I was asked by Rob Dowler of MGS (Government of Ontario) to moderate a panel at this year's Showcase Ontario. The panel was on "Transformational Leadership for Today's Public Service" and took place on September 23, 2009. They assembled a stellar panel for me to moderate. The panelists were:
* Shirley Hoy, former City Manager, City of Toronto and now CEO of Toronto Lands Corp;
* Tony Dean, former Ontario Secretary of the Cabinet and now a fellow in residence at the School of Public Policy & Governance, University of Toronto; and
* Alex Himelfarb, former Clerk of the Privy Council (Government of Canada) and the newly appointed Director of the School of Public & International Affairs, Glendon College.
To say this was a stellar panel would be a gross understatement. What was interesting to me was that all three worked together to achieve some substantial breakthroughs in intergovernmental cooperation. As you can imagine, entrenched interests make this kind of three level cooperation difficult most of the time. Anyway, the 10 minute presentations from each of the panelists was quite interesting.
Tony was the first to speak and he talked about 1) the importance of "people issues" in the public service including proper and enlightened leadership; 2) Complex policy issues and 3) Execution. He spoke of the need for the establishment of benchmarks and measurement which requires robust information systems to provide evidence in terms of both delivery and policy. He underscored the importance of public sector leadership in protecting the core values of the public service and building a culture of flexibility and innovation within the public service.
Alex spoke about 1) the deterioration of the policy role within government and 2) the challenge to be innovate with the current "cult of accountability". He contrasted today's Deputy Minister to DM's when he first joined government. DM's 20 years ago focused on policy and provided "fearless advice and loyal implementation", while today's DM is an executioner and provides "loyal advice and fearful implementation". He sees the reductions of the past having a significant negative impact on the policy capability of public service. As a result, there is decreased demand for policy advice from politicians. The advent of technology has resulted in the "democratization" of the policy process, where expertise has become devalued. On the cult of accountability Alex spoke to the need to be innovative (as part of a learning organization) and to take risks which has been affected by a focus on blame.
Shirley spoke of the "implementation gap" in government...how to properly implement broad policy decisions and that public servants had become too risk averse. She spoke of the need to focus on results and outcomes and using technology as an enabler for transformation. She sees that we are in a post bureaucratic model of government and that no single level of government can tackle the complex problems and policy challenges that face society today.
Following the presentations, the floor was opened up for a Q & A session. There were questions on technology as an enabler; the trend of centralization of decision making; and how to ensure innovation within public service.
A video of the session is presently being edited. Once it is complete, I will provide you with the link so that you can all watch what was a fascinating session.
Wednesday, September 23, 2009
Tuesday, September 22, 2009
IPAC/Deloitte Leadership Awards Jury - Day 1
Well we had quite a day today. But first a little about the reception last night for all the finalists in the IPAC/Deloitte Public Sector Leadership Awards. The reception was held on Monday night in the Martini Bar of the Pantages Hotel (and no I did not wear my mask & cape!). It was a great evening and I had a wonderful time meeting the finalists and invited guests.
Today the jury had the pleasure of listening to the 9 finalists in the Federal/Provincial/Territorial category. All the finalists wonderfully put forward their case and explained to the jury what they have accomplished and how they accomplished it. I really can't say anymore or else I risk spilling the beans! The Gold, Silver and Bronze recipients will be announced at the Gala Awards Dinner on November 5, 2009 as part of the 5th annual IPAC Leadership Conference being held on November 5 & 6 at the Pantages Hotel in Toronto.
Special thanks to Rob Fowler, Deputy Minister, Executive Council of Nova Scotia for chairing today's jury.
Tomorrow the juries will meet with the finalists in all the other categories: Municipal; Health Care; Education; and Not-for-profit.
Today the jury had the pleasure of listening to the 9 finalists in the Federal/Provincial/Territorial category. All the finalists wonderfully put forward their case and explained to the jury what they have accomplished and how they accomplished it. I really can't say anymore or else I risk spilling the beans! The Gold, Silver and Bronze recipients will be announced at the Gala Awards Dinner on November 5, 2009 as part of the 5th annual IPAC Leadership Conference being held on November 5 & 6 at the Pantages Hotel in Toronto.
Special thanks to Rob Fowler, Deputy Minister, Executive Council of Nova Scotia for chairing today's jury.
Tomorrow the juries will meet with the finalists in all the other categories: Municipal; Health Care; Education; and Not-for-profit.
