Ontario's health spending is so misaligned that it is feeding the shortage of nurses and other health professionals to the point that hospitals and long-term care homes are forced to spend more money with contract agencies just to keep up with the demand for staff.
That’s the message of a new research report from the Canadian Council for Policy Alternatives (CCPA) that found Ontario is deliberately "under-spending" on public health care in a bid to prop up for-profit health care agencies.
The spending crisis outlined in the report, which is titled “Hollowed out: Ontario public hospitals and the rise of private staffing agencies” (and which you can read here), was highlighted this week when Michael Hurley, president of the Ontario Council of Hospital Unions (OCHU), visited Sudbury alongside Andrew Longhurst, who wrote the report for the CCPA.
As part of a road tour of Ontario communities, Hurley was in Sudbury on May 21 to spell out the details of what he said the report calls the severe underfunding for Ontario health care.
The 45-page document written and researched by Longhurst states Ontario's public hospitals are under intense pressure to keep their collective noses above water.
"Provincial funding and policy decisions have left hospitals with multi-year budget deficits and several staff shortages," said the report.
Longhurst said the root of the problem is that Ontario is under-spending on hospitals and health care in general. Longhurst said this is not because the province doesn't have the money — it does have the money — but the government is using public money to provide funding to the private, for-profit health facilities, he said.
"The provincial government continues to encourage for-profit involvement that is destabilizing Ontario's health system," said Longhurst.
"The first form of hospital privatization, outsourcing publicly funded surgeries and diagnostics, involves shifting the simplest, most profitable procedures out of hospitals and into investor-owned facilities.”
This would include private clinics doing such things as cataract eye surgery, minimally invasive gynecological procedures, MRI and CT scans, and eventually hip and knee replacement surgeries.
The other factor that is undermining Ontario's health spending is what Longhurst called "the dramatic growth" of the costly for-profit staffing agencies.
Longhurst explained that as hospitals lose their own nurses and health-care workers, they are forced to go to contract agencies to hire temporary nurses and health-care workers who are hired at a premium, just to fill the vacancies.
He said one problem feeds into the other. Nurses and health-care workers will quit regular hospital duty because they might be dissatisfied with wages and working conditions. They get snapped up by contract agencies that pay them higher wages with better work schedules and better working conditions.
Longhurst said that under-spending for public health facilities is the root of the problem.
He called it "a vicious cycle of parasitic independence" that takes money away from the public sector and pumps it into the private sector.
“In rural and Northern regions where shortages are often most severe, agency costs jumped. For instance, agency costs increased by 216 per cent in the Northeast region of Ontario, which includes Sudbury,” said Longhurst.
"So what we have seen is that a decade of provincial austerity created today's hospital conditions. In 2022, the most recent year available, Ontario had the lowest per-capita hospital spending in the country, behind B.C., Quebec and Alberta in real per capita terms,” said Longhurst.
He said in the 10-year period from 2013 to 2022, Ontario hospital spending increased by only four per cent. The rate of inflation for that same period, according to the Bank of Canada, was 22.09 per cent.
Hurley said the decision to provide OHIP funding to private clinics comes at the expense of not enough funding for the public hospitals. He said it is a deliberate ideological choice by the Ontario Conservatives.
"They're ideologically committed to privatization, rather than being committed to providing an efficient service, and that's a problem," he said.
Len Gillis covers health care and mining for Sudbury.com.