The Ben Mulroney Show - Toronto needs to be better if we want to call ourselves a world class city

Episode Date: June 9, 2025

Guests and Topics: -Toronto needs to be better if we want to call ourselves a world class city -Revolutionizing surgical wait times: a simple solution for Ontario with Guest: David Urbach, Head of Surgery at Women’s College Hospital and Professor of Surgery at the University of Toronto If you enjoyed the podcast, tell a friend! For more of the Ben Mulroney Show, subscribe to the podcast! https://globalnews.ca/national/program/the-ben-mulroney-show Follow Ben on Twitter/X at https://x.com/BenMulroney Enjoy Learn more about your ad choices. Visit megaphone.fm/adchoices

Welcome back to the Ben Mulroney show and hello for the first time today because I My colleague and good friend Greg Brady had to take over the first part of the show as I have to be on Global's the morning show to promote the fact that we are now on YouTube. That's right the Ben Mulroney show You've enjoyed my dulcet tones for so long and now you got you're stuck with my face on YouTube So enjoy have at it and let's build this community wherever we can find our listeners and now our viewers. So earlier this morning on my way into the office, I was listening to Greg Brady, as he had a guest on Harrison Lohman, who's the managing editor of the hub.ca. And he told a story that highlights the crisis that we find our

health care system in. I've said many times before, never before have we put more money into the system. And never before have the outcomes been so poor. And you can look at all sorts of all sorts of metrics. But this one, this all sorts of metrics. But this one, this anecdote speaks volumes. And I'm gonna, well, let's, I'm gonna read a little bit of it for you. Should I read it first? Yeah, I'm gonna read a little bit of this

because this is shocking stuff. So Harrison Loman said, today my colleagues and I came across a woman lying in a pool of her own blood at the front door of a clothing shop on Toronto's Queen Street. As we assisted her, I remembered more of my first aid. I take it her colleague told me that she tried to stop a man from stealing an article of clothing.

So there's that as well, right? Multiple people walked by the scene, some gawked. Myself, her colleague, and a passerby all tried calling 911 only to receive a busy signal. We waited 10 minutes, nothing. Let's listen to Harrison. I was just with my colleagues having a drink on Friday around Soho and Queen Street Rest,

and we came out of the bar, and we were walking by a clothing shop, and we found one of the employees there lying in a pool of blood that was growing. She had a massive gash in her head. We were speaking to her colleague. Apparently she had tried to stop a man from stealing a bunch of clothes and he had grabbed her and it seems smashed her head against the frame of the door. She was bleeding pretty profusely. People were

walking by. I have a real frustration around sort of the bystander syndrome we sometimes see in Toronto. Anyway, we're calling 911. We get like a busy signal saying like, you know, all operators are currently busy, stay on the line. 10 minutes pass, still nothing, trying to help her and reassure her telling her that an ambulance is coming soon. It's not coming soon. Let's put this into context, right? Queen Street is just off of University Avenue, and it's just four or five blocks south of some of the most storied, important and vital hospitals in this country. It's called Hospital Row. So we're talking you could run there. You could run to one of those hospitals in maybe five minutes, four minutes. And so far, 10 minutes, right now they wait 10 minutes. Let's continue with Harrison. Thankfully,

a retired doctor walks by we're applying the very shirts this guy was trying to steal on her head to stop the bleeding and finally get someone but still they haven't come. What's required is my colleagues and I flagging what appears to be an off-duty fire truck on Queen Street. This is downtown Toronto near the largest center of hospitals in Canada. They come out and then they're radioing an ambulance. We still don't have one and almost 15, I think 20 minutes by the time they finally get to this woman and are able to assist her and help her. Like we almost watched someone die on Friday, I think.

So I want to take your calls at 416-870-6400 or 1-888-225-TALK. Does this surprise you or have you gotten used to the circling of the drain that is the Canadian health care system and notably the poor performance of emergency services in the city of Toronto? Can we still call ourselves a world class city if things like this happen? And look, yes, it's an anecdote. It doesn't necessarily reflect the broader performances, but this doesn't surprise me. This doesn't surprise me. And I wish we could just be honest. As I say, you got to take the world as it is, not as you want it to be. We want to live in a world where our health care system is the envy of the world. Does that sound like an example of

an aspect of our health care system that is the envy of the world? The answer to me is obvious. It is no. But I want to hear from you at 416-870-6400 or 1-888-225. Talk short of throwing a ton of money at this problem. How should we fix this? How do we go about fixing how long we have to wait for the police, how long we have to wait for an ambulance, how long people have to wait on 911. I get that there are multiple levels of government that are responsible for all the things that I've described so far. But come on, like, can we stop pretending lying to ourselves that everything is hunky dory, that everything is great.