Monday, September 21, 2009
IPAC/Deloitte Public Sector Leadership Awards: Finalists
On Tuesday September 22 and Wednesday September 23, 2009 the finalists in the second annual IPAC/Deloitte Public Sector Leadership Awards will be making their presentations in front of the juries.
This year we received over 80 submissions in all categories of the award:
* Federal/Provincial/Territorial
* Municipal
* Health Care
* Education
* Not-for-Profit
The winners will be announced at a Gala dinner on November 5, 2009 as part of IPAC's Leadership Conference (November 5 & 6, 2009 at the Pantages Hotel in Toronto).
The finalists are as follows:
Education
Innovation Strategy:Transforming Education in the Applied Health Sciences
The Michener Institute for Applied Health Sciences, Toronto
Dr. Paul Gamble, President and CEO
Coming Down from the Mountain
Simon Fraser University, Burnaby, British Columbia
Cathy Daminato, Vice President, University Relations
Leadership for Student Success
Ryerson University, Toronto
Julia Hanigsberg, General Counsel and Board Secretariat
Not-for-Profit
From Vision to Reality
Children’s Treatment Network Simcoe York
Louise Paul, CEO
BIXI: Société de vélo en libre Service (SVLS)
Montreal
Alain Ayotte Président
Cancer View Canada – The CPAC Partnership Portal
Canadian Partnership Against Cancer
Lee Fairclough, Vice President,Knowledge Management
Municipal
Reclaiming the Street of Shame
Vancouver Police Department, City of Vancouver
Adua Porteus,Inspector
Leading Change – Neighbourhood Revitalization
City of Edmonton
Kathy Barnhart, Branch Manager
The kids@computers: Leading Investment in Disadvantaged Children and Communities
City of Toronto
Ted Lis, Director Social Services, Employment and Social Services Division
Streets to Homes
City of Toronto
Ian De Jong, Manager Streets to Homes Shelter, Support and Housing Administration
Health Care
The Canadian Paediatric Surgical Wait Times Project
Hospital for Sick Children, Toronto
Monica Cottafavi, Communications Manager
Improve – PHSA’s Program Focusing on Patients and Empowering Staff
Provincial Health Services Authority, British Columbia
Jennifer MacKenzie, VP Strategic Planning, Transformation and Infrastructure
Partners for Aboriginal Health
Saint Elizabeth Health Care
Shirlee Sharkey, President and CEO
Federal/Provincial/Territorial
Response to the 2007 Passport Surge in Demand
Department of Foreign Affairs and International Trade Canada
Gerald Cossette, Associate Deputy Minister
Creating a Culture of Leadership in the Alberta Public Service
Deputy Minister Council, Alberta Public Service
Dale Silver, Public Service Commissionner
Health Canada’s The Way Forward Initiative –An Enterprise Approach to IT
Health Canada
Rudy de Sa, CIO
Pacte pour l’emploi
Ministère de l’Emploi et de la Solildarité sociale
Bernard Matte, Sous-ministre adjoint
Evaluation on Health Technologies for the Ontario Health Care System
Medical Advisory Secretariat and Ontario Health Technology Advisory Committee
Dr. Birthe Jorgensen
Director
Vision et leadership en santé publique
Institut national de santé publique du Québec
Dr. Pierre Gosselin, Responsible scientifique (INSPQ)
Leading the Transformation in Stewardship
Ontario Ministry of Health and Long-Term Care
Debbie Fischer, Assistant Deputy Minister
Advanced Communication and Collaboration Services
Ministry of Citizens’ Services, British Columbia
Jill Kot, Assistant Deputy Minister
Project Management Centre of Excellence
Ministry of Citizens’ Services, British Columbia
Richard Poutney, Assistant Deputy Minister Common Business Services
Tonight we will be holding a reception for all the finalists as well as invited guests from government and the broader public sector. It will be a very interesting evening.
This year we received over 80 submissions in all categories of the award:
* Federal/Provincial/Territorial
* Municipal
* Health Care
* Education
* Not-for-Profit
The winners will be announced at a Gala dinner on November 5, 2009 as part of IPAC's Leadership Conference (November 5 & 6, 2009 at the Pantages Hotel in Toronto).
