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Ontario hospital and LTC staffing and capacity plans: worse than you thought

By 2027 the PC health care funding plan falls $21.3 billion short, their hospital bed plan falls 500 beds short, their plan to free up hospital capacity by moving hospital patents to long-term care is unlikely to work, and their nurse and PSW staffing plan will fall 33,000 short according to the Financial Accountability Office ( FAO ).  Important and appalling news. But the human problems are actually much worse. The FAO focuses on measuring the gap between the government's stated plans and the government’s stated aspirations.  The bigger -- and much more important -- problem is that the government aspirations fall so very far short of actual human needs. So, on staffing, the FAO makes no claim that government aspirations are adequate to human need. Indeed, their staffing projections do “not reflect an assessment about the quality of services that should be provided by these programs.” As a result, the FAO estimates the government aims to add 1,000 hospital beds between now and
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There's money galore for private clinics -- while the PCs starve health care

Actual provincial program spending is much less than "planned" Provincial Spending was $6.4 billion less than planned over the first 9 months of the fiscal year 2022/3 according to the Financial Accountability Office (FAO). That is 5.0% less than budgeted. After the first half of the year, the FAO had reported that the government had underspent its budget by 4.1% ($3.5 billion).  Health was underspent by $1.25 billion – or 2.3% less than planned. This is an increase from an underspend of $859 million reported by the FAO after the first half of the year.   The news of the $1.25 billion underspend on health comes just as the province scooped up another $776 million from the federal government for health care to deal with urgent health needs like the hospital crisis.  But, instead of dealing with urgent hospital needs, it looks like the province will bank the cheque and underspend the health budget it set last March.      Despite the health underspend, the for-profit clinic

Revenue is flowing in -- but harder times are ahead for public sector services

Ontario government revenue is way up -- $16.6 billion higher than the forecast in the Budget just six months ago. That’s an average increase of $2.7 billion per month -- or up another 1.5% every month.  Revealingly, the quarterly increases in revenue reported have grown sharply: from a modest $1.2 billion in the first quarter report, to $5.8 billion in the second quarter report, on to a whopping $9.6 billion now in the government's new 3rd quarter report .  Yet the fact that the government was massively underestimating revenue was obvious right from the get go when the Budget was re-introduced in August.   The slow recognition of the extra revenue reduced pressure on the PC government to improve health care funding during a hospital capacity crisis. And not one extra penny was added for hospitals, despite the crisis.   It would be hardly surprising if more revenue is recognized in the final two reports for this fiscal year – the 2023 Budget and the September 2022/3 Public Accounts.

Four Ways the Ford Government is Privatizing Hospitals

Premier Ford wants for-profit surgical clinics -- but that is just one area where his government is privatizing hospitals.  Unfortunately, there is so much more.    The privatized American heath care disaster is on full display right on our doorstep. According to the US government 31.6 million Americans have no health insurance whatsoever, including 3.7 million children.  Many millions more have inadequate health insurance.  A recent survey indicates that f orty-three percent of working-age adults were inadequately insured in 2022.  Twenty-nine percent of people with employer coverage and 44 percent of those with individual coverage were underinsured.   Forty-six percent of respondents said they had skipped or delayed care because of the cost, and 42 percent said they had problems paying medical bills or were paying off medical debt.  Medical bills hit African Americans and Latinx/Hispanics especially hard. US health care costs per capita are twice Canadian costs ($15,275 [Candian doll

33,000 missing Ontario hospital jobs and the hospital capacity crisis

Hospitals in provinces other than Ontario have 18% more staff than hospitals in Ontario.  Much, but not all of this is due to low levels of inpatient staffing in Ontario.  In that area, hospitals outside of Ontario have 38.7% more staff.   Understaffing : Ontario hospital full time equivalent (FTE) jobs are reported at 189,519 in 2020/21. With a population of 14,740,102 at the end of 2020 this means there are 1.286 FTE hospital jobs per 100 population. Across the other provinces and territories (absent CIHI data for Quebec and Nunavut) the ratio is 221,917 FTEs for a population of 14,648,959, or 1.514 FTEs per 100 population.  In other words, there is 18% more hospital staff capacity in the other provinces and territories than in Ontario.  Put another way, if Ontario had the same staffing capacity as the other provinces and territories,  we would have another 33,778   full time positions  working in Ontario hospitals.   This low level of staffing is notable because  it has

Compensation for hospital workers has declined for years. But Ford still wants more

The Ford government suggests it must reduce the real wages of hospital workers via Bill 124, and now even proposes to appeal the court decision that found the legislation unconstitutional.  However, no such need exists - quite the opposite. Spending on compensation has been shrinking as a portion of hospital budgets for many years.  The result of this shrinkage? The short staffing, workplace violence, staff burn-out, and falling real wages that are currently hobbling hospitals. Spending on compensation has consistently declined as a percentage of total hospital spending in Ontario:  Data source: CIHI,  Provincial/territorial hospital spending by type of expense, province/territory and Canada (excluding Quebec and Nunavut) ,  The decline in compensation is not something intrinsic to modern hospitals.  The experience in Ontario is in stark contrast with the experience in  the rest of Canada. For provinces and territories other than Ontario, compensation is increasing as a share of total

Huge cuts in public sector wages predicted

The Ontario Financial Accountability Office (FAO)   says  that, with inflation, real wages in the public sector will decline 11.3% over the three year period  2021/2 - 2023/4 .  This would radically deepen the trend towards lower wages during the last ten years.   The FAO reports that since 2011, the average annual salary for the Ontario public sector employees (defined here as employees of schools, colleges, provincial government, provincial agencies, and hospitals) has increased by $10,385   -- or 1.6 per cent on average annually.  This is the lowest increase of all the sectors and lower than inflation, which averaged 1.8 per cent per year. Over the ten years that would be about a 2% pay cut.   The FAO reports that wage settlements were the lowest in the provincial public sector over the last decade:   Hospital Wages Especially Challenged: The FAO predicts hospital wages will increase even less than in the public sector  -- just 1.2% annually over the five year period 2021-22 t