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Ontario Election: COVID crisis puts biggest-ticket system in campaign crosshairs

COVID crisis, deeper problems put vital, biggest-ticket system in campaign crosshairs

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Backlogged surgeries, burned-out health-care workers and pandemic pressures.

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After more than two years, COVID-19 is still exacting a brutal toll on Ontario’s health system and its workers, a crisis likely to loom large when voters head to the polls June 2.

Health care accounts for the largest chunk of provincial spending by far – about 42 cents of every dollar in a provincial budget that totalled $185 billion last year – and is a key issue battleground in any election. But all that spending isn’t enough to satisfy many critics, and systemic troubles laid bare by the pandemic are only likely to heighten the focus on health care during the election campaign, many say.

Per-capita health spending in Ontario has ranked among the lowest in Canada since 2008, Ontario’s Financial Accountability Office reports. In 2020, it was $4,800 per person, the lowest of any province.

“We have chronic underfunding of the health-care system,” said Sharad Rai, a family doctor and president of the London District Academy of Medicine. “I want to see evidence the parties are acting to alleviate the suffering of Ontarians. There are long wait times for surgeries, particularly hip and knee replacements, and mental health services.”

Someone posted a large sign of appreciation at the Oakridge Arena COVID-19 assessment centre in London on Saturday March 21, 2020, the pandemic’s first month in Southwestern Ontario. Derek Ruttan/The London Free Press
Someone posted a large sign of appreciation at the Oakridge Arena COVID-19 assessment centre in London on Saturday March 21, 2020, the pandemic’s first month in Southwestern Ontario. Derek Ruttan/The London Free Press

Aiming to make disparate parts of the health system work more efficiently, Doug Ford’s Progressive Conservative government embarked on an aggressive reorganization after it was elected in 2018.

The PCs established Ontario Health, a super-agency overseeing much of the system, and began dismantling the province’s 14 local health integration networks, large regional agencies that allocate health-care dollars, to create– smaller, collaborative groups led by local health-care providers.

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In its 2019 budget, the government unveiled a plan to merge Ontario’s 35 public health authorities into 10 larger regional entities by 2020-21.

Then the pandemic struck.

The first wave of the virus triggered a scramble for personal protective equipment for health workers, a pandemic pay boost for front-line workers and extra funding to shore up bed space. The government resorted to four sweeping shutdowns and rolling restrictions to help protect hospital capacity as COVID-19 exposed deadly gaps in Ontario’s long-term care homes.

The health-care strain caused by surging case counts also forced the government to halt non-urgent surgeries three times — during the first wave in March and April 2020, the third wave in April 2021 and amid this year’s Omicron-fuelled fifth wave in January.

COVID cases among hospital staff, particularly during the fifth and sixth waves, have hampered their ability to ramp up surgical volume.

People lined up at the COVID-19 vaccination centre at the Western Fair Agriplex in London on Wednesday March 24, 2021. (Mike Hensen/The London Free Press)
People lined up at the COVID-19 vaccination centre at the Western Fair Agriplex in London on Wednesday March 24, 2021. (Mike Hensen/The London Free Press)

The result is a backlog of more than 21 million surgeries, procedures and diagnostic tests, according to the Ontario Medical Association (OMA), which represents the province’s doctors. Those missing surgeries include people whose procedures were cancelled or postponed, and also ones who are not yet in the queue because they put off primary care visits and specialist referrals.

Digging out won’t be easy, amid staff burnout and continued community COVID transmission keeping many health workers of the job.

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“It doesn’t matter which political party is in charge, but the OMA and government of Ontario need to work together to address the human health resource problem,” Rai said. “It’s untenable (that) we have 1.3 million Ontarians with no family doctor.”

jbieman@postmedia.com


WHERE THE BIG 3 PARTIES STAND

From left, Premier Doug Ford, Liberal Leader Steven Del Duca and NDP Leader Andrea Horwath.
From left, Premier Doug Ford, Liberal Leader Steven Del Duca and NDP Leader Andrea Horwath. Postmedia files

LIBERALS

WHAT THEY SAY:

“Something we should be taking as a major lesson from the pandemic is that the conditions of work are the conditions of care,” said Kate Graham, Liberal platform co-chair and London North Centre candidate.

