Ontario says it will move towards a patient-based health-care system. (Canadian Press)

Ontario's Liberal government on Monday took the first step in its new health-care accountability legislation, which could result in drastic changes to the way care is delivered in Canada's most populous province.

In this year's provincial budget, the government said it would move towards a patient-based system that would, in effect, have hospitals competing with each other to deliver patient care. Hospitals that provide the lowest-cost treatments would get more patients, more work and more money.

The legislation introduced Monday is called the excellent care for all act, and if passed would "make health-care providers and executives accountable for improving patient care," according to a news release from the Ministry of Health.

The legislation would require hospitals to:

• Develop and post annual quality improvement plans.
• Create quality committees to report to each hospital board on quality-related issues, including the public annual quality improvement plan.
• Link executive compensation to achievement of quality plan performance improvement targets.
• Implement patient and employee satisfaction surveys and a patient complaints process.

"[Monday's] announcement is a key part of the government's Open Ontario Plan to improve quality and accountability in health care by ensuring health-care professionals work together in the best interests of the patient," said the release.

Saving millions, helping patients possible

The province believes the changes could save millions of dollars every year by forcing hospitals to compete for cash by doing acute care in-patient surgeries more cost effectively than others.

"The government is improving the quality of our health-care system while making it more accountable to patients," said Ontario Health Minister Deb Matthews.

"We want our health-care system to be focused on patient needs with health services supported by the best evidence and highest standards."

Ontario already bases some of its funding on this type of model — notably in emergency rooms.

But the reform being considered by the Health Ministry would broaden those incentives, and that could result in some procedures being centralized in certain hospitals or cut in others.

Critics say the changes could mean that patients in areas outside major centres would almost certainly have to travel for treatment.

Matthews, however, says the proposed changes are "innovative," and would ensure Ontario is getting "the very best value for the money that we spend on health care."