When Nicole Vaz joined Trillium Health Partners in Mississauga, Ontario, in 2013, the hospital's legal function was two people: Vaz and a law clerk. Thirteen years later, she is the organization's senior vice president, general counsel and chief compliance and privacy officer – and the in-house legal lead on the $13.9-billion hospital redevelopment that took home Infrastructure & Projects Deal of the Year at the 2026 Canadian Law Awards.
The redevelopment covers the design, construction, financing, and maintenance of The Peter Gilgan Mississauga Hospital (which will house Ontario’s first hospital dedicated to women and children – the Shah Family Hospital for Women and Children) and The Gilgan Family Queensway Health Centre. It is the largest healthcare infrastructure public-private partnership in Canadian history and the first project in Canada to use a formal progressive design-build-finance-maintain delivery model.
"Private practice gave me an incredibly strong foundation," says Vaz, who spent three years in the litigation group at McMillan Binch LLP and then nearly eight years in the health law and insurance defence groups at Lerners LLP as an associate and then a partner. "But I was increasingly drawn to the opportunity to become more deeply involved in a healthcare organization – to understand its challenges, its leadership, its community, and to actually contribute to decisions that have a lasting impact."
THP had a particular pull. Vaz says the system is the sole hospital serving its geographic patient population – a catchment covering Mississauga and West Toronto that Vaz describes as the most socio-demographically diverse community in Canada. "We offer community and specialized services from birth straight through until the end of life," she says. "That affords us the unique opportunity to understand population health and to transform the way we deliver care to a community that represents the world."
Building a legal function from scratch
The portfolio Vaz now oversees – legal, compliance, privacy, corporate governance, internal audit, and insurance – did not exist under one leader when she arrived. She frames its development around three pillars: building trust in a high-stakes, resource-constrained environment; recruiting and retaining talented individuals; and deliberately structuring the function in alignment with how public healthcare actually operates.
"A strong legal function is not necessarily built through legal expertise alone," she says. "We rise and fall together. The real measure of success isn't just what we manage from a pure accountability perspective, but how our function collectively helps the organization move forward."
Navigating an untemplated $13.9-billion deal
The $13.9-billion contract for The Peter Gilgan Mississauga Hospital had no ready-made provincial template. The progressive design-build-finance-maintain model – in which contracting parties collaborate through a development phase to refine design, pricing, and risk before construction begins – required Vaz's team to navigate legal terrain that was, by her own description, unprecedented in the province. Infrastructure Ontario's project page for the redevelopment details the scope of the delivery model.
"This is not a conventional construction transaction," she says. "We were supporting the development of a path forward without relying on a ready-made template. The in-house team's role was to connect the dots – to appreciate the advice coming in from the various stakeholder teams and then help translate that into a path forward for the organization and its mission."
That connecting role extended well beyond legal advice. On a project spanning real estate, construction, corporate governance, environmental, municipal, and energy law, involving provincial, municipal and local community stakeholders alongside a large private-sector consortium, the in-house team's value is institutional coherence. "You will be in many rooms as the glue that connects the various streams of work together," Vaz says of her legal team. "Each siloed team will think about the risks within its own workstream. But there needs to be a team – including the in-house legal team – that oversees the collective risk, to ensure it's still sustainable, feasible, and aligned to the organization's culture and mission."
The project also required future-proofing in the physical design. In the new hospital's obstetrics model, newborns requiring acute care will remain in the same room as their mothers rather than being transferred to a congregated neonatal intensive care unit. "It can be very traumatic to be separated," Vaz notes. Operating rooms are being built larger than conventional designs to accommodate artificial intelligence-assisted surgery and specialized care teams, anticipating technology that does not yet fully exist. THP also opened a physical mock-up facility in East Mississauga in 2024, where leaders, clinical staff, and the broader community can walk through prototype rooms and provide feedback before construction locks in decisions.
That sense of purpose runs through every design decision. “I think we have always had in our mind the fact that this build is more than bricks and mortar,” Vaz told Canadian Lawyer at the 2026 Canadian Law Awards ceremony. “This build is intended to represent a transformative era of delivery of care to the community through technology, through innovation, and through patient design and care.”
Privacy law hasn't kept pace with AI in healthcare
Alongside the physical build, Vaz identifies a parallel challenge: governing digital transformation within a framework where it’s challenging for legislation to keep pace with innovation and where the sector and regulators need to collaborate as the landscape evolves. "There is an urgent need to modernize privacy laws and guidelines so that we can work with our regulators to ensure patient care is seamless across the province," she says. "AI is going to help us fill gaps that otherwise cannot be filled."
"For a public hospital, the greatest exposure is not the risk of a data breach necessarily," she says. "It's the growing gap between the speed of digital transformation and the organization's ability to govern how personal health information is being collected, accessed, shared, used, and retained."
The central question, she says, is not just whether a technology is legally permissible, "but whether the hospital can demonstrate that its use is necessary, secure, responsible, accountable, transparent, and consistent with our obligations to the community – because the consequences go well beyond regulatory findings or financial penalties. They affect patient trust, institutional reputation, and potentially the delivery of care itself."
Advice for lawyers considering an in-house move
For private-practice lawyers considering the transition, Vaz is direct.
"Moving in-house is not just a change of employer. It's a change in how you practise law. It's a change in how you measure success," she says. "Do not move because you are seeking a different pace or a different lifestyle. Move because you are interested in being a part of the organization – what matters to its people, understanding its challenges, helping shape its decisions, taking shared responsibility for the outcomes."
Once you're in, she adds, the foundation is relational. "Credibility and trust are everything. Invest in relationships. Listen carefully. Be accessible. Do not judge. Don't assume your clients are going to take your advice. It's not personal. It's complex."
After 13 years, her own commitment to Trillium Health Partners is unambiguous. "This is my community," she says.
Nominations for the 2027 Canadian Law Awards will open soon. The deadline to submit is February 5, 2027.