Whether it's incompetence or selfishness, Doug Ford and Sylvia Jones are failing us.
5 Years of Ontario Premier Doug Ford
This crisis has been years in the making through insufficient planning, inadequate funding, and blatant disrespect for healthcare professionals. And at least in recent years, it's been intentional - the Ontario government wants people to be frustrated about the state of healthcare to the point that we accept private for-profit healthcare without thinking about it too much. But if our public healthcare system was just funded adequately in the first place, and frontline workers were actually listened to, we wouldn't be where we are right now.
So, it's been a long 5 years of watching our healthcare system collapse under Doug Ford. The nursing shortage in Ontario may not be new under his "leadership", but his government passing Bill 124 in 2019 was the start of a much steeper decline in this province, among other things.
You may be wondering what else Ford and Ontario Health Minister Sylvia Jones have been doing to combat this crisis, so let's take a look at that first.
What are Ford & Jones Up To?
Ontario Health Minister Sylvia Jones still denies the existence of a nursing crisis (November 2022), and Ford rejects his government's own analysis of Bill 124 and its impact on the staffing crisis (January 2023). How can you combat a crisis without even acknowledging it?
Other "steps" taken by Ford & Jones:
Adding new beds without more staff, which increases ratios, making care more unsafe and contributing to nurses leaving
Lying to the public about how well things are going
Ford talking about how many nurses are registered with the College of Nurses of Ontario (CNO) means nothing - those registered does not equal actively practicing in the province
The registered non-practicing class of RNs and RPNs has been increasing, along with registrants practicing outside of Ontario
Even if we were to believe all of these new nurses were being hired, it doesn't matter if you're not working to retain them!
Taking steps to advance the scopes of nurses (more work while pay is capped and working conditions worsen)
Spent $859 million less than expected in first half of 2022
Will have underfunded healthcare by $21.3 billion needed for hospitals, home care and long-term care by 2028 unless the government changes course
Sylvia Jones' Bill 60
Bill 60, Your Health Act
On February 21, 2023, the Ontario government tabled this bill that in their words, aims to reduce surgical backlogs. However, this bill proposes to repeal the Independent Health Facilities Act, 1990 and replace it with new legislation. This would allow for more private clinics to open. Jones said there would not even be a cap on the number of clinics allowed to open!
Jones has also said there will be elements of the application process and the agreements that will be kept private due to the “business model nature.” So, we won't even necessarily know how much these services are costing the public.
So, what are the major problems with this?
Where will the staff be coming from? From public hospitals!
How will patients be protected from upselling? They won’t be!
Why do politicians ignore the data that privatization will result in worse outcomes for patients? Profits!
Ontario Liberal Health Critic Dr. Adil Shamji acknowledged that there may be a role for not-for-profit clinics in the province’s health-care system, but it isn’t the solution to the health-care crisis. He posits that there is “no ambition” by the Ford government to address root causes of the crisis. If the Ford government has no interest in addressing the root causes, how can anyone trust that they have patients' best interests at heart?
“I'm not trying to be absolutist or ideological, but to make a massive pivot, particularly to one which is very clearly been signaled a move to for-profit healthcare, without addressing the root causes that are handicapping our health-care system, is disingenuous.”
Shamji provided examples of how patients could be upsold, like the purchase of more expensive, higher-quality lenses for cataracts surgery, which may be available quicker than the OHIP-covered.
Busting Myths of Privatization
Increases the true cost to taxpayers
Data obtained from the Canadian Institute for Health Information (CIHI) shows that knee replacement surgery in a public hospital, paid by the province, costs about $10,000. The same surgery in a private clinic can reportedly cost patients up to $28,000. When the province pays for the knee replacement surgery in a for-profit clinic, the amount is kept secret, due to confidentiality agreements.
Herzig Eye Institute will receive $150 more per cataract surgery than public hospitals, costing taxpayers an extra $750,000
Through upselling, as discussed previously
Worse patient outcomes and higher death rates
With a focus shift from patient care to profits, there is incentive to cut corners and deliver lower quality care
Covid-19 outbreaks at for-profit long-term care homes infected nearly twice as many residents than in any publicly run ones (with 78% higher mortality rates), and death rates were higher before the pandemic as well
One Canadian systematic review showed 2% higher mortality rates in for-profit hospitals
Increased pressure on healthcare workers
Public hospitals will have to compete with private for staff and funding
Surgery wait times are not due to operating room capacity, but lack of funding to keep them staffed - the Auditor General report found that more than a third of hospitals across the province were operating at less than 90% capacity
Potential to worsen wait times
Privatization may reduce waits for those who can afford to pay, but likely worsens wait times overall
Ontario actually had the shortest waiting times in Canada for hip and knee replacement surgeries in 2021/2022 — 73% of patients received knee replacement surgery within 6 months
Patients in provinces outsourcing surgeries to for-profit clinics waited longer - in British Columbia, only 70% of patients received knee replacements within 6 months, while in Alberta, it was 53% and in Quebec, 48%
Saskatchewan has allowed residents to pay out-of-pocket for an MRI since 2016, but wait times have actually increased
What’s the Federal Government Up To?
On March 6, 2023, NDP MP Don Davies sponsored a motion that says the following:
Every single Conservative AND Liberal voted against it.
Additionally, in March 2023, Pierre Poilievre, leader of the Conservative Party of Canada and the leader of the Official Opposition, called for a countrywide standardized testing process to speed up licence approvals for doctors and nurses.
Health care is within the provinces’ jurisdiction, but the Conservatives are again only focused on hiring new nurses rather than doing anything to retain them. Not to mention that this proposal only applies to provinces and territories willing to participate in the "Blue Seal" program.
Could this help if done right? Sure. But it's definitely an interesting proposal considering the time this would take when we need action now, as this has been going on for years.
Additionally, this seems to have been greatly oversimplified when each province and territory has their own regulatory college. These are 2 huge separate processes that would have to be completely rebuilt.
What Can You Do?
Listen to nurses and other healthcare workers, as well as patient experiences
Call on the government to address the nursing crisis by listening to what nursing leaders have been screaming for years
Find your MPP at https://www.ola.org/en/members and advocate to keep healthcare public
Vote for people committed to improving working conditions for healthcare workers (which includes voting Ford out at the next opportunity!)
References
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