Chris Mazza found the perfect way to separate the publicly funded air ambulance service he ran from his private ventures. He had a one-way mirror installed on the glass wall dividing the communications section – the nerve centre of the operation – from Ornge's private, for-profit businesses.
The special film on the glass was removed in January, a few weeks after Dr. Mazza, chief executive officer of Ornge, went on medical leave. The nurses, pilots and other workers who handle all the calls for air ambulances at Ornge's headquarters on Explorer Drive in Mississauga now have a clear view onto the other side. But there is little to see these days, apart from empty cubicles.
Dr. Mazza's dream of leveraging the publicly funded "hospital in the air" into a world-class medical transport business – one he could market for profit to other countries – lies in tatters. He was terminated last week, ending his six-year reign at Ornge, and spends his days holed up in his Toronto home, medicated and deeply depressed, said someone close to him.
Meanwhile, forensic auditors are poring through Ornge's financial records and Ontario's Health Ministry is investigating 13 Ornge-related incidents, including three deaths, to determine whether the care of patients was compromised in the name of profit.
Investigators want to know about the $148-million Ornge spent on a fleet of helicopters whose medical interiors are rife with problems, making it difficult for paramedics to perform life-saving CPR. They are also looking at whether taxpayers' money was used for private gain, and why an air ambulance service owned a speedboat and fancy motorcycles.
Dr. Mazza's personal ambitions and the Ontario government's desire to outsource services traditionally performed by bureaucrats to the private sector came together under one roof at Ornge, and the scandal swirling around it has exposed the dark side of public-private ventures that are executed with little transparency or oversight.
Ornge is not the first spending scandal on the McGuinty government's watch, but it eclipses all the others, including eHealth and the province's lottery corporation, with so much more than just money at stake. Ornge handles more than 20,000 patients a year, including the critically ill and injured. Just this week, it dispatched a helicopter to the scene of the horrific vehicle accident near Stratford, and airlifted one of the survivors to a hospital in Hamilton.
Until recently, the very nature of what Ornge did helped insulate it from scrutiny and hold its critics at bay, said Jacob Blum, Dr. Mazza's former right-hand man. "People in the business of saving lives do so for the greater good and not for their own gain," he said in an interview.
Mr. Blum, who was instrumental in the creation of Ornge, left in July, 2008, because he said the plan that he crafted, one that former health minister George Smitherman signed off on, was to have Ornge generate revenues by exporting the intellectual property to other jurisdictions and put all of that money back into the front-line air ambulance service.
"Never did I think the sound vision of Ornge would go off the rails," Mr. Blum said.
Dr. Mazza was a man with a promising future. He grew up on a farm near Hamilton, the second of three boys, and put himself through university working summers at a Coca Cola plant. He graduated from medical school at the University of Toronto in 1989. But he also demonstrated an interest in business, earning an MBA.
He began his career as a staff physician and trauma team leader at Sunnybrook Health Sciences Centre. It was his appointment in 1996 as medical director of Sunnybrook's air ambulance program, which oversaw evacuations for all Toronto hospitals, that launched him on his way to taking over responsibility for the entire province. In 2005, he led the integration of all parts of the air ambulance system into Ornge.
It was Mr. Blum who introduced Dr. Mazza to Mr. Smitherman shortly after the Liberals took office in 2003. The McGuinty government wanted to create a new entity responsible for all aspects of the provincial air ambulance service, including managing contracts with private-sector air carriers to supply helicopters and planes. And the highly driven Dr. Mazza was ready for a new challenge.
Amid his career success, there was personal tragedy. His teenage son, Josh, was killed in a skiing accident in 2006. The loss hit Dr. Mazza hard, say those close to him. He visited his son's grave every day.
But he forged ahead with his plans for Ornge, which former and current employees say he ran like his personal fief, instilling a culture of fear and secrecy throughout the organization. The stress was so bad, sources say, that at least five employees in the communications centre were taken out on stretchers. "We thought they were having heart attacks," one said.
One December day in 2007, Dr. Mazza summoned a group of air ambulance employees to a town hall meeting. Someone had used an exacto knife to deface a family photograph of one of his executives, and Dr. Mazza thought the culprit worked in the communications centre. He launched into a 20-minute tirade against the employees responsible for saving lives by co-ordinating air ambulance service across Ontario.
"You guys are nothing more than roofers," he told them. "I think a monkey could do this job."
It was no secret to employees that Dr. Mazza held them in such low regard.
"We were like caged animals put up for show," said a paramedic who asked not to be named.
Dr. Mazza also made it clear he wanted to replace employees who had specialized training in medicine and aviation with less qualified "communications officers" who could handle all aspects of the job, from tracking flights to fielding calls from paramedics and hospitals. At the town hall meeting, Gary Van Amelsvoort, a senior flight planner, spoke up, saying the new policies did not allow him to provide proper care to patients. "You're getting rid of people with the proper expertise," he said.
The remark was the end of Mr. Van Amelsvoort's decade-long career in air ambulance. That evening he got a telephone call at home, telling him not to come back to work. Mr. Van Amelsvoort said Ornge hired a private investigator to follow him for a couple of weeks and Dr. Mazza had bullet-proof glass installed in his office.
At the same time, several employees in the communications centre worried that replacing trained paramedics and pilots with less qualified staff could compromise patient safety. Karen Tzventarny, a registered nurse who quit in 2009 after five years working in the communications centre, left after her boss tried to get her to do flight planning.
"I'm a registered nurse, not a monkey," she said in an interview.
Earlier this week, Kelly Long, Dr. Mazza's partner and a former Ornge employee, answered the phone at his house, but said he was in no shape to talk. Dr. Mazza put his house on Blackdown Crescent, in Toronto's Kingsway neighbourhood, up for sale for $1.4-million earlier this month.
"They're feeling persecuted," a friend said.