The finalists are as follows:
Education
Innovation Strategy:Transforming Education in the Applied Health Sciences
The Michener Institute for Applied Health Sciences, Toronto
Dr. Paul Gamble, President and CEO
Coming Down from the Mountain
Simon Fraser University, Burnaby, British Columbia
Cathy Daminato, Vice President, University Relations
Leadership for Student Success
Ryerson University, Toronto
Julia Hanigsberg, General Counsel and Board Secretariat
Not-for-Profit
From Vision to Reality
Children’s Treatment Network Simcoe York
Louise Paul, CEO
BIXI: Société de vélo en libre Service (SVLS)
Montreal
Alain Ayotte Président
Cancer View Canada – The CPAC Partnership Portal
Canadian Partnership Against Cancer
Lee Fairclough, Vice President,Knowledge Management
Municipal
Reclaiming the Street of Shame
Vancouver Police Department, City of Vancouver
Adua Porteus,Inspector
Leading Change – Neighbourhood Revitalization
City of Edmonton
Kathy Barnhart, Branch Manager
The kids@computers: Leading Investment in Disadvantaged Children and Communities
City of Toronto
Ted Lis, Director Social Services, Employment and Social Services Division
Streets to Homes
City of Toronto
Ian De Jong, Manager Streets to Homes Shelter, Support and Housing Administration
Health Care
The Canadian Paediatric Surgical Wait Times Project
Hospital for Sick Children, Toronto
Monica Cottafavi, Communications Manager
Improve – PHSA’s Program Focusing on Patients and Empowering Staff
Provincial Health Services Authority, British Columbia
Jennifer MacKenzie, VP Strategic Planning, Transformation and Infrastructure
Partners for Aboriginal Health
Saint Elizabeth Health Care
Shirlee Sharkey, President and CEO
Federal/Provincial/Territorial
Response to the 2007 Passport Surge in Demand
Department of Foreign Affairs and International Trade Canada
Gerald Cossette, Associate Deputy Minister
Creating a Culture of Leadership in the Alberta Public Service
Deputy Minister Council, Alberta Public Service
Dale Silver, Public Service Commissionner
Health Canada’s The Way Forward Initiative –An Enterprise Approach to IT
Health Canada
Rudy de Sa, CIO
Pacte pour l’emploi
Ministère de l’Emploi et de la Solildarité sociale
Bernard Matte, Sous-ministre adjoint
Evaluation on Health Technologies for the Ontario Health Care System
Medical Advisory Secretariat and Ontario Health Technology Advisory Committee
Dr. Birthe Jorgensen
Director
Vision et leadership en santé publique
Institut national de santé publique du Québec
Dr. Pierre Gosselin, Responsible scientifique (INSPQ)
Leading the Transformation in Stewardship
Ontario Ministry of Health and Long-Term Care
Debbie Fischer, Assistant Deputy Minister
Advanced Communication and Collaboration Services
Ministry of Citizens’ Services, British Columbia
Jill Kot, Assistant Deputy Minister
Project Management Centre of Excellence
Ministry of Citizens’ Services, British Columbia
Richard Poutney, Assistant Deputy Minister Common Business Services
Tonight we will be holding a reception for all the finalists as well as invited guests from government and the broader public sector. It will be a very interesting evening.
Friday, September 18, 2009
New Study from the US: 45,000 excess deaths annually linked to lack of health coverage
More evidence that the lack of universal health care in the USA has a direct impact on health outcomes. A recent study from Harvard has highlighted that there are approximately 45,000 excess deaths in the US due to lack of universal coverage. Read on.......
A study published online on Sept 17th estimates nearly 45,000 annual deaths are associated with lack of health insurance. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.
The new study, "Health Insurance and Mortality in U.S. Adults," appears in the online edition of the American Journal of Public Health.
The Harvard-based researchers found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.
Lead author Dr. Andrew Wilper, who worked at Harvard Medical School when the study was done and who now teaches at the University of Washington Medical School, said, "The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health. We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease - but only if patients can get into our offices and afford their medications."
The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking education, income and many other factors including smoking, drinking and obesity into account. It estimated that lack of health insurance causes 44,789 excess deaths annually.
Previous estimates from the IOM and others had put that figure near 18,000. The methods used in the current study were similar to those employed by the IOM in 2002, which in turn were based on a pioneering 1993 study of health insurance and mortality.
Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease. An increase in the number of uninsured and an eroding medical safety net for the disadvantaged likely explain the substantial increase in the number of deaths associated with lack of insurance. The uninsured are more likely to go without needed care.
Another factor contributing to the widening gap in the risk of death between those who have insurance and those who don't is the improved quality of care for those who can get it.
