The Inside Agenda Blog

Steve Paikin: Fifty Billion Dollars -- Too Much for Bureaucracy, Not Enough for Health Care?

by Steve Paikin Friday May 16, 2014

The Ontario Liberals, like the federal Conservatives, ran up huge deficits in hopes of protecting people from the worst ravages of the Great Recession. The feds actually presented a budget in 2009 with a deficit north of $55 billion.

But the economy has been improving and so have the nation's balance sheets. As a result, unless something dramatic happens, the federal government will balance its budget next year.

That's not the case for Ontario, which could be the last province in the country to balance its books if current trends persist. Critics of this Ontario government point to an unwillingness by the Liberals to reign in spending as the cause. The Grits insist they have the leanest government in the country, and charts in the 2014-15 budget document confirm that: Ontario, in fact, has less program spending per capita of any province in Canada.  

And yet, critics persist that the Liberals are spending too much.  Tory leader Tim Hudak says if he wins the election, he'll fire 100,000 of the 300,000 additional employees the Liberals have funded in the broader public sector.

Questions have persisted: is there enough "fat" to fire, so Ontarians don't lose valuable public services they want?

Let's take Ontario's $50 billion health care system. The Liberals have added a considerable amount of administration to the system during their ten years in power. Local Health Integration Networks now manage the resources of their respective parts of the province. That is a whole new layer of bureaucracy. And Community Care Access Centres procure services for patients and make sure those services are properly disbursed. The CCACs have at least tripled their organization charts since the Liberals came to power in 2003. Neither Ontario's population, nor the number of sick people the health care system treats, have tripled in the past ten years.

Since the Liberals returned to power with a minority government in 2011, their staffing levels in the Ministry of Health and Long Term Care have also increased significantly. In 2011, the ministry had eight assistant deputy ministers, one associate deputy minister, and 40 policy directors.

Deb Matthews has been Ontario Health Minister since October 2009.

By 2013, there were still eight ADMs, but two associate deputies, and 49 directors. This year, the ministry added a third deputy minister of health. The deputy minister jobs traditionally fetch a salary of between $400-500,000. And the Grits also this year raised the number of assistant deputy ministers to 12 from eight.

When the Tories were in power from 1995-2003, they staffed the ministry with five assistant deputy ministers, and 30 directors.

Could the Liberals be trying to skirt around their own civil service management wage freeze policy by promoting people to higher paying jobs, since they can't pay them more to do the same job? Certainly, that's the scuttlebutt in the bureaucracy. The result is a glut of higher paid bureaucratic positions.

The LHINs were supposed to curb the growth of jobs in the ministry. In fact, the opposite has happened. 

The Ministry of Health plans to oversee $50 billion worth of spending in this fiscal year. You'd like to think as much of it as possible would go to actually treating patients. The evidence may suggest otherwise.

Read all of Steve Paikin's recent blog posts on the Ontario election.