SoVote

Decentralized Democracy

Ontario Assembly

43rd Parl. 1st Sess.
February 27, 2023 09:00AM
  • Feb/27/23 1:30:00 p.m.

It’s a pleasure to rise today to respond to this opposition day motion and highlight some of the many investments and new programs our government is making to clear the surgical backlog and improve the patient experience across the province.

Honestly, Madam Speaker, the Leader of the Opposition said, “if only Ontario’s ORs are allowed to operate at full capacity”—well, I can tell you, they are allowed to operate at full capacity. She said that by prioritizing hospital ORs, we’ll be reducing wait times right now. Well, since the beginning of the pandemic, our government has been investing in prioritizing hospital ORs. We’ve invested $880 million in surgical recovery funding, almost a billion dollars, for our hospitals to increase—that’s just for them to increase; that’s in addition to the other funds they get—surgical hours and address procedures that were delayed as a result of the COVID-19 pandemic. That money is to fund more surgeries and diagnostics at hospitals, including opening more operating rooms, more for longer hours, and more on evenings and weekends, when possible.

But hospitals are independent corporations that make their own decisions about how best to use their resources. The government does not dictate how many ORs they open at any particular time on any particular day. That is up to the hospital to decide and to make sure they have the staffing in place to do so.

Although we have put in an extra billion dollars—almost $880 million—so far we haven’t got the backlog cleared. The money has gone some way to clear the backlog, but our government knows that people like Nathan, who was mentioned, are still waiting way too long. We don’t want Nathan to have to suffer, or to wait, or to have five rescheduled surgeries. We don’t think that’s appropriate, and that is why we’re taking more steps. We added an additional $330 million for the hospital surgery backlog this year, for hospital operating rooms.

Unfortunately, we’ve done what the Leader of the Opposition suggests, by prioritizing hospitals and giving them a lot of extra money, but there are limits to what hospitals can do with those resources. They can do as much as they can, and that’s what they’re doing.

But Nathan shouldn’t have to wait, so our government is taking that next step. The next step is making it faster and easier for people to access surgeries and procedures they need, by better integrating and using community and diagnostic centres to increase capacity and to complete more publicly funded services—and these, increasing community capacity, target patients who will have been waiting the longest amount of time for their treatment, and expand available options to receive safe and quality care. This will mean shorter wait times for common but vital surgeries such as cataract and hip and knee surgery—eventually; that will be in 2024—and you can expect, people of Ontario, shorter wait times for diagnostic services, as well, such as MRIs and CT scans. We’re starting by tackling the existing backlog for cataract surgeries, which has one of the longest wait times for procedures.

Just let me take a moment to digress a bit, because the Leader of the Opposition had some story about saving money and said that cataract surgeries cost an OHIP fee of $500 in a hospital, whereas at a for-profit clinic they cost $605. I wrote down what she said. The fact is that a clinic will get a fee that includes a facility fee—that’s maybe the $605, assuming those numbers are accurate; I’ll give her the benefit of the doubt—but the hospital doesn’t just get the $500 OHIP fee. The OHIP fee goes to the doctor performing the surgery, but the hospital gets hospital funding, infrastructure renewal funding, nursing funding and a whole bunch of other funding, and believe me, the clinics don’t get that. They just get the $605 mentioned by the member opposite. So it’s very misleading, I would say, to say that one kind of person is getting more than the other. That is not the way it is. The fee is a $500 OHIP fee plus a facility fee in a clinic.

The other thing I want to point out is that the member said that more than a third of operating rooms in Ontario public hospitals do not meet the 90% target for operating room use. I think she pulled this from a December 2021 report of the Auditor General, so I think that might be dated. However, if we’re going to pull from that report, let me just add this quote from the Auditor General’s December 2021 report: “Studies have shown that outpatient surgeries can be performed more efficiently and cost-effectively when performed in an ambulatory setting. As well, because these ambulatory settings often specialize in a handful of types of surgeries, more can typically be done in a day as compared to the number that are performed in a general hospital setting. For example, a 2014 study released in Health Affairs (a peer-reviewed journal on health policy and research) found that procedures done in ambulatory surgery centres took about 31.8 minutes (25%) less time than those in hospitals. Estimated cost savings ranged from approximately $363–$1,000 per outpatient case, depending on the surgery.” That’s the quote from the same Auditor General’s report that my friend opposite has quoted from. Clearly. there’s a difference of view there.