The research, carried out at the Cambridge Health Alliance and Harvard Medical School, analyzed U.S. adults under age 65 who participated in the annual National Health and Nutrition Examination Surveys (NHANES) between 1986 and 1994. Respondents first answered detailed questions about their socioeconomic status and health and were then examined by physicians. The CDC tracked study participants to see who died by 2000.
The study found a 40 percent increased risk of death among the uninsured. As expected, death rates were also higher for males (37 percent increase), current or former smokers (102 percent and 42 percent increases), people who said that their health was fair or poor (126 percent increase), and those that examining physicians said were in fair or poor health (222 percent increase).
Dr. Steffie Woolhandler, study co-author, professor of medicine at Harvard and a primary care physician in Cambridge, Mass., noted: "Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives."
Dr. David Himmelstein, study co-author and an associate professor of medicine at Harvard, remarked, "The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance. Even this grim figure is an underestimate - now one dies every 12 minutes."
A study published online on Sept 17th estimates nearly 45,000 annual deaths are associated with lack of health insurance. That figure is about two and a half times higher than an estimate from the Institute of Medicine (IOM) in 2002.
The new study, "Health Insurance and Mortality in U.S. Adults," appears in the online edition of the American Journal of Public Health.
The Harvard-based researchers found that uninsured, working-age Americans have a 40 percent higher risk of death than their privately insured counterparts, up from a 25 percent excess death rate found in 1993.
Lead author Dr. Andrew Wilper, who worked at Harvard Medical School when the study was done and who now teaches at the University of Washington Medical School, said, "The uninsured have a higher risk of death when compared to the privately insured, even after taking into account socioeconomics, health behaviors and baseline health. We doctors have many new ways to prevent deaths from hypertension, diabetes and heart disease - but only if patients can get into our offices and afford their medications."
The study, which analyzed data from national surveys carried out by the Centers for Disease Control and Prevention (CDC), assessed death rates after taking education, income and many other factors including smoking, drinking and obesity into account. It estimated that lack of health insurance causes 44,789 excess deaths annually.
Previous estimates from the IOM and others had put that figure near 18,000. The methods used in the current study were similar to those employed by the IOM in 2002, which in turn were based on a pioneering 1993 study of health insurance and mortality.
Deaths associated with lack of health insurance now exceed those caused by many common killers such as kidney disease. An increase in the number of uninsured and an eroding medical safety net for the disadvantaged likely explain the substantial increase in the number of deaths associated with lack of insurance. The uninsured are more likely to go without needed care.
Another factor contributing to the widening gap in the risk of death between those who have insurance and those who don't is the improved quality of care for those who can get it.
The research, carried out at the Cambridge Health Alliance and Harvard Medical School, analyzed U.S. adults under age 65 who participated in the annual National Health and Nutrition Examination Surveys (NHANES) between 1986 and 1994. Respondents first answered detailed questions about their socioeconomic status and health and were then examined by physicians. The CDC tracked study participants to see who died by 2000.
The study found a 40 percent increased risk of death among the uninsured. As expected, death rates were also higher for males (37 percent increase), current or former smokers (102 percent and 42 percent increases), people who said that their health was fair or poor (126 percent increase), and those that examining physicians said were in fair or poor health (222 percent increase).
Dr. Steffie Woolhandler, study co-author, professor of medicine at Harvard and a primary care physician in Cambridge, Mass., noted: "Historically, every other developed nation has achieved universal health care through some form of nonprofit national health insurance. Our failure to do so means that all Americans pay higher health care costs, and 45,000 pay with their lives."
Dr. David Himmelstein, study co-author and an associate professor of medicine at Harvard, remarked, "The Institute of Medicine, using older studies, estimated that one American dies every 30 minutes from lack of health insurance. Even this grim figure is an underestimate - now one dies every 12 minutes."
Wednesday, September 9, 2009
Health Care - US
I usually don't comment on politics on this blog, but in this case I will make an exception, especially as it relates to Health Care, President Obama and the opposition to health care reform in the USA.
I have been astounded by the level of so-called debate in the US over the proposed reforms to the US health care system and the vitriol of those opposing the public option. When debate descends to the level where President Obama is compared to Hitler, you have to wonder what these critics have been smokin'! Then you have people like Sarah Palin who have said that the Obama plan includes "death panels" of bureaucrats who would decide who lives or dies. Where did she get that? There is no such thing, and yet she makes headlines "by being economical with the truth" as Sir Humphrey would say.
