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Ford government stumbles into a health care staffing crisis as job vacancies top 42,000

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Job vacancies across the Ontario economy have sky-rocketed over the last two years, with a ten percent increase in 2020 and a 66% increase in 2021.  Compounded that represents an 82% increase in two years.  Correspondingly, the average offered hourly wage for all occupations went up 4.6% in Ontario (to $23.70) from the end of 2019 to the end of 2021.  The increase in job vacancies is particularly marked in health care industries. In hospitals, there has been a continuous increase in the number of job vacancies and in the job vacancy rate since 2015, with a sharp spike in the last two years. Job vacancies went from 3,635 at the end of 2015 to 8,855 at the end of 2019 (just before COVID), and then onto 16,685 by the end of 2021.  That is a 359% increase since the end of 2015 and a 88% increase since the end of 2019. The hospital job vacancy rate has increased from 1.6% at the end of 2015 to 6.3% at the end of 2021. In nursing and residential care facilities the pattern has been broadly
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Spending on health must get much larger

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The long term fiscal and economic outlook released this week by Ontario's Financial Accountability Office (FAO) shows that big increases in health care spending are required in the years ahead.   The FAO forecasts that provincial government spending on health care will increase from an average of 6.4% of gross domestic product (GDP) to 7.6% for years 2024 through 2031. It will then go to 8.3% in the 2030s and 9.1% in the 2040s. An increase from 6.4% of GDP to 9.1% is a big increase in health care's share of economic activity.   A key factor driving this is an aging population.  Older people need more health care. For the current decade (2020-30), the FAO forecasts provincial health care spending increases at 5% per year:   A key take away from this is that the health care workforce will need to expand.  The staff shortages that currently bedevil health care are going to get worse if there is not a concerted effort to recruit and retain health care staff by making health care a
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Health care support workers have the highest number of workplace injuries

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Lost time injury (LTI) claims for workers compensation by health care support workers have shot up in the last few years, even before COVID-19.     For many years, claims were in the 2,500 range, before starting an upward track in 2014, rising to 4,271 in 2019, just before COVID-19 hit.  That is about a 60% increase.   Other major occupations in health care saw the number of claims remain basically flat between 2002 and 2019 (with things changing in 2020, as we shall see).    By 2019, health care support workers had the second most workplace lost time injury claims of any occupation reported by the Workplace Safety and Insurance Board (WSIB) - only motor vehicle and transit drivers had more, with 4,901 in 2019. In 2002, health care support workers had only the eighth highest number of LTI claims. So things have changed. The increase in injury claims among health care support workers is more remarkable as WSIB has been on a tear to reduce lost time injury benefit claims – with total
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Location: Ontario, Canada
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The Ford PC government thanks hospital employees by telling them to work harder for less. And, oh yeah, we're privatizing your work.

With as much fanfare as it could muster, the Ford PC government re-announced its Budget plan of $300 million for hospitals to deal with the backlog of surgeries and procedures caused by the COVID-19 shut down of hospital services.  Despite the (attempted) fanfare, the Financial Accountability Office (FAO) has reported that the government’s budgeted plan for dealing with the backlog will fall hundreds of millions of dollars short of what is required to clear the COVID-19 backlog over three and a half years . The government says it is not working with the FAO estimates (indeed) and declined to make an estimate of how long it would take to deal with the backlog. The government did, however, state that it will “closely monitor” surgical outputs and wait times and will “implement additional measures if needed”. The government claims the funding will enable hospitals to operate at 110-115% capacity. Operating room hours will be extended into the evening and weekends.  That's a lot
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Doug Ford and the PCs plan another decade of austerity -- except even harsher this time

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Ontario's Financial Accountability Office (FAO) reports that the nominal health care funding increases planned by the Ford PC goverment between 2019/20 to 2029-30 fall well short of the nominal increases over the previous nine years (2010/11-2019/20, the period of public sector austerity that followed the last recession). Indeed, as the increase planned on a go-forward basis (between this year, 2021-22, and 2029/30) amounts to only 2% annually , we are looking at significantly harsher austerity than the 2010/11-2019/20 period , where funding increased 3.2% annually. As the FAO notes, the health care austerity imposed over 2010-20 "included a number of significant spending restraint measures, including: freezing base operating funding for hospitals from 2012-13 to 2015-16; reducing physician payment rates in 2013 and 2015; and limiting investments in new long-term care beds, with only 611 new beds created between 2011 and 2018."   This time around the plan is to impose h
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Ford PC government plans years of cuts to hospital services

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The pandemic led to a brief reprieve from the austerity that has bedevilled Ontario hospital care since the great recession. After decades of being on par with other provinces, hospital funding fell far behind the rest of Canada. At the start of the pandemic the Ontario government was obsessed with the lack of capacity in Ontario hospitals, tragically compounding the crowding in long-term care by ordering hospitals to discharge patients to long-term care.  Despite the mass death in long-term care, very few sick or dying resients were transferred for treatment in hospital. They died in their homes.   But the government also moved to increase hospital funding in 2020-21 -- increasing it by more than ever before. That new money is temporary, however.   Cuts are coming: The government established a budgeting system in 2020-21 which would see much of the COVID-related funding budgeted under special funds distinct from the normal ministry line items. So, much of the increased funding for th
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The Ontario Budget: Hard Times Ahead

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Health Care: To ease future cuts, the government established a budgeting system this year which would see much of the COVID-related funding budgeted under special funds distinct from the normal ministries. So much of the increased funding for the Ministry of Health or Ministry of Long-Term Care is not reflected in their line items but instead through special funds that are then later allocated to a ministry. So first the good news: The health and LTC  special COVID funds  are “budgeted” to continue for a couple of years.  An additional $4 billion in 2021–22 and $2 billion in 2022–23 is currently planned to help the health sector address COVID-19.   The bad news, however, is that even with that continuation of special COVID funds, overall health care and LTC funding is budgeted to go down -- by $1.9 billion in 2021/22 and another $500 million in 2022/23. That's a lot of cutting.  Of course that is “down” after a major increase this year.  Including the special funds, $72.8 bil
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