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Q:
You’ve been in leadership positions, and you’ve
watched leaders for a long time — what do you think
are the greatest strengths in public sector leadership
today? What are their greatest weaknesses?
If I think about healthcare, there are many people itching to
make changes for the betterment of patient care. For decades we
have talked about the social determinants of health. Improving
income is key. What is an individual doc to do with that? Well,
at St. Mike’s in Toronto there is a real attempt to make sure their
patients are getting all their income benefits. And Dr. Ryan Meili
and colleagues in Saskatoon have a program called UPSTREAM
which actually clothes principles in reality. The re-discovery of
the Guaranteed Annual income and the substantial policy work
on the topic forty years ago has engaged public servants (in On-
tario, at least) and the social organizations outside government
looking for better ways to direct income to poor people. This so-
cial engagement and blurring of policy lines takes real leadership
and I see it as very positive.
Q:
Those examples are rare, though.
They are. The last several decades and have been very difficult for
anyone who is inspired by a desire to see a fairer society. The pen-
dulum swing following the 1978 Bonn summit was the beginning.
Frankly it has been hard for the ordinary person to see themselves
in government policy since. Maybe that is why Trump and Sand-
ers have been having such a run in the US primaries. Even now
in Canada we do not talk about poverty. We talk about the middle
class. I recently did a bit of research for a conference on basic in-
come and it is sad to see how little progress has been made. The
Ken Carter Commission on Taxation concluded (in 1966!) that the
tax system placed an unfair burden on the poor. The Senate Com-
mission on Poverty of 1971 concluded that Canada should adopt
a guaranteed annual income. Almost 50 years later, we’re talking
about it like it’s a new idea! The Royal Commission on the Status
of Women and, in the early 80s, the McDonald Commission on the
Economy all came to the same conclusions. I was lucky to have
begun a public service career when the fashion was public and so-
cial engagement. Searching for evidence was expected, as was en-
gaging in discussion and, if necessary, argument with your Deputy
Minister or Minister (as long as you were polite and respectful). I
really don’t know now. It seems to me that in Ottawa, and in most
provincial capitals, those reflexes might be a little rusty.
Q:
So what keeps you optimistic and engaged?
I really do believe a better world is possible. I also believe that it
requires relentless effort to change anything. At CFHI, with our
small budget ($17 million in the face of a $220 billion healthcare
spend in Canada), we can make a difference and most importantly
we are already showing that good ideas applied, tested and evalu-
ated can be spread by willing imitators and adapters. Patient care
will improve and it will likely cost less than now. Change always
14
/ Canadian Government Executive
// June 2016
The Interview
Maureen
O’Neil
Maureen O’Neil
has been leading the CFHI since 2008, but she’s been fighting battles in the policy
trenches with her signature energy and enthusiasm for decades. She has served as President of the
International Development Research Centre, Interim President of the International Centre for Human
Rights and Democratic Development, President of the North-South Institute, and Deputy Minister of
Citizenship, Government of Ontario. She serves on a broad range of boards at the provincial, national
and international levels. Patrice Dutil, the editor of CGE, caught up with Ms. O’Neil to talk about lead-
ership in creating a culture of sustained innovation.
On Leadership, Healthcare,
and Innovationwith
President of the Canadian Foundation
for Healthcare Improvement