Background: ITAC Responds to the Report of the Commission to Reform Ontario Public Services

The Report of the Commission on the Reform of Ontario Public Services (popularly known as the Drummond Report after Commission Chair Don Drummond) delivers urgent and sobering messages about the state of Ontario’s economy. It also contains over 300 recommended measures which, if undertaken immediately, could prevent the bleak prospect of a $30 billion debt by 2018. The report is an excellent analysis of Ontario’s economic present and future. The changes it recommends are bound to be controversial. All belt tightening measures are. However, for so richly seeding the democratic discussion that must precede any serious austerity program, the Commission and the Ontario Government are both to be commended for this report. Ontario clearly faces hard choices and change. The choices must be made in cognizance of their wider implications. ITAC has reviewed the report from the perspective of the ICT industry, which is a vitally important contributor to Ontario’s economy, particularly as it transitions into a 21st century, knowledge-based economy. Our focus is on three key areas of the report: health, education and business services.

Health

The Drummond Report acknowledges the importance of health information technology to enable improved efficiency in the Ontario health sector. At least 19 of 105 health recommendations identify health information and/or HIT as critical success factors in proposed government health reforms. ITAC is a strenuous advocate for precisely this level of more widespread, integrated and strategic use of technology to improve outcomes and reduce cost.

The report identifies key trends in health IT that can be exploited to improve efficiencies, safety and outcomes. These include: use information to better manage the health system; increased use of telemedicine (Telehomecare, Teledermatology, Tele-ophthalmology); leverage electronic health records to manage chronic disease and medications; and improve communications between institutions, primary care and CCACs. ITAC fully concurs.

ITAC is already working with government to improve efficiency of the health system. We are engaged with the Ontario government, eHealth Ontario and Cancer Care Ontario at a strategic level in the development of an eHealth infrastructure for Ontario. ITAC and its member companies also engage with other key stakeholders in the Ontario health system such as OntarioMD and other professional and industry associations to ensure that the vendor community is prepared to meet standards that are designed to improve productivity, patient safety and health outcomes.

ITAC believes that digitization of the health sector can be accelerated bringing needed reforms online more quickly. We support the report’s “bottom-up” approach which will put information technology into the hands of clinicians who can drive innovations that improve productivity, patient safety and health outcomes.

The Commission’s report also identifies a number of inefficiencies that can be ameliorated by information technology. For example, technology can facilitate the necessary shift from hospital- based treatment to clinic and home-based prevention. ITAC welcomes the focus the report places on technology’s role in gaining efficiencies and reducing costs. We concur with the report’s observation that technology itself, even when it is currently deployed, is not used fully effectively in a manner to drive the best return.

Education

ITAC concurs with the report’s observation that a strong education system is critical to Ontario’s prosperity and global competitiveness. Participating as we do in a global knowledge-based economy, Ontario’s excellence in education is currently its chief asset. Meeting the challenge set out by the report “to deliver education as efficiently and effectively as possible” requires careful attention to what is central to the role of the education system and what is secondary. ITAC believes that the primary role of the education system is to educate – to produce the skilled graduates necessary to fuel the growth of our knowledge-based industries and to drive innovation. So we support the report’s perspective on the importance of preserving teaching excellence. We particularly applaud the focus given to the need to preserve and improve experience based learning.

ITAC also supports the Commission’s call for a revision of current research funding structures. We know we cannot turn our back on the importance of discovery research to a robust knowledge-based economy. Preserving this activity is table stakes. However, it is possible that the role of post-secondary institutions in commercializing innovation is both misunderstood and over-stated. There is a plethora of commercialization entities within our universities that may or may not be serving a useful purpose. So ITAC supports the call for an evaluation and revision of Ontario’s research funding structures particularly if, by gaining efficiencies in this area, we can preserve or improve teaching quality and the quality of graduates.

Business Supports

Whatever the respective merits of Ontario’s 44 business support programs, ITAC believes that the very best business support program of all is a competitive tax regime. The Government is to be commended for the steps that it has taken in the harmonization of retail sales tax and the ongoing reduction of the corporate tax burden. Preserving the competitive tax regime must be central to any review of business support programs. In a period of tough choices, sacrificing tax reform in favour of preserving programs would be a poor choice.

It is tempting then to support the Commission’s call for a full grandfathering of all programs followed by a “from scratch” rebuild based on programs that deliver productivity improvement and innovation. However, the suggestion that Ontario cease making refundable tax credits, including those for research and development, would be hugely detrimental to Ontario’s innovation ecosystem.

Ontario is currently in the privileged position of being home to the vast majority of R&D activity in the Canadian economy. All provincial jurisdictions and virtually all international jurisdictions compete aggressively through direct and indirect incentives to attract and retain high value R&D jobs and infrastructure investments. R&D activity is highly mobile. It can be relatively easy to displace to lower cost jurisdictions, especially if the incentive structure changes or if its future becomes uncertain. ITAC has recommended measures to reform the Ontario research and development credit – such as opting for a labour-based approach to the calculation of the credit – but it would never support a complete removal of the credit even for a short period of time.

The Commission’s Report contains a great deal of useful counsel. One theme, in particular, pervades the whole report whether the topic is health, education or other services. The report persistently calls for the efficiencies to be gained through integrated service delivery, automated back office activities and shared service environments. ITAC, without reservation, supports this thinking. We have witnessed the efficiency gains and cost reductions possible by this approach repeatedly in our interaction with private sector and some public sector customers. Advocacy for this approach is a central tenet of our ongoing advocacy for government service modernization and transformation. We work actively with the Ontario Government on this front and are ready to do whatever is required to help government achieve the vision of better integrated, more efficient service delivery.

For more information, please contact Lynda Leonard: leonard@itac.ca or 613-238-4822 x2239.