Defend Public Healthcare

Cascading health care cuts are resulting in significant problems for home care patients and their families, seriously undermining the main defense the government makes for its policy of hospital and long-term care cutbacks.  With hospital cutbacks and a virtual freeze on long-term care beds, home care and unpaid caregivers must now take care of sicker and sicker patients. This change in home care has been sudden and dramatic, as demonstrated in the graph below  from the the Ontario Association of Community Care Access Centres (the OACCAC represents the public sector organizations which manage home care for the government).   The OACCAC suggests  this shift means home care now replaces 150 long-term care homes, each with a capacity of 130 residents.  The OACCAC estimates cost pressures of about 5% per year to offset demographic changes and for the absorption of patients that would otherwise have been treated in hospitals or long-term care.  The OACCAC adds that funding has f

The Ontario government recently  put out a release bragging that they will fund $50 million per year to renew existing hospital facilities.  However, in her September report the Auditor General reported that  Ontario hospital funding is less than the renewal needs for existing hospitals. "The assessments of hospital facilities identified $2.7 billion dollars of renewal needs, requiring annual funding of $392 million to bring assets to what is considered good condition. However, since 2014/15 actual annual provincial funding has been $125 million..."  In other words, the government has put out a release announcing that they are reducing hospital capital renewal funding -- from a   level that was already only a fraction of what is needed to bring hospitals to good condition. The release also brags that they will provide $12 billion over ten years for new hospital facilities (as distinct from funding to renew existing hospital facilities discussed above). That

New hospital inpatient length of stay data published by the Canadian Institute for Health Information (CIHI) indicates [1] Ontario lengths of stay continue to decline, but the pace of decline has picked up, and [2] the gap between the Ontario and Canadian average length of stay is growing and has now hit startling levels. Since 2007/8, Ontario inpatients have 0.6 fewer days in hospital. This is a decline in length of stay of 8.7%. The Canadian average declined only 0.1 day (1.3%). The Ontario decline corresponds with the real funding cuts for Ontario hospitals in recent years. Much of this occurred in the last year -- Ontario inpatients had 0.3 fewer days in 2014-15, a decline of 4.6%. The Canadian average is now 1.2 days longer – or, put another way, Canadian patients stay 19% longer. This corresponds with the extra funding Canadian hospitals get compared to Ontario hospitals.  The trend is even more apparent if we look at “age standardized average length of stays” (

There has been a general trend downwards in public sector employment in Ontario according to Statistics Canada. In the last two years, Ontario has lost 19,000 public sector workers, with most of the loss occurring in the last year. The downwards trend in Ontario contrasts with the upward trend across the rest of Canada.  While Ontario lost over the last two years, the rest of Canada gained 73,400. Over the last year the rest of Canada gained 65,300 public sector jobs, while Ontario lost 12,700 public sector jobs. This may understate the cuts in the Ontario broader provincial public sector (i.e. public sector workers, like health care workers, that are primarily funded by the province, excluding federal and municipal employees). Austerity has been much harsher for the Ontario government than the federal and Ontario municipal governments. So the Ontario broader provincial cuts may be softened by modest growth in the federal and municipal sectors. The level of public

Health care and hospital funding : Despite significant new revenue and lower than expected debt costs, health care spending is almost exactly identical to the amounts planned in last year’s Budget for 2015-2018.  The total health budget for 2015/16 came in (on an “interim” basis) basically the same as planned in the 2015 Budget (that is unusual, more often they under-spend the health budget).    For 2016/17 and 2017/18, they plan to keep basically to the targets set out in the 2015 budget (plus a small increase of $100 million in each of those two years -- an extra 0.2%).  Overall, health is planned to increase 1.97% in 2016/17 and 1.93% in 2017/18. That will see health expenditures fall again as a percentage of the economy but is a little bit higher than the planned all-program expense increase (of 1% in 2016/17 and 1.7% in 2017/18).  That is far short of costs pressure due to increased utilization, aging, population growth, and inflation.  Hospitals are budgete

Federal Health Cash Transfers  ("CHT") to the Ontario government will rise 5.94% in 2016/17, or by $778 million. This, in itself, would pay for a 1.5% increase in Ontario health care funding even without a single extra penny from Ontario tax revenues.  This follows a $736 million increase (5.96%) to federal health care cash transfers to the province of Ontario for this year. Despite this, the Canadian Institute for Health Information (CIHI) estimates that total health funding by the Ontario government is only going up by about $352 million this year -- or about 0.7%. This falls well short of aging, inflation, utilization, and population growth cost pressures and deepens  the trend in recent years to reduce health care and hospital funding in real terms.  So far, there are precious few signs that the government will reverse its policy of health care austerity in its upcoming 2016/17 budget. Likely, Ontario funding will fall far behind federal health care funding once