As you know, the Ontario Liberal Party won a majority government in the election that was held on July 12th. Prior to the election, the ruling Liberals had only a minority government, which meant that the opposition parties held the balance of power in the provincial legislature at Queen’s Park, which enabled them to have some influence over the government’s legislative and policy agenda. The election on July 12th changed that. The Liberal government is now in a position to push through its policy agenda without having to rely on the support of either of the other two political parties. The implications for Ontario’s health care system will be significant.

Although it’s still too early to tell exactly what the new government is planning for our health care system, we can expect the Ministry of Health and Long-Term Care to continue advancing the vision for health care that the Liberal government laid out in its recent election platform and in its main health care policy document, Ontario’s Action Plan for Health Care, which was released in January 2012. The government can also be expected to implement more of the recommendations made in Dr. Samir Sinha’s comprehensive report on seniors’ care, Living Longer, Living Well, as well as other recommendations made in some of the government’s other policy strategies, such as in its mental health and addictions plan, Open Minds, Healthy Minds.

Despite the uncertainty we face in the lead up to the next legislative session, we do know some of the specific health policy priorities that the government will advance in the first year of its new mandate, because the Premier, Kathleen Wynne, has already indicated that she will reintroduce the 2014 Spring Budget, which failed to pass in early May due to opposition from the other two parties. When this budget is reintroduced, it will certainly pass because of the government’s majority status.
It may therefore be worthwhile to re-examine some of the main health care commitments outlined in this document.

When the Spring Budget was first introduced, we issued a press release voicing our support for many of its provisions, which include expanding the scopes of nurses and other health care professionals, investing $11.4 billion in capital grants for hospital expansion and redevelopment projects, increasing pay for PSWs in the home and community sector, committing to modernizing long-term care facilities, and making additional investments in the province's mental health and addictions strategy.

The budget also committed to increasing investments in home care service by an average of five percent per year in order to support initiatives such as the five-day home care service target and the five-day wait time target for nursing services for patients with complex needs. These investments in home and community care were intended to improve the health care system’s capacity to care for patients after hospital discharge, while avoiding costly hospitalization and long waits for patients in the emergency room, as well as freeing up hospital and long-term care beds for those who need these most.

Although the government’s emphasis on improving care in the community is encouraging – given that most patients want to be cared for in their homes and communities whenever possible, and that community-based care is much more affordable than hospital-based care – we remain deeply concerned that the increases announced in the budget will not be sufficient to enable nurses and other health care professionals to provide the level of care that our aging and growing population requires. The severe restrictions on funding across the hospital, community, and long-term care sectors threaten to have negative implications for our health professionals and the millions of Ontarians who depend on the care they provide.

Ontario’s hospitals, especially, are facing unprecedented budgetary constraints, but the proposed investments in capital grants for hospitals will not increase their operating budgets, which puts increasing pressure on employers to fund increases in compensation costs for nurses and other health providers through ‘productivity gains’ and other ‘tradeoffs.’

Unfortunately, eliminating full-time positions for nurses is one of the ‘tradeoffs’ employers have been making when trying to control rising costs. According to the latest statistics from the College of Nurses of Ontario, the full-time employment rate for RPNs in Ontario is now 56.8 percent, which represents a troubling 4.1 percent decrease over just one year. The percentage of full-time employment positions for nurses is now far below the provincial goal of 70 percent full-time nursing employment, which the Ministry of Health and Long-Term Care established under a previous Liberal government.

As our Executive Director, Dianne Martin, has said previously in the media: “This trend is having dire consequences for our nurses, as it diminishes the continuity of care and fragments care, which threatens patient outcomes, making it increasingly difficult for nurses to maintain the service levels required to meet their patients' health care needs. It's also important to remember that the life of a part-time nurse is extremely difficult, filled with incredible amounts of stress and uncertainty.”

Consequently, we believe that our elected leaders have to do more to support Ontario’s nurses and their health care colleagues. And this is the reason that we will be pushing the government to improve the rate of full-time employment for Ontario’s RPNs and to advance the other policy proposals that we submitted to the government in our 2014 pre-budget consultation document.

We will also be engaging with the government to continue advocating for the appropriate utilization of our RPNs as outlined in the recently-published final report of our Role Clarity Project, It’s All About Synergies, which the last Liberal government helped fund. The recommendations and strategies outlined in this report can be expected to improve the effectiveness and efficiency of our nursing teams, which can in turn be expected to help ease the financial pressure on our health care system, while improving patient outcomes and creating healthier working environments for our nurses.

We are looking forward to engaging the new government as a partner in this important work. The future of our health care system depends to a great extent on the decisions that our elected leaders make over the course of their term in office, which will expire in four years’ time.

Although we are encouraged by many of the health care and nursing policy commitments that the new government has made, including some of those discussed above, we know that unless the government takes decisive action to better support our province’s nurses, we are going to continue to see nurses struggling with crushing workloads, which will result in higher incidences of sick days, more overtime hours, and higher numbers of nurses choosing to leave the profession – at a time when we need these vital health professionals more than ever.

The time has come for our government to do more to support our nurses so that they can continue to provide the high quality care that the people of Ontario need and deserve.

Category: Influencing Policy, Influencing CareDate: Thursday, June 26, 2014