Raising the stakes: How SickKids Foundation CEO Jennifer Bernard plans to raise billions (with help from Ryan Reynolds)

There aren’t many charitable organizations that use the word “billion” when they set their fundraising goals. But that’s the league Toronto’s SickKids Foundation plays in.

For the past few years, the foundation that feeds the No. 1 (or No. 2, depending on the year)¹ children’s hospital in the world had been pushing toward a goal of $1.7 billion. When the Patient Support Centre was completed, Jennifer Bernard’s work began.

Freshly arrived from running Women’s College Foundation, the new CEO took the reins of a fundraising team that pulls in about $200 million a year, from 1.3 million donors. Now, on the cusp of SickKid’s 150th anniversary, she’s almost ready to go public with the foundation’s next, even bigger project—the one they’re calling “Heal the Future”—that could change how health care is done.

In the meantime, Bernard has a lot to share about fundraising in a time of increasing demands for the donated dollar, and about working with stars like Ryan Reynolds.

In Canada, we often think, maybe naïvely, that in a country with universal health care, the government should provide all the funding. Why are hospital foundations like yours needed?

The complexity of health care, the cost of everything—drugs, equipment, people—has escalated exponentially. We also have a very large aging population in Canada, putting enormous strain on our system. And we have an infrastructure that’s really old. There are only so many dollars that come from the tax base that can be funnelled into health care. And most people don’t realize that for many decades now, government hasn’t been buying major equipment for hospitals. Government has had a community share for building a hospital—there’s what the government gives and what they expect you to raise from the community. And government doesn’t fund research directly, and that’s what really accelerates health care. Without philanthropy, hospitals can’t do the best research. They can’t push the limits. They can’t find discoveries and cures. Because government doesn’t take taxpayer dollars and gamble them on things they’re not sure of. They let philanthropy do that.

When you’re trying to convince people to give you money, what works?

Showing the impact. Numbers, talking, jargon, even big science—they don’t usually get people in the heart.² It’s showing people the before and the after. It’s bringing them into the journey of, in our case, the patient, the family that’s going to benefit from their support. You keep in touch with them. You make them part of the story. It’s not a transaction, like, “Give us the money and go away.” Even with our smallest donors, we try to make them feel special and that your gift makes a difference.

What prevents people from giving?

There’s a bit of cynicism about the sector, generally. Does the money make a difference? Is there a benefit to giving? Where does it go? And because it’s such a big sector—look, we’re bigger than retail, we’re bigger than oil and gas. We’re 8.5 per cent of GDP. We employ two million people in the not-for-profit sector. So, there’s gonna be a range of players and actors, and not everybody’s gonna be great at transparency and communication, or even have the resources.

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I was speaking with the CEO of another hospital foundation who said the biggest issue they face is the competition for donor funds. What have you found?

The competition is fierce. But quite honestly, there is enough wealth in Canada to support the charities in Canada, especially the major ones. What I want us to do is stop competing against each other, and either partner or support each other. Because the donor community is kind of tired of us, as my son would say, throwing shade on somebody else to allow us to fundraise. It ends up sabotaging you. There’s always been this “us and them.” Like, it’s either us or Princess Margaret, or us or University Health Network. Because there’s not a lot of duplication. Each hospital is pretty specialized, and what we have to do is make people aware of that specialization and give them good reason to support us. I don’t think we have to tear each other down to reach our goals, ‘cause there’s more than enough money.

Competition can also mean getting attention for your cause. In that sense, what role does somebody like Ryan Reynolds play?

