Premier putting profits over health care
Policy decisions show Tories are intent on shaking confidence in public system
When the Doug Ford government took office in June 2018, it made a commitment to solve the problem of hospital hallway medicine. Indeed, the premier promised that hallway medicine (also referred to as hospital overcrowding) would be gone within a year.
The best measurement of hallway medicine is time taken for emergency room (ER) patients to get a bed in hospital. The more hospitals are crowded, the longer it takes for admission to a hospital bed.
In June 2018, wait times for ER patients to get a hospital bed were recorded as 14 hours — not great and needing improvement. A year after the Ford government started, despite the premier promising a solution within a year, wait times had increased to 15 hours. Today, the average wait time is 22 hours — showing overcrowding is about 50 per cent worse.
Understandably, government has been focused on responding to the pandemic strain on Ontario’s hospitals. However, the government has placed limits on hospitals’ ability to reduce hallway health-care with its adoption of Bill 124. This act restricts nurses’ pay increases — during the highest inflation experienced in decades — to one per cent annually. Despite recognition of “health-care heroes,” Bill 124’s draconian limit on compensation demonstrates disregard for the contribution nurses made potentially risking their lives treating patients infected with COVID-19.
The government actually doubled down on its disrespect for nurses when Ontario’s Superior Court declared that Bill 124 is unconstitutional. Rather than accepting that decision, the government decided to appeal the court’s opinion.
Now, in part because of Bill 124, Ontario hospitals are facing the worse nursing vacancy in history. Nurses are leaving hospital work at an alarming rate, moving to other jurisdictions or agency work where salaries are better. Hallway medicine is made worse when hospitals have insufficient staffing. If the government were serious about eliminating hospital overcrowding repealing Bill 124 would be a way to demonstrate resolve.
Instead of prioritizing a solution to the 50 per cent increase in hallway medicine during their time in office, the government is focused on expanding the role of for-profit private clinics to address surgical backlogs. In contracting private businesses like the Herzig Clinic to perform cataract surgery, the government has offered for-profit facilities about 20 per cent more money than hospitals receive for treating cataracts.
Some surgery needs to move out of Ontario hospitals into community surgery centres. However, there are plenty of hospitals doing surgery in the community that should compete for increased cases. Instead, the government has opted to pay for-profit providers a higher rate in a request for proposals process that precluded hospitals.
These two policy decisions — destabilizing hospital staffing through Bill 124 and paying for-profit clinics extra public funding to do surgery — reduce public confidence in medicare. Sick people or families with loved ones requiring admission to hospital are inevitably distressed when patients are kept in hallway corridors for days, waiting for a hospital bed.
Seeing the harried and overworked nurses trying to care for sick people without sufficient staffing tells Ontarians that our publicly funded system is failing. And this appearance of a system under siege inevitably raises the demand that we need a different system that allows people to pay for enhanced access to a better, private system.
This message is amplified by the government insisting that we need private sector “expertise” to solve pandemic backlogs. Adding insult to injury, the government then adds a premium to the price that is it willing to pay for-profit providers, reflecting the reality that for-profit care is always more expensive.
A government that intends to expand the opportunity to make profit from Ontario’s health system could be expected to destabilize our public system with rigid wage limits and then turn to the private sector for solutions. The 50 per cent increase in hallway medicine and the expansion of private clinics suggests this government is more committed to increasing the opportunity for health-care profits than it is to medicare.