Madam Speaker, as I said, we’re targeting shorter wait times for common but vital surgeries such as cataracts, hip and knee replacements so the people of Ontario can expect shorter wait times for those things and for diagnostic services such as MRI and CT scans, because this government thinks they’re waiting too long. And we’ve started by tackling the backlog for cataract surgeries—as I’ve said, one of the longest waits for procedures. This past month, we issued four new licences to health centres in Windsor, Kitchener-Waterloo and Ottawa to support an additional 14,000 publicly funded cataract surgeries annually. As I said the other day when I was quoting the member from Thunder Bay–Superior North, people are delighted to not have to wait so long to get their surgeries. They’re very excited to be able to get on with their lives. These additional volumes make up 25% of the province’s current cataract wait-list, and this will significantly reduce the surgical backlog.

In addition to shortening times, providing these publicly funded services through community surgical and diagnostic centres will allow hospitals to focus their efforts and resources on more complex and high-risk surgeries such as Nathan’s surgery. He’ll be able to get in sooner as a result.

We’re also investing more than $18 million in existing centres to cover care for thousands of patients, including 49,000 hours of MRI and CT scans, 4,800 cataract surgeries, 900 ophthalmic procedures of other varieties, 1,000 minimally invasive gynecological surgeries, and 2,845 plastic surgeries. As a result, surgical wait-lists will return to pre-pandemic levels, it is anticipated, by March 2023. And as always, these services will continue to be provided at no cost to the patient, with their Ontario health card.

Beyond all the work our government is doing to address the surgical backlog, we’re also building up our health care system for the future. One of the key investments that we’re making is to achieve this through the expansion of access to primary care. When people have health care available in their communities and in ways that are convenient for them, they’re much more likely to seek and receive the treatment they need when they need it and stay healthier. Delivering convenient care to people in their communities will help Ontario stay healthier by diagnosing illnesses earlier, starting treatments as soon as possible, and keeping emergency wait times down when you and your family need urgent care.

Ontario leads the country in the number of people who benefit already from a long-term, stable relationship with a family doctor or primary care provider. Over 90% of Ontarians has a regular health care provider. But we can do more, and we will do more.

That’s why we’re increasing training opportunities at the same time as expanding team models of primary care across the province of Ontario. Work is already under way to train the next generation of doctors, nurses, personal support workers and other health care professionals in this province.

We’re expanding training spots to more health professionals in Ontario every year, with 455 new spots for physicians in training, 52 new spots for physician-assistant training spots, 150 new nurse practitioner spots, 1,500 additional nursing spots, and 24,000 personal support workers in training by the end of 2023.

This is all very good news for Ontarians. By adding new health human resources to Ontario’s workforce, more team-based care will be made available to Ontarians.

When family physicians work in a team model alongside other physicians, nurses, dietitians, social workers, pharmacists and other health care professionals to deliver programs and services, you get better continuity of care and more access to after-hours care.

We’re increasing the number of spots for physicians to join a team model of care through the expansion of existing family health organizations, and allowing new ones to form. This will add up to 1,200 physicians in this model over the next two years, starting with an additional 720 spots for physicians joining our family health organization model in 2022-23 and 480 spots in 2023-24. These family health organizations will be required to provide comprehensive primary care services, extend evening and weekend hours of practice, and provide more weekend coverage so people can access a family physician when they need it.

Team models of primary care have demonstrated how bringing health care providers together as one team can improve the patient experience and how people access care.

Speaker, another way that we are building on this is through the development of Ontario health teams. Teams of primary care providers, regardless of model, will be central to all Ontario health teams across the province.

Finally, I want to highlight the important work that our government is doing to develop a 10-year capacity plan for health human resources. Last fall, we began our work to develop an Integrated Capacity and Health Human Resources Plan for Ontario. We’re analyzing current gaps in our system, anticipating needs over the next 10 years, and determining solutions to addressing growing health care demands. The plan will focus on how to meet this demand through investment, health human resources and innovative solutions.

This year, we’re building on this work and shifting our focus to working directly with leaders in our health system on a workforce plan that includes where to prioritize current and future resources, addressing and minimizing system gaps, and building a strong health system for the long term. The plan will also look at specific strategies for increasing the number of health care professionals, starting with physician assistants, nurse practitioners, registered nurses, registered practical nurses and medical laboratory technologists, and will also look at the retention of our health workforce through incentives, leveraging programs like our Learn and Stay program as well.