Well, I’m gonna tell you, you can’t have a better brand ambassador and human being. I was kind of skeptical that he was going to be as good as advertised. He’s better. He came for a visit on my second day. I didn’t know he was coming. Very nondescript. No security, regular street clothes. Drove up, went through a side door. And we always send our stars—anybody coming to visit the kids—a package on them. He knew every kid’s name. He knew their story, he knew their parents. He obviously has an incredible memory. He had internalized them, greeted them, was goofy with them, recorded things on their phones. The magic of Ryan is not just that he’s a big star; it’s that he’s 100 per cent authentic. Working with celebrities, which I have for many years, is not as much fun as it sounds. Ryan, honestly, is a Canadian treasure, and we’re very lucky that he’s chosen us.³

Let’s talk about large donors versus small donors. What’s the bigger source of funding?

I asked that question when I started, because it’s hard to tell from the outside. It’s actually pretty close: 99 per cent of our donations come from smaller donors, meaning those who give less than $50,000. Less than one percent come from a very small group of transformational donors who give $5 million or more. In terms of amounts, it’s around 55 per cent transformational donors, 45 per cent everybody else. The big impact of transformational donors is that they can accelerate a program with a $10-million gift, whereas we have to find lots and lots of people to accumulate that amount of money. We have 130,000 monthly donors who give us probably about 20 bucks. And those are among our most valuable donors, because they stay with us 10, 15, sometimes 30 years. And then we have transformational donors like Peter Gilgan, Garry Hurvitz, the Labatt family, the Slaights and many others, who have given us gifts of $10 million, $15 million, $100 million. But those are often over 10 years, and they may or may not give at that level again.

How is the economy affecting donations right now?

It’s not a great time. So much of donation is tied to psychology. Whether or not people have more money or less money is one thing. It’s how they feel about the money and how secure that money is. Historically, people give seven to 10 gifts a year, a little bit shotgun. Now, a lot of people are narrowing that list, shedding smaller charities as their pocketbooks get tighter. I’d say corporate donations are probably the biggest hit we’ve seen. They’re really decreasing their charitable giving to increase shareholder return.

Why is it that most large donors seem to be families and not companies? Why don’t we see the TD wing of a hospital?

Individuals outstrip corporations 10 to one in all philanthropy. There’s no comparison. And that’s because they have complete control over the funds. They can direct them any way they want. They can be tied to personal values. They can be tied to an experience a family has. When you try to go to a corporation, you have to go through a thousand hoops and a thousand doors, and there’s usually only one bucket for your area, and it’s very limited.

In my own experience trying to raise funds for a charitable organization, it felt like the challenge came down to two things: finding new donors, or going back to the same donors again and again. What’s harder?

Finding new donors. Harder, more expensive, more time-consuming, higher attrition. When you have a captive audience that believes deeply in your mission—ours is healthier children, a better world—it is easier to go to them and get them to give again and again, and give more, and give their ultimate gift, than to try to convince somebody who is new to you, who doesn’t know you as well, who isn’t as invested, to bring them on that journey.

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Have you begun to incorporate AI?

I am blessed with a wonderful business intelligence and technology team here at SickKids. It’s one of the marquee areas that we have that a lot of organizations don’t. So, we have data scientists, and we’re a data-driven organization. With 1.3 million donors, you have a lot of data to play with.

Let’s talk about the health care system. There’s a sense that the system is buckling. How accurate is the idea that we’re in crisis?

I would say there’s a sense that certain services are not functioning the way we would like them to. And that the government’s not keeping up with the demands. And that’s why people are, particularly at SickKids, willing to be philanthropic, because they know some of it will be solved by philanthropy and some of it will be solved by the hospitals doing things differently. But one of the big strains that I don’t think a lot of people in Canada are aware of is how short we are on the right people to work in our health care system.

I was getting to that, but tell me.

For pediatrics, in particular, it’s a speciality on top of a speciality. You become a regular doctor, then you specialize in pediatrics, and then you might specialize in another area. So, it takes a lot longer, it’s more expensive, more time-consuming, and fewer people are choosing it. And so the competition for pediatric specialists has never been greater, globally. We train probably 60 per cent of the pediatric specialists.⁴ The Americans are just coming in and offering them—the sky’s the limit, right? So, one of the huge pressures is making sure we can attract and retain people here in Canada, and that our institutions cannot just pay them competitively but give them the facilities to compete with what we’re seeing in other parts of the world.