“If we want to see patients receiving great care in our hospitals, if we want to see better care in long-term care . . . respecting and valuing the staff providing the care is one of the most important things governments can do,” she said.

Ensuring that workers, particularly in the health sector, have the resources they need to provide expected care levels will loom large in the Liberal platform, Graham said.

The Liberals say system-wide change is needed to bolster home care for seniors, after what Graham calls the “catastrophic” loss of life in Ontario’s long-term care system during the pandemic. The party is also slamming the Ford government’s Bill 124, which limits public-sector pay raises, including those for nurses.

“It’s shameful, it’s short-sighted and it’s bad policy and it means that our health-care system will continue to struggle, even after the pandemic,” Graham said. “We need a government . . . that understands the weaknesses and frailties that we see in the system, including the conditions of work, and is prepared to do something about it.”

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PLATFORM HIGHLIGHTS:

• Raising personal support workers’ base wage to at least $25 an hour and increasing pay for other health-care workers.

• Providing workers with drug, dental and mental health services covered by Ontario’s public health insurance plan.

• Publicly funding medications to treat and prevent HIV, including PrEP (pre-exposure prophylaxis) and antiretroviral therapies.


NEW DEMOCRATS

What they say

“We need a government that will invest in health care, that understands the heart of health care is all about people,” said NDP candidate Terence Kernaghan, who was London North Centre MPP in the last legislature.

“It really comes down to front-line staff, making sure we hire more nurses and doctors. Many people struggle with not having a family physician,” he said.

The pandemic has taken a crushing toll on front-line and many other workers’ mental health , Kernaghan said. For families with loved ones struggling with mental health issues and trying to navigate limited, publicly funded supports, it’s “like watching an accident in slow motion.”

“It’s up to the government to make sure funding is in place so people can get help where and when they need it,” he said. “This is . . . desperately needed by so many folks.”

Ontario’s health system is at a critical crossroad as the province moves into the post-emergency phase of the pandemic, Kernaghan said. The Ontario NDP are concerned the Tories will use the virus crisis as a backdoor way to introduce private health-care providers into the system.

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“What we require are urgent investments. . . . A move to privatization will hurt us in the long run,” he said.

“We’ve committed to ensuring hospital funding is restored and keeps up with inflation and population growth, our aging population and unique needs of communities.”

PLATFORM HIGHLIGHTS

• Publicly funding psychotherapy and counselling through a new program that would cost $500 million a year to start and $1.15 billion a year when fully in place.

• Reducing the wait list for children’s mental health services with $130 million in funding over the next three years.

• Introducing universal drug and dental coverage, noting dental care for low-income Canadians and some early overtures into pharmaceutical coverage were included in the latest federal budget under a minority Liberal government backed by the federal NDP.


PROGRESSIVE CONSERVATIVES

WHAT THEY SAY

“We want to keep building on what we started,” said Health Minister Christine Elliott, a high-profile cabinet member not seeking re-election.

“When we were elected, we came in with a plan to end hallway health care . . .  Then the pandemic came along and exposed even more problems.”

Early in the pandemic, the province grappled with a warehouse of expired personal protective equipment, a lab system that wasn’t integrated and health care infrastructure issues, overlooked by previous governments that had mostly focused on operational spending, she said.

The PCs plan to spend billions on health infrastructure over the next decade to revitalize aging hospitals, build new facilities and increase hospital capacity by 3,000 beds, on top of the more than 3,100 created in the last two years, Elliott said.

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They also plan to expand medical education, with hundreds of new undergraduate and post-graduate positions in the next five years, along with policy changes to make it easier for nurses trained outside Ontario to practise here, she said.

“We’ve got a strong foundation that we are going to build on, both in terms of human capital and infrastructure capital,” she said. “That’s going to continue so that the people of Ontario know they have excellent quality health-care facilities and excellent quality people caring for them.”

PLATFORM HIGHLIGHTS

• Pledging $1 billion over the next three years to expand home care services.

• Planning to build 30,000 net new long-term care beds by 2028.

• Spending $30 billion in next decade for health-care infrastructure improvements.

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