Let's remember, like I said, we've been throwing money at this for years and it hasn't solved the problem. The problems are getting worse. And this is this is the I mean, I would like to say it's the defining crisis of our time, but let's be honest, we got a lot of crises we're dealing with. Let's welcome Randy to the conversation. Randy, thanks so much for calling into the Ben Mulroney show. Hi, how you doing? Well, thank you. Well, you're going back to your original question. This is not

throwing money to the health care issue. This is a Toronto issue, because that 911 is being funded by the City of Toronto. So the City of Toronto throws money out everywhere, stupidly, to stupid, stupid, stupid things. They should look and analyze how many calls come in, how many people are on the job. It doesn't take a rocket scientist to figure out, hey, I need 10 more people. Well, hire them and get rid of the loafers

that work for the City of Toronto and do nothing like those guys that were sitting in the coffee shop. Yeah. What happened to those guys? Did they get lose their jobs? Yeah, no, listen, the common sense that you're pushing here. I don't know how well that would that would fly at City Council, my friend, but I do appreciate you adding your voice to the conversation. Rob, you're next. Welcome to the show. adding your voice to the conversation. Rob, you're next. Welcome to the show. Yes, the process. Oh, my niece has been a dispatcher for two years for Toronto 911. And she's the real data. One in five calls is legit. The other four are nothing or or Oh, yeah, not important. I know that it's hard to deal with it. But if they could deal with that one in five Yeah, legit call. And of course, they have to call everyone back to make sure that the call was. They can't be caught assuming that it was a fake call or, or, or, or, or not legit. But there's no way that that is a problem that is specific to Toronto. There's no way if it's a problem here, it's a problem everywhere.

I would, I would imagine it is. I was astounded that the number was that high. Yeah. Well, we got bad actors, we got irresponsible people, we got people who don't care about, you know, that their call might be taking attention away from someone more deserving. But again, this is this has got to be a problem writ large. And yet I guarantee you there are a lot of municipalities that have as complex a city to run as Toronto, I bet you their outcomes are better than ours. Joanna, welcome to the show. And I just wanted to relate my story with 911. My daughter was visiting from out of

the country. She had done the Toronto Marathon later that night. She had she had a choking incident. So, and no, she couldn't be nothing. I was doing the Heinlich maneuver, whacking her on the back. We couldn't clear her airway. My husband called 911, and I'm downstairs with her. He's upstairs in the house, and I'm frantically trying to save her life. And I'm calling to him, what's going on? And he goes, I can't get through to 911. They put me on hold.

Finally, we cleared her airway. We hung up. And they called us 10 minutes later. So you took care of everything. Yeah, finally. But I'm saying, you know, like, you don't put somebody on hold and then call them back 10 minutes later and say, is everything OK?

Well, of course. And thank goodness you and your husband had the the wherewithal to be able to deal with that crisis. A lot of people simply they call 911 because they can't deal with a crisis. But Joanna, thank you so much. We've got time very quickly for David. David, quickly tell me your point. Our problem is with these cities and any municipality and group that we have to deal with is that when there's a problem with the amount of end users like ambulance and fire people we need, we'll end up hiring five more bureaucrats in the office to manage them than hiring the

people that do the work. No, you're right, David. That's a very good point. We love to build a bureaucracy and that's where a lot of the money goes. Hey, thank you so much. Let's keep very good point. We love to build a bureaucracy. And that's where a lot of the money goes. Hey, thank you so much. Let's keep these calls going. This is a very important conversation for the City of Toronto.

The Ben Mulroney Show continues. Welcome back to the Ben Mulroney Show. We're going to keep our conversation going. We started last segment about this horrible story of a young woman who was bleeding from the head on Queen Street and thanks to some passersby, was able to get help from them and but the the wait to get help from 911 was insurmountable. Let's now you're wondering how many people are working how many people are working at 911 as dispatchers well

here is that number. At that time which I believe was 6 p.m. on Friday night, there were seven people answering the 911 phone lines for the entire city of Toronto. Seven. And at that point, it was a 14-minute hold just to get through. So you'll remember last week, Olivia Chow, our mayor, gleefully proclaimed that the city was gonna be funding Pride to the tune of $300,000 this year. $300,000, that could pay for three more full-time dispatchers. Seven people manning 911 for the entire city of Toronto at a time where we know crime spikes.