Does fundraising have a role to play in keeping people here?

We are the biggest funder of the research centre, and it plays a twofold role. We pay to bring in fellows, we help support chairs, which allow people to have time to do research. But the biggest part is that, say we raise $1 million for a research fellow. That first million is usually leveraged seven to 13 times to attract other funding from outside agencies. So, that first little bit of philanthropy is used to open the gateway to attracting more money.

Some hospitals say that children’s health care is being left out of funding increases, even though the number of kids is growing.

I agree. The way they compensate health care is really against an adult model. When you do cardiac surgery, for example, you’re compensated for a certain amount of hours. My understanding is that the compensation is based on doing a stent in a heart. So, it might take an hour and a half. Well, we don’t do surgery on full-size hearts. We often do surgeries on hearts the size of a grape. And it takes a huge, experienced team sometimes 10 hours. But we don’t get different compensation, because it’s “heart surgery.” One size fits all. In children’s health care, you need eight different-sized blood pressure cuffs. You need beds of different sizes. Because you gotta go from a neo-nat to—my son at 18 was six-foot-five, 220 pounds. So, it’s exponentially more expensive to take care of children.

What’s next?

Our next project is going to be for precision child health, which is a paradigm shift in how we take care of children. Until now, we’ve always gone with a population-health approach, meaning we push things out that work for the vast majority but don’t pay attention to those who fall by the wayside, who don’t respond because of their genetics or environment. Precision health is tailored to the individual. Stop wasting treatments, time, procedures that will never work. Start with each child as an individual, look at everything—from their genetic code to their postal code—and figure out what works for them.

Do you imagine staying here to see that project to fruition?

I certainly do. This is it for me. This is my last stand. I’ve had an incredible career in philanthropy, and I have the privilege of ending it at the greatest, I think, institution in Canada. And precision child health is one of the things that attracted me. It’s about changing the outcomes for all the kids that are left behind, using all the tools in our tool box. This is the campaign I’ve been waiting for my whole life.

How often do gifts from transformational donors come with restrictions?

The vast majority. We are getting better—and this is something the entire sector needs to do—at asking for unrestricted dollars that can go to the highest priorities. Traditionally, especially as an organization matures, you get so excited when you have a priority that you can ask for. And so what tends to happen is the pendulum swings very hard to restriction. And then you realize you’re starving the organization of the opportunity to innovate or, if something catastrophic happens, they don’t have any unrestricted money to respond. And so one of the things that we’re working really hard on is asking each transformational donor to give a portion of their gift to unrestricted.

1. The top three children’s hospitals in the world are Toronto’s SickKids, Boston Children’s Hospital and the UK’s Great Ormond Street. In the past few years, Boston and Toronto have gone back and forth for top spot.
2. But here are some pretty staggering numbers: In 2022-23, SickKids had 521,000 patient visits and treated 850 babies in its neonatal intensive care unit. It also performs 11,000-plus surgeries a year and 95 per cent of Ontario’s pediatric organ and bone-marrow transplants, and has an average of 269 beds occupied daily.
3. Through the Ugly Sweater Campaign that runs every Christmas, Reynolds has helped raise about $4 million in total. Bernard also cites his halo effect in getting other celebrities to donate their time. (And if you haven’t seen his 2023 ugly-sweater ad yet—featuring a cameo from Leafs captain Auston Matthews—do yourself a favour and watch it.)
4. Bernard is referring to SickKids’ experience a few years ago, in which it trained approximately 60 per cent of pediatric oncologists in Canada. It has also been true that 80 per cent of pediatricians across Canada receive at least some training at SickKids. Additionally, current figures show that, each year, SickKids trains more than 350 fellows from nearly 60 countries, and the SickKids Research Institute brings in approximately 230 fellows for pediatric research training.

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