Defend Public Healthcare

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staffing.   Less and less of hospital spending is on staff.   Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development.  It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staff per capita than hospitals in Ontario. Overall, if Ontario had the same staffing capacity as the other provinces and territories, there would be another...

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. ...

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 ...

The massive cut in the number of hospital beds in Ontario in the 1990s is, by now, well known. Community and labour movement campaigns over the last fifteen years stopped the decline in the  number of beds, but the push for cuts is relentless.  Hospital beds per capita have continued to decline right up until the most recent data reported. Moreover, Ontario remains a low capacity outlier -- with far fewer beds per capita than other provinces.   This chart excludes Neonatal ICU beds and bassinets.  CIHI does not report data, in this case, for Quebec. This Canadian Institute for Health Information (CIHI) chart (above) shows a 6.9% decline in hospital beds per capita from 2009/10 to 2018/19 .   Ontario had fewer beds than any other province reported per capita.  The next lowest (Alberta) had 12.2% more beds in 2018-19 . There was even a decline in the absolute number of Ontario ICU, Obstetric, Pediatric, and Complex Continuing Care ("LTC") beds, with th...

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 patter...

There's a lot of news stor ies of late about hospitals overflowing with too many inpatients and not enough beds. Here's some of the headlines:       What is not so often reported is that this is directly related to Ontario's policies of very high hospital bed occupancy and very few hospital beds. The graph below shows curative hospital bed occupancy in European countries -- with occupancy levels usually hovering around 75%. The exceptions are Ireland (which has well above average occupancy) and Macedonia and the Netherlands (which have well below average occupancy). Between 2008 and 2014 most countries saw a small decline in bed occupancy.  Under the OECD definition, "curative" hospital beds excludes rehabilitative and long term care beds.  Eurostat, “Health care resource statistics – beds,”  2016, http://ec.europa.eu/eurostat/statistics-explained/index.php/Healthcare_resource_statistics_-_beds Ontar...