The Unseen Mandate: Toronto's Top Doctor and the Public's Right to Know

Toronto, like any great city, relies on its civic leaders to steer the ship. And when it comes to safeguarding our collective health, the Chief Medical Officer is, without exaggeration, an absolutely crucial figure. Yet, for all the gravitas of this role, one can’t help but wonder if we—the public, the very people served—are truly in the loop about what, precisely, we expect from them.

Consider, if you will, the case of Dr. Eileen de Villa, our city’s Chief Medical Officer of Health. Appointed back in March of 2017 for a five-year stint, her contract, quietly, was extended for another half-decade in January 2022, effectively securing her position until March of 2027. And in truth, while Dr. de Villa has navigated some incredibly turbulent waters—a global pandemic, to name just one—the whole process, honestly, begs a rather fundamental question: where, exactly, is the public's blueprint for success?

You see, it’s not just about who holds the title; it's about what that title means in the public consciousness. In a world increasingly demanding transparency, there’s a noticeable void. We lack a publicly articulated job description, a clear set of performance indicators, or even a robust, open discussion about what metrics define a 'job well done' for such a vital public health guardian. It's almost as if the criteria exist in a kind of hushed, internal language, far from the everyday citizen.

Think about it: in virtually any other significant role, especially in the private sector, there are usually benchmarks, targets, and a very clear understanding of what success looks like. So, why, for one of our city’s most critical public health positions, does this seem to evaporate? It feels, dare I say, a little opaque, doesn't it?

The current system seems to lean heavily on annual internal reviews—fine, as far as they go—but it leaves little room for upfront, public dialogue. Councilor Paula Fletcher, for one, has voiced genuine concerns, pointing out that top civic appointments, roles that fundamentally shape our city's future, often bypass a transparent, competitive hiring process. This isn't just about bureaucracy; it's about genuine accountability to the people of Toronto.

And this isn't to diminish Dr. de Villa's efforts, not at all. But rather, it’s about the system itself. Shouldn’t there be a more proactive approach? A clear outline of expectations, goals, and even challenges laid out before an appointment or an extension? It’s not just about knowing who the person is; it's about understanding their mission, their strategic direction, and how their performance will ultimately be measured, publicly. This way, the city, the Chief Medical Officer, and most importantly, the citizens, are all on the same page.

Because ultimately, when we talk about public health, we're talking about our shared well-being. And in that crucial conversation, every Torontonian deserves a clear voice and a clear understanding of the expectations we place upon those entrusted with our health.