We have more positions open, which was pointed out by the member opposite, but that’s because we are hiring more health care professionals than ever before. That’s what Ontarians want. They want to have more health care professionals delivering more health care as soon as possible.

We will ensure that we have a greater understanding of each community and their local needs and that we have a plan to recruit and retain the health care workers needed, including our family doctors, nurses, specialists and other health providers, in every region of the province. We will begin by prioritizing the areas most in need, like rural and remote communities, where we know gaps already exist.

Ontario’s population is projected to increase by almost 15% over the next 10 years—and this really addresses the comments about how somehow we’ve decided to make a crisis. I don’t think that’s true at all. What I think is that demographics are here, and demographics have a certain reality, and we need to pay attention to those. Ontario’s population is expected to increase by almost 15% over the next 10 years. That alone places significant demands on our health care system. But on top of that significant population growth, much like other OECD countries, we have an aging population. It is well known that we use much more health care resources as we age, and certainly within the last 10 years of life—it generally is considered to be responsible for some 90% of the health resources that we use in our lifetime.

The Conference Board of Canada recently noted that population aging alone will drive 20% of all health-corresponding increases in the coming decade. The population which is age 65-plus is the fastest-growing segment of the population, and especially the group over 85. That population, the group over 85, will increase by 141% between 2022 and 2042. By contrast, the population of seniors aged 75 and older is expected to increase by 49.3%, from 1.2 million to 1.8 million, over the next 10 years. By contrast, the Ontario population of 65-plus will increase from 2.5 million in 2019 to 4.6 million in 2046. It will make up 23% of all Ontarians by that point. That would be one out of four—seniors, people over the age of 65—in Ontario if that comes to pass.

We need to continue to grow our health care workforce to meet the demands of our growing and our aging population. This plan that we have and our significant investments in our health care system will incorporate the lessons we’ve learned from COVID-19 and ensure we are prepared and equipped to meet the health care needs of Ontarians for years to come.

Thank you again for the opportunity to speak, Madam Speaker, to this opposition day motion. I’m confident that the government has a plan, and I think it’s very important that we make sure there is access to surgeries for people like Nathan who are waiting too long.

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  • Feb/27/23 2:10:00 p.m.

The Conservative government is eroding our public health care system. With medicare, our health care is based on our needs, not on our ability to pay. This Conservative government is jeopardizing that by not prioritizing public health care and publicly funded operating rooms. Their bill, ironically entitled Your Health, puts profit over people, over your health, and literally allows big corporations, private shareholders and private clinics to make big profits off the backs of sick people. And make no mistake: Those sick people include the very burnt-out front-line health care workers—mostly women, mostly Black and racialized—that this government has attacked since the beginning of this pandemic by not providing them with the N95 masks they needed desperately to save their lives; by not legislating the paid sick days they needed so they didn’t have to go to work sick; and bleeding them dry with Bill 124, which attacked their wages, while ensuring they worked in chronically understaffed, under-resourced and unsafe working conditions, and while this government simultaneously created legislation to protect bad-faith, for-profit long-term-care operators from being sued by families of deceased elders left to die in their own feces—starving, dehydrated, alone.

Friends, this government has never prioritized your health. Instead, their master plan is the privatization and the profitization of health care.

This government’s health care privatization bill does nothing to address the staffing shortage crisis in our public health care system, and in fact it’s making the surgical backlog and wait-lists longer.

Rather than invest in our public hospitals, this government underfunds public hospitals, which has caused a mass exodus of our nurses, RPNs, doctors, surgeons, PSWs and health care professionals into the for-profit private clinics and hospitals, where, yes, they’re paid two, three, four times—maybe sometimes even more. But the oversight and patient protections, should something go wrong in these independent health facilities that are not connected to hospitals, are severely compromised, if present at all.

All this is happening while this Conservative government has sat on, and is still sitting on, hundreds of millions—billions—of contingency funds they could be using to invest in public health care. How do you hoard cash while people are literally dying—and dying in pain—waiting for years for surgeries, while operating rooms in our public hospitals sit empty? ERs are shutting down left, right and centre. Seniors are being charged thousands of dollars for OHIP-covered surgeries. I don’t know how the Conservatives sleep at night.

I’ll end with the words of thousands of ONA nurses and health care professionals I joined last week: Beds don’t save people; nurses save people. Safe staffing saves lives. Better staffing, better care, better wages will save our public health care system—not this Conservative government’s health care privatization scheme.

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