Let's bring Cathy into the conversation. Cathy, how are you this morning? Hi, yes. It's actually Jackie. Oh, Jackie, I'm sorry. That's okay. I just I have two things. One thing is a question. Did anybody think of putting the woman in a car and just going to the ambulance when they couldn't get through it in 911? Well-1. Just because there's just so many of these obstacles. Sure, but let me play devil's advocate because I don't know a lot about a lot, but the stuff I've seen on TV and the stuff I remember from my first aid courses, when you happen upon a person bleeding from the head, the first thing they say is don't move the person in

case they have a neck or spinal injury. And so like honestly I don't want to make it worse so and let's also not forget that we live in a city where we are supposed to rely on these basic emergency services and so the assumption would be if we wait here if we call if we do everything have to, someone will come and someone will help us. But it seems like there were failures across the board. Kathy, oh, you said you had a second part. Okay, well, the second part is the reason why I say this is 15 years ago, my son was playing hockey. He was 12 years old at the time.

And we were in Ajax, I believe. We called for an ambulance for the boy 45 minutes it took. So what I'm trying to say here is this problem's been an ongoing problem and I think it's absolutely pathetic that we don't have that available in Toronto or the surrounding districts. Absolutely. This is why I asked if anyone thought of that. I know a first aid course. I agree you don't move them but after you know 10 minutes you're not getting through, you're just south of five hospitals. I'm just wondering why no one thought of that. I bet you it crossed their minds. I bet you but they probably said the second we move her is the

second the ambulance is going to show up. It's Murphy's law. Kathy, thank you so much for being here. And give us a call. 416-870-6400-18888-225. Talk. Does this story surprise you? Does it disappoint you? Does it anger you? And what can we do to solve the problem of emergency services not being there during an emergency? Hey, Tom, welcome to the Ben Mulroney show. Yeah, maybe I'm way off here or too futuristic, but are we not at a point technologically speaking where AI would be able to screen the call like that one caller gentleman said

with his relative 20% are the true deal. So wouldn't AI be able to answer the phone, police fire ambulance, what's the emergency, oh my dog ran away. Well, lady get off the line. We're not gonna forward you to a real person. And is that not possible yet? I mean, it could be.

If it's not possible, could you imagine the city of Toronto developing this and selling it across the world? Well, I don't think the city of Toronto should be in the business of building software. I think that should be left to the private sector. Something tells me if this city did that it would balloon in cost and it just wouldn't work. That's my humble opinion. No, no, listen, you're not wrong, but we are at, we're at a point now where 9-1-1 is supposed to be manned by human beings and the fact that we only had seven human beings As dispatchers at 9-1-1 on a weekend where we know statistically crime goes up

This is I mean, where's the buck stop who who is responsible for this? But anyway, Tom, thank you very much and let's welcome Rio to the conversation. Hi Rio Yeah, hi. Nice to talk to you. Yeah. Um, let me say the city can't even cut grass. I just noticed last weekend, they finally started cutting the grass on Martin grows, which was a North South Kipling Avenue at our Burnham, throw up all these places in a total. And she went on about the snow removal, the mayor. And you know what? It wasn't, it's not that bad. But when you got something you can schedule so easily, like cutting grass, like it's a joke that you let over a month go by and the grass is three, four feet tall. Because I do landscaping. Yeah. We cut grass every week and it's not done. And the taxes are massive. And when I, and I don't know,

when I go to Ireland, everything is immaculate. Somebody's in charge of every square inch of that place. You can go to villages, towns, and everything looks like it was cut five minutes ago. Yeah, Rio, I don't think it's wrong of us. I don't think it's unfair of us to say, where are our tax dollars going? If our property tax has gone up two years in a row by double digits, that's more money

coming out of my pocket. What am I getting for it? I'm clearly not getting reliable 911 service. You're not cutting the grass. You're not removing the snow. You didn't take care of sort of the flood protection because of last year's floods. What exactly are we getting for our money? And unfortunately, we're going to get to a point where somebody's gonna die when they're waiting

on services they should be depending on to keep them alive. Rio, thank you for the call. Robert, welcome to the Ben Mulroney Show. Hi there. Yeah, the problem is multifaceted. One, they're understaffed on the call takers, but they have multiple drug overdoses per shift

that are costing $1,000 per call minimum. Yeah. They have to go take care of these people. And that's taking up valuable resources, police, fire, and ambulance. That's a good point. I mean, I don't know the numbers, but I'll take you at your word. Yeah, that's what I've heard. It costs around $1,000 between all three services going, picking up someone, taking them to the hospital, them being treated.

