Northerners looking for more details of election health care promises, skeptical of change

All major parties in the Ontario election are putting price tags on hiring doctors to connect millions of Ontarians to primary health care, but some in northeastern Ontario say details are scarce and money alone won't fix the problem.

Just prior to the snap election call, Progressive Conservative Health Minister Sylvia Jones promised $1.8 billion to expand health teams across the province in an effort to connect two million Ontarians with family physicians by 2029.

Since then, Ontario liberal leader, Bonnie Crombie, has promised $3.1 billion to recruit an additional 3,100 family doctors by 2029, along with what Crombie calls a "guarantee" of a family doctor for everyone in Ontario. 

NDP leader Marit Stiles says the party, if elected, would spend $4.05 billion to recruit 3,500 new doctors over the next four years — more money and more physicians than either the PCs or Liberals. 

She's also framing the promise as a "guarantee" of access to a family doctor.

Green Party Leader Mike Schreiner has said his party is "committed to ensuring that everyone in this province has access to a family doctor, nurse practitioner, or primary healthcare provider," but hasn't released details yet.

There are few details from the parties on how the money will be spent across the province and fewer still on addressing the crisis in northern Ontario, which has its own unique set of obstacles, said a couple of health care providers in the region.

The remote and rural nature of the region complicates and compounds the stress of  providing family care, said Dr. Kevin O'Connor, making it unattractive to the dwindling number of medical graduates who chose family medicine.

As a rural generalist in Mindemoya, on Manitoulin Island, he provides primary care as well as emergency room coverage without much of the support that doctors in cities like Sudbury have.

He said he's not reassured by the emphasis on promises to put money toward hiring more doctors because he said it's more complicated than that, and is urging politicians to take a deeper look.

"I'm very frustrated to a certain extent by these platforms, in that all they talk about, and this sounds funny for me to say, is doctor, doctor, doctor, doctor, doctor," he said. "We need to talk about the system, we need to talk about nurses, we need to talk about whole teams and how things are going to be allocated."

O'Connor said he thinks the politicians, instead of promoting doctors as a solution, should tap the skills of other health care providers so doctors can focus where they are really needed.

"Maybe you're not going to have your own family doctor the Norman Rockwell way 50 years ago, but you're going to have access to this team," he said. "And then there will be family doctors involved, maybe with their name on the patient, but that's not who you're going to see every time."

Jennifer Clement is a nurse practitioner who worked in a clinic for 18 years and recently left to start a consulting company called Clement-Scarfone and Associates.

While she also supports the team approach, she said at her former clinic, it was a continuing problem to recruit staff.

"Especially the further north you get, it's very hard to attract staff," she said. "So I haven't seen anything about that plan. And from what I understand nobody's really talked about it yet. How are they going to attract people to work in these rural communities?"

NDP Leader Marit Stiles launched her health platform in Sault Ste. Marie, making mention of a 'northern command centre" to manage capacity but not giving much information about what that means.

"The needs of the north are very different than the needs down south," said Clement. "Our distance, driving across our region. So it would be interesting to see what that looks like; saying it, unfortunately, right now, is just a lot of lip service." 

While both Clement and O'Connor said how the parties handle the health care crisis influences their votes, it may also be crucial to those receiving care.

Laurie Kendrick moved to Sault Ste. Marie three years ago to help support her parents who lost their family doctor, and in doing so lost access to her primary care provider.

She has spent a lot of her time shepherding her elderly parents to various appointments and spells at the emergency room as illnesses flared up.

"You're really kind of just managing each crisis as it comes along," she said. 

How politicians manage health care is still a key influence as she heads to the polls, despite the recent diversion in the headlines to the threatened trade war with the United States.

"It's still going to remain a primary issue way more than tariffs," she said. "They will come and they will go. But this is where we're stuck right now. It is a really awful place to be for elderly and other people as well." 

She does remain hopeful since her father was recently assigned to a nurse practitioner and will receive continuous care. Her mother passed away in December, she said, after a fall.

Slim hope for solutions in four years

Clement, Kendrick and O'Connor say they doubt the election will be a catalyst for real change, and are highly skeptical that most, or all, Ontarians will be connected with a family doctor in the next four years as promised.

O'Connor said the flaws in the system are too deeply embedded.

"We're in a bit of a doom loop, right now," he said.

"We're getting by with locums and agency nurses that are more expensive than the usual doctors and who come in and can make good livings and get out, and not have to be in the community.  And, you know, God love them. We need all those people. But what we're doing to fix the problem is at the same time perpetuating the problem. So what we need is some higher level thinking about the structure and how we can get a reset."

He's encouraging some real structural change but says there's no evidence that the parties are digging into the problem.

"The headlines are so unrealistic: a doctor for everybody, trust my party." he said. "I don't think that they're thinking hard enough about it or taking it seriously enough, at least in their messaging. I think they're just saying what people want to hear."