After our annual conference in Fredericton, I took some time off and stayed for a couple of days at the Algonquin Hotel in St. Andrew's. It is a wonderful Gatsbyesque place. At night, on the front lawn, they have a fire pit going with a number of Muskoka chairs around the fire. We were sitting there one night and talking to some of the other guests. A few of them where from the USA, so we asked them about Health Care reform. One was from Massachusetts and the other one was from Connecticut. They were both against the "public option" as they felt that people should take individual responsibility and that they did not want to pay for people who do not take care of themselves. We continued the debate, though when they stated that the fair news in the US was Fox news, we knew where they were coming from. Mind you it was a civilized debate, not the overexcited, screaming & yelling that one has seen at US town hall meetings. Must have been the effect of being in Canada that calmed them.
Whatever your position is on the public option in the US, you should at least have a civilized discourse!
Back to the substance of the debate - tonight Barack Obama addresses Congress to try to get his message across. We will see if he will be successful. I have my doubts, given that they have let the anti-reform side frame the debate. Whatever comes out of Congress will be watered down and the winners will be the special interest groups (US insurance companies) and the losers will be those with out coverage or with inadequate coverage.
You have to wonder why a society as individually generous as the US (compare their charitable donations per capita to other countries) would be against the concept of putting in place a universally accessible health care system. It is not as if the US system produces better health outcomes or costs less than other "socialized" health care systems. Some of the opposition is based on not wanting a government health bureaucracy and the assumption that government can't run anything (the example they give is Hurricane Katrina). But is it better to have multiple private health insurance bureaucracies that result in a huge administrative overhead (some estimates are that this overhead is 30% of the health care bill in the US).
I could go on, but I think I will stop here - there is much on this topic in cyberspace...check it out.
Stay tuned and see what happens with this interesting debate.
I have been astounded by the level of so-called debate in the US over the proposed reforms to the US health care system and the vitriol of those opposing the public option. When debate descends to the level where President Obama is compared to Hitler, you have to wonder what these critics have been smokin'! Then you have people like Sarah Palin who have said that the Obama plan includes "death panels" of bureaucrats who would decide who lives or dies. Where did she get that? There is no such thing, and yet she makes headlines "by being economical with the truth" as Sir Humphrey would say.
After our annual conference in Fredericton, I took some time off and stayed for a couple of days at the Algonquin Hotel in St. Andrew's. It is a wonderful Gatsbyesque place. At night, on the front lawn, they have a fire pit going with a number of Muskoka chairs around the fire. We were sitting there one night and talking to some of the other guests. A few of them where from the USA, so we asked them about Health Care reform. One was from Massachusetts and the other one was from Connecticut. They were both against the "public option" as they felt that people should take individual responsibility and that they did not want to pay for people who do not take care of themselves. We continued the debate, though when they stated that the fair news in the US was Fox news, we knew where they were coming from. Mind you it was a civilized debate, not the overexcited, screaming & yelling that one has seen at US town hall meetings. Must have been the effect of being in Canada that calmed them.
Whatever your position is on the public option in the US, you should at least have a civilized discourse!
Back to the substance of the debate - tonight Barack Obama addresses Congress to try to get his message across. We will see if he will be successful. I have my doubts, given that they have let the anti-reform side frame the debate. Whatever comes out of Congress will be watered down and the winners will be the special interest groups (US insurance companies) and the losers will be those with out coverage or with inadequate coverage.
You have to wonder why a society as individually generous as the US (compare their charitable donations per capita to other countries) would be against the concept of putting in place a universally accessible health care system. It is not as if the US system produces better health outcomes or costs less than other "socialized" health care systems. Some of the opposition is based on not wanting a government health bureaucracy and the assumption that government can't run anything (the example they give is Hurricane Katrina). But is it better to have multiple private health insurance bureaucracies that result in a huge administrative overhead (some estimates are that this overhead is 30% of the health care bill in the US).
I could go on, but I think I will stop here - there is much on this topic in cyberspace...check it out.
Stay tuned and see what happens with this interesting debate.
Whale Watching
This video has nothing to do with public administration, though I guess it has to do with public policy. After the annual conference we went to St. Andrew's and went whale watching. On our 3.5 hour tour we saw 30 Right Whales. There are only 300-350 Right whales left in the world and we were lucky enough to see almost 10% of the population. Enjoy.
Tuesday, September 1, 2009
Annual Conference
Sorry about the lack of Video blogs from Fredericton. I had a few problems uploading my first video blog and did not get to any others. In the next little while I will produce a summary video blog (now that I have figured out how to upload). Stay tuned.
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