Alex Munter planned to begin his final day on the job at CHEO the way he started 13 years ago: At the 7:30 a.m. huddle with a team of respiratory therapists, the sometimes overlooked pillars of health care.
Things have changed since 56-year-old Munter took on the role of president and CEO of the regional children’s hospital in 2011. For one, CHEO now has twice as many respiratory therapists as it did 13 years ago, one sign of the steep growth in demand and complexity that has marked Munter’s tenure on the job. Another sign? The hospital’s budget has more than doubled since he began, most of that over the past five years.
On his first day, Munter met with teams throughout the hospital to introduce himself, to listen and to learn. On Tuesday, his last day on the job, he was there to say thank you.
“What my plan is for Tuesday is just to thank people for their remarkable hard work,” Munter said in an interview. “I will miss the people.”
He remembers respiratory therapists from CHEO being among hundreds of nurses and other staff who answered a request to help out in hard-hit long-term care homes during the early months of the pandemic, taking shifts in the Ottawa home where two staff members died from COVID. One respiratory therapist went from CHEO’s NICU (neonatal intensive care unit) with the youngest, frailest patients, to working with the frail elderly.
Munter remains in awe of the people who make up what he calls “my work family.
“This line of work is not for everybody. But the people who are here are here because they want to make a difference. That is the secret sauce.”
Munter leaves the role as the longest-serving hospital CEO in Ottawa and the longest-serving children’s hospital CEO in the country. He takes over as CEO of the Canadian Medical Association in December. CHEO’s chief of staff Lindy Samson will step in as interim president and CEO until a permanent replacement is hired.
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His career began at age 14 when he founded and produced the Kanata Kourier newspaper from his suburban basement. He later served on Kanata council, regional council, and Ottawa council. In 2006, he ran for mayor, finishing second to Larry O’Brien.
Munter draws a direct line through his eclectic career to his work at CHEO and his new role with the CMA. Founding a community newspaper helped him learn about the community, which led him to municipal politics in which health and social services is a major focus. He chaired Ottawa’s health board when the city brought in its controversial first no-smoking bylaw.
“That led to a career in health and social services management and now is leading to a broader system role.”
Prior to CHEO, Munter was executive director of the Youth Services Bureau and then CEO of the Champlain Local Health Integration Network (LHIN), the regional agency responsible for planning and funding health services in the region. His new role at CMA will include working on solutions to national issues such as access to health care and physician shortages.
Munter oversaw CHEO during a period of both austerity and spiking demand, for mental health and critical care services, among other things. Pediatric hospital budgets were already inadequate to serve the needs when he took on the role, he said, and then they shrunk. Munter was a leading voice fighting for the “right-sizing” of pediatric health care in Ontario, a campaign that took on a new urgency during the pandemic when CHEO and other children’s hospitals were overwhelmed.
That call was answered by the provincial government in the form of $330 million in new funding for pediatric hospitals, which included an annual boost of almost $50 million for CHEO. It was the single biggest increase in pediatric capacity in Ontario’s history.
That puts CHEO in a better position to serve the growing needs of the community, Munter said. Among other things, the hospital doubled its critical care beds in 2022 and is currently building a new integrated treatment centre that will connect to the hospital through an underground tunnel.
The steep growth in demand for mental health services, though, continues to put unsustainable pressure on CHEO and agencies that serve children and youth. Surging demand for mental health care for children and youth began about the same time Munter took on his role at CHEO. At first, many experts believed the surge reflected de-stigmatization and the fact that more children and youth were seeking help. Now health officials understand the issues differently. He cites a graph that shows a spike (“like a hockey stick”) that began around 2011 and has not stopped growing. It coincides with the more common use of social media apps with algorithms that target children and youth in often harmful ways.
It is a crisis that hospitals like CHEO “can’t treat our way out of,” he said, but requires a broader response. Cellphone bans in schools are among responses that represent good progress, he said.
“The idea that we would allow big tech to rewire our kids’ brains and children’s health organizations would just clean up the mess is preposterous,” he says.
The use of cellphones and the impact of social media on children and youth have been on Munter’s mind, both at work and at home.
During his tenure as hospital CEO, Munter and his partner became fathers. Their son is now six years old and just started school. After his first day, he announced that he had his own desk and should also have his own phone.
“I said ‘Yep, good idea, when you are 75.’ I figure this is going to be a long negotiation,” Munter said, laughing.
Munter added: “Parents have a critical role in this and my view is that government regulations should exist to support parents and to level the playing field.”
Munter’s job has frequently thrust him into the spotlight. One area he has preferred to keep low key is his salary.
Among public hospital CEOs in Ontario, who are among the highest paid public employees, Munter is an anomaly. His salary — $329,999.81 — has not changed since he took on the role, a period in which inflation increased by 30 per cent. Many CEOs of Ontario hospitals now earn at least double that amount.
During an exit interview with the Ottawa Citizen, Munter said he started his job during a period of austerity in health care funding, especially pediatric care, and decided to donate 10 per cent of his pay back to the hospital, something he has never spoken about publicly.
It is a practice he has continued for 13 years.
“It seemed like the right thing to do.”
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