Address by Dr. Peggy Leatt - Liberty Health Chair

I would like to begin by thanking Liberty Health for their generous gift to the University of Toronto.

In particular I would like to thank Mr. Gery Barry, President of Liberty Health for his leadership in supporting the development of this Chair. The idea of a University Chair in Health Management Strategies has never been more important than it is today.

No matter which country we look at we find a common problem: what are the health policies and management strategies that will ensure access to comprehensive high quality health services for all at a reasonable cost? That question is at the center of debates internationally by health policy-makers, managers, academics, community leaders and individual citizens.

Canada is no different. Canadians are proud of their health care system but every level of government - federal, provincial, and municipal is challenged in some way by the issue of sustainability of our current level of services. The recent announcement of the appointment of Mr. Romanow to examine health services in Canada re-enforces the magnitude and complexity of the problems we face, and the extent to which Canadians have concerns that health care may not be there when they need it.

Today, I have been asked to say a few words about the future directions for the Liberty Health Chair and the impetus this can create at the University of Toronto.

Let me begin with research…

Health management and policy research’ is one form of health services research. While it cannot be considered ‘rocket science’ it is not an area that should be under-rated in its importance. The diverse theories and research that collectively make up the body of knowledge and research methodologies in this field have the potential to influence the every day lives of all Canadians in a significant way.

No-where else in Canada can you find more talent in health services research than here at the University of Toronto and its affiliate institutions.

As one small department in the Faculty of Medicine, the Department of Health Administration has been successful in bringing attention to the need for research in this important area. The outstanding record of external funding received in the Department is evidence that faculty members in the Department of Health Administration and elsewhere in the University are recognized nationally and internationally for excellence in health services research. The Liberty Chair will open up the potential for an even broader range of research topics to be pursued in partnership with members of the Faculty of Law. Let me illustrate by a few example research questions:

How do we ensure that every Canadian has access to all health services from health promotion, disease prevention, diagnostic services, acute episodes of care, rehabilitation, long-term care and so on? How do we ensure access is equitable?

How should health services be organized and financed to provide high quality services with the best outcomes for the health of the community? How should consumers or communities be involved in decision-making about health services?

What have been the experiences of other provinces and many other countries in attempting to enhance accountability for health services through regional health authorities? What can we learn from the experiences of managed care and integrated health systems in the United States?

Are private sector funded organizations better managed than those funded by the public sector? Which is the most efficient? Which is the most effective in terms of health outcomes?

How can we best utilize the human resources that will be available to provide services? Should we be designing new roles for key providers such as doctors and nurses? Are there new team approaches that will better serve the health care needs of communities?

What policies need to be in place concerning funding and prescribing drugs? Which is the most effective way of implementing a new approach to drugs?

How can we ensure that service quality is enhanced and that system errors are minimized?

These are just a few of the important questions that can be pursued - all require the expertise and collaborative effort from many disciplines and perspectives.

My second topic is education…

Although it is not well publicized, The Department of Health Administration has a long history of innovation in education. The Department was created at the end of World War 2 and the University of Toronto became one of only four universities in North America at that time to recognize the need for advanced training for managers in top leadership positions in health care in Canada. For the first 20 years of the Department’s history, hospital boards across the country would send the persons earmarked to be the next CEOs to receive training in our Program. We would like to think that the majority of the influential leadership positions across Canada are filled with University of Toronto alumni. In 1996, in response to changing needs of the field, the Department again took the lead in North America to craft a management education program with modern teaching and learning methods for adult learners who work full-time. This Program has become an outstanding success and is the envy of other programs in North America elsewhere.

The Liberty Chair will also enable us to develop a broad range of education programs in management, policy and clinical evaluation for practicing clinicians, managers and policy makers - physicians, nurses and others - who are taking on important leadership roles in our health care system. We need flexible programs that build upon participants’ experiences and are offered in innovative modalities to meet the needs of these important groups.

Let me turn for a minute to training for health services research. The University of Toronto is now recognized as the number one environment where rigorous training in health services research may be obtained. It is a rich multidisciplinary environment offering students an array of interesting and exciting activities.

We need to aggressively pursue initiatives to obtaining secure funding for students to pursue PhD level education without difficult financial constraints. Unless financial assistance is obtained we will continue to lose good minds to other research centers.

A Chair in Health Management Strategies provides an ideal opportunity to build on this history and tradition of the Department of Health Administration and to advance our education programs and to continuously experiment with teaching and learning approaches.

Creating a forum for scholarship and debate…

I began my remarks this afternoon by talking about the global nature of the health care problems we face. The Liberty Health Chair will provide an excellent vehicle for sharing ideas and experiences from around the world. The health management challenges we face are complex and in order to be able to understand them we need to engage the minds of the brightest and the best. There are no simple answers. This new Chair can serve as a focal point to bring together the brightest and the best of the University’s academic and practitioner community to debate issues and generate solutions.

We will be able to expand our collaboration with a broad range of health science partners - medicine, nursing, public health, social work, pharmacy, rehabilitation sciences and so on. We will be able to bring together faculty and students from the faculties of law, management, political science, sociology to mention just a few.

The Department of Health Administration is fortunate to enjoy enviable relations with the field of health management and policy - the new Chair will facilitate the expansion of current relationships between the University of Toronto and its academic health sciences centers, community agencies, the Ontario Ministry of Health and Long-term Care, long term care organizations, home care programs and many more.

The potential of being able to take part in debates with international renowned scholars is very exciting. We would welcome Mr. Romanow and other leaders from around the world at the table with us to discuss new opportunities, new strategies and new ways of implementing changes in health care.

None of the ideas I have described can be realized unless we have effective mechanisms for communicating our work to others. This is an area that has not been well developed. The new Chair can provide the opportunity to develop new approaches for the University of Toronto to act as a hub or nerve center of activity to disseminate knowledge widely through all types of media - written, spoken, electronic and so on.

In closing…

I have described to you a brief outline of a vision for the future. All of us here today are proud to be associated with this fine institution - the University of Toronto - an organization with a history of outstanding scientific achievements and one that ranks amongst the very best in the world. This vision can be achieved with your help. I would like to invite all of you to be part of this new initiative - to make an investment in the future of our health care system here at the University of Toronto.

I want to again thank Liberty Health for showing leadership - for creating this chair as a beginning - as a way to open doors to new pathways for success. I would also like to take this opportunity to thanks Dr. Arnie Aberman, Dean Daniels, Dean Naylor and Dr. Vivek Goel for facilitating this very important program.

Thank You.

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