It's around that sort of dollar value. And then myself, I've called in a structure fire, what I thought was a structure fire, and waited on hold for 20 minutes. Yeah. Just to get through. Yeah, it's nuts. Absolutely nuts. It's like, what are we paying for?

Robert, thank you very much. And this is, like I said, last week, our mayor was very pleased to announce that the City of Toronto was going to kick in $300,000 for Pride because they had lost some corporate sponsors. That's great. But if you polled the majority of Torontonians, if it's a binary choice between funding a parade or hiring three new dispatchers for 911, I think you're gonna find a lot of people siding not necessarily with pride. And I'm not trying to make pride the issue here.

I'm trying to make the issue like if we have a crisis, if we have a budget crunch, then we should be making smarter decisions. And the fact that we got to a point that on a Friday night or a Saturday night, 911 was was staffed by seven dispatchers is is is insulting to the taxpayer and dangerous to people who absolutely need to avail themselves of that service. Dan, welcome to the Ben Mulroney show. Ben, the the people that were staffing the 911 had to go off to, to counsel to figure out

how to rename streets. But I called your, your previous caller about the AI, this is actually sparked the great comments. AI is just a language learning model. It learns off of whether it's Wall Street Journal or Google or whatever we have, or if we can start, we have all the we can start, we have all the history, the prior history of all the calls and not just with Toronto, but other jurisdictions, it could so well work as an AI model to filter through the calls and venue directed to a real human being who can then you know, for liability. Yeah, listen, there's no way that that work is not being done somewhere.

There's no way. So the question is like, but we need to respect the idea of best practices. Find a city out there that is doing 911 better than us, and let's just copy them. But we won't do that. We'll always find the Toronto way of doing it. And the Toronto way of doing it is five years too late

and $500 million more expensive. All right, let's welcome Nick to the conversation. Yeah, hi Ben. So I just wanted to call in and talk about the transfer of care. So a big part of the problem that we face on, I'm not a paramedic, but I've worked in the healthcare system before

is that when the paramedics, they pick up their patient and they drive them to the hospital, they have, they're forced to wait there in the hospital, you know, a lot of the times in the hallways until there's a doctor available that can pick up that patient and transfer that cancer from the paramedic to the hospital. And with the system so overrun, I mean, that's got to be a large majority of the problem that we're facing. Well, thank you for bringing that up. I appreciate it. We got time for one last call. Mike, you've got the last word. Yeah. Hi, good morning, Ben. I had a chainsaw accident about three weeks ago, 15 stitches

across my leg. Wow. You okay? Yeah, right now I am. But at the moment, I thought I was going to bleed out. I was trying to call 911, 10 minutes, 10 minutes to get through. Just to get through. Just to get through. Wow. And it's just so annoying.

Yeah. Where's our money going? Well, there's a lot of waste. I was in a fender bender. I had two addresses, but they tried to charge me $1,500 for fire and ambulance. My truck blew up. Another charge of about $500 something dollars.

And it's crazy. Ambulance charge, $45. Yeah, you have to pay the ambulance charge despite paying taxes. And meanwhile, $20 million is thrown down a rat hole just to police protests with very few arrests. Welcome back to the Ben Mulrooney Show. All right, time for some good news in the health care sector. It's rare that we have something like this to report, so I really want to spend some time on it. But look, if there are a lot of metrics by which we gauge the health of our health care system and

surgical wait times is one of those metrics. And by and large, generally speaking, they have been getting longer for especially for things like knee replacements, hip replacements, that sort of thing. There's some numbers that say on average patients wait 120 days for certain types of surgeries. But in places like Western Ontario, waiting can be longer than 350 days. That being said, some research has been done on how to improve these wait times. And one of the people behind this, this study and these ideas is joining us right now, David Urbach. He's the head of surgery at women's college hospital and professor of surgery at the University of Toronto. Professor, thank you so much for being here. Thank you. So what did your analysis

discover in terms of where the I I guess, where the choke points might be? What we found is that without adding any additional capacity to the system, so without building any new operating rooms, hospitals, surgeons, if we could just reallocate patients more efficiently to the surgeons who had the most capacity to see them. So that means sending people to the next available provider and having all the surgeons work together in teams. By undertaking that, we can actually prevent anybody from exceeding their recommended wait times for hip or knee replacement surgery in Ontario. Yeah, that was so impressive. The number

