recommends that the province push the federal government to fund on-reserve First Nations education equal to the per-student provincial funding for elementary and secondary education.

Failing that, he recommends the province itself should step up to provide that funding.

Giroux said when the federal government was making program cuts in the 1990s, First Nations education received a two per cent per year funding increase.

However, when the federal government started investing in social programs again, the two per cent increase for First Nations education was left in place.

Because provincial education spending has increased significantly over the last 10 years, there's now a disparity in the per-student funding between on and off-reserve education, Giroux said.

“There's a huge social cost to that,” he said.

“That's why, in our view, the federal government needs to step up. If the federal government doesn't do it, the province should step in.”

 

On health-care

More than 130 of Drummond's recommendations relate to health care, which represents about 40 per cent of the province's budget.

One of his main recommendations in this area is that growth in health-care spending should be capped at 2.5 per cent each year to 2017-18.

“At least it's not a cut, as was previously done in the 1990s,” Dr. Denis Roy, CEO of Health Sciences North, said.

Roy said he's not yet sure how this spending cap will affect the hospital.

“One has to do the best we can with whatever we have,” he said. “We have to reorganize. That's exactly what we've been doing over the last few years — to eliminate waste and try to give the best care in the cheapest way.”

Overall, Roy said he supports Drummond's recommendations because they focus on the importance of health promotion and chronic disease management rather than hospitalization.

In the past year, Health Sciences North has focused heavily on ambulatory care to deal with chronic conditions.

The report does state that outpatient services should fall to Community Care Access Centres (CCACs) and private health care operators “which have demonstrated that they can do this sort of work for much less than hospitals.”

“The outpatient services that we've been offering include the diabetes day centre,” Roy said.

“This I'm not so sure the CCAC could carry out. With the heart failure clinic, we'd love to have the CCAC get involved in this. But, as (North East CCAC CEO Richard Joly) likes to say, he doesn't have the manpower to do so at the present time.”

The report also recommends that the province's 14 Local Health Integration Networks be given more power to integrate health services.

Giroux said there are currently about 2,500 health organizations funded by the province, most of which are not overseen by the LHINs.

“From a patient perspective right now, there are silos in the system that are causing prejudice to patients,” he said.

“If there was real integration, we could have a real health care system, and not what we have right now, which isn't a system. What we have right now essentially is a combination of silos, which do their best within the resources they have to meet patient needs.”

Posted by Arron Pickard