was down to zero. But so you've just told us what we would have to change in the system. But what is the status quo? How does it work right now? And why is that? Tell me like, because that's, this is the system that we need to change. Yeah, so it's quite interesting, sort of by historical accident, we have a system of direct physician referrals. So for example, if you need a knee replacement, you've got arthritis, a sore knee, have difficulty walking, your family doctor has to send you to a surgeon. And right now the system as it currently exists does not have a way to ensure that you're seen

by the next available surgeon, the surgeon with the shortest list, or the surgeon even who's most appropriate for you because we've sort of left it up to this highly decentralized market. And the family doctors don't have all this information. Right, so if my family doctor says you need a knee replacement, I know just the guy and he could send me to a guy who's got a list, a wait list of a couple of months long,

but meanwhile there's a guy he doesn't know who's just is equally competent and ready to do it, who could see me in in two weeks. Exactly. Right, And so how does this you said that so that's one part of it, but you said you referenced sort of a team approach as well. What do you mean by a team approach? Well, because there's two choke points. The first one is the wait to see a surgeon for a consultation. And that actually isn't all that long in Ontario right now for for these procedures. The second choke point is the weight for the

surgery once you've seen a surgeon and they've decided you do need to have surgery. And that can be really long, like you know that can be a year, a year and a half or longer. Whereas other surgeons have OR accessibility within a month or two. So what we proposed, and this model exists to a small extent already, is surgeons work together in a team, just like is common in family medicine and obstetrics and cardiac surgery, for example, and they share the load of all the patients so that the patients are assigned to the next available skilled surgeon who can do that. Okay, so I guess what you're saying then is in the current system, the doctor, the surgeon who does the initial assessment is the one who does the surgery. But if they worked in a team, in a collaborative team, there could be surgeon A who

does the assessment. He briefs the team and the first available surgeon on that team then takes the surgery. Exactly. Is this done anywhere else in the world or in Canada? Yeah, it's done, but it's not done commonly. The best example I can give is obstetrics, where a woman who's pregnant is followed for several months by her obstetrician. When you're in labor, you go to hospital, and there's an obstetrician who's on call that night. You know, you haven't necessarily seen them before, but they're your doctor, and they're skilled, and they're supervised, and you'll have an excellent outcome. So it's exactly that type of model. So, Professor, can I just say, if you were here, I would stand up,

and I would give you a round of applause for you and your team for doing this sort of thing, for thinking outside of what is the common box in Canada. Anytime there's a problem in our healthcare system, it seems like the powers that be think, all right, let's just throw more money at the problem. And for sure, you've said that there would have to be an outlay of an initial investment to get this off the ground. But I'm so optimistic and emboldened by the fact that you and your team looked at this through a different lens. How can we optimize what we already have? Yeah, exactly. And if I can say what people can do, what the public can do is emphasize

that what they want is access to care. Yeah. And, you know, my observation as a physician leader in Ontario is that the quality of care that people get, once you're in hospital, we provide excellent care, whether it's surgery, whether it's admissions or you're having a heart attack. The suffering that exists out there right now is a problem of access. And what people need to tell

decision makers, political leaders, whoever will listen, is they want access. And if that means seeing the next available skilled person, that they're happy to do that, just like it works when you walk into a bank or when you go on a customs line or when you fly on an airplane. Now, Professor, you looked at a very particular type of surgery here. Is this concept that you're putting forth, is it something that is portable throughout the healthcare system? Are there other surgeries that could benefit from this? Yep, there's nothing unique or magical about this.

We just studied joint replacement because it was such a big problem, not a common surgery and a source of a lot of suffering in the population. But this could be applied to things like cataract surgery, to gynecologic surgery. Basically any service for which queuing or waiting is a feature and for which there's multiple providers with multiple queues, this is the solution and it's been adopted by every industry that has to manage queuing.

They all work in this way. It's just healthcare that has this very quaint antiquated historical approach to how we connect people to the point of service. David Urbach, to you and your team, I swear this is one of the best moments. I haven't felt this way in a long time when talking about the healthcare system because to hear you talk about this and to present a solution that could actually change things and give us better outcomes without billions of dollars being thrown to hear you talk about this and to present a solution that could actually change things and give us better outcomes without billions of dollars being thrown at the problem.

This is my goodness. I hope people hear this and take the ball and run because what a great idea. Thank you and congratulations. Thank you.