Bill 124 a challenge to ending Ontario health-care staffing crisis, internal ministry documents say

The Ontario government's wage restraint legislation and deteriorating working conditions have played a role in the province's health-care staffing crisis, internal documents from the Ministry of Health acknowledge.

In briefing materials prepared for Minister of Health Sylvia Jones, ministry officials say shortages of nurses and personal support workers (PSWs) "have become worse" during the COVID-19 pandemic. The documents explicitly identify pandemic-related burnout, "concerns about wage disparity via Bill 124" and working conditions as the main challenges to ending shortages.

The notes say attrition among nurses in Ontario is at about five per cent annually, on par with pre-pandemic years. While nurses are not leaving the profession, the documents say, they are abandoning "front-line positions."

Increasing the number of nurses in the province and avoiding higher rates of attrition "are required to head off chronic shortages," the materials say.

For PSWs, attrition can be as high as 25 per cent each year, though it has recently averaged about 14 per cent.

"Wages and working conditions continue as key drivers" of PSWs leaving the health-care system, the internal documents say

Radio-Canada obtained the documents through a freedom of information request. They are part of a transition binder compiled in the summer to help distil key issues facing the health-care system as Jones stepped into the role of health minister. Global News Toronto reported on the findings earlier Monday. 

Premier Doug Ford's government passed Bill 124 in 2019. The law capped wage increases for public sector employees at one per cent annually for three years and was met with fierce opposition from workers, labour groups and unions.

Last November, the Ontario Superior Court struck down the law, ruling it unconstitutional because it infringed on charter rights guaranteeing freedom of association and collective bargaining. The government is appealing the ruling. 

Critics of the law have long argued that it contributed to severe health-care staffing shortages. Ford has previously said it was a necessary part of tackling the province's deficit, and that the province would bargain with individual groups in good faith as the bill's statutes expire. 

Ontario making 'good progress' on health care, ministry says

When asked to comment on the document's findings, Hannah Jensen, a spokesperson for the Minister of Health, said Ontario isn't the only jurisdiction dealing with health-care challenges..

"The challenges facing our health care system are not unique to Ontario. While there is still more work to do, early results are showing that we're making good progress on our government's plan to build a stronger health-care system."

Citing provincial data, Jensen said more than 14,500 more nurses and more than 1,000 family doctors registered to work in the province since 2018. She noted 2022 was a record year for nurse registration alone, with 12,802 nurses new to the system, according to the College of Nurses of Ontario.

"We also have a pipeline of talent in training, with nearly 30,000 nursing students currently enrolled in colleges and universities across the province."

A 'dishonour' to Ontarians needing health care

Bernie Robinson, interim president of the Ontario Nurses Association, says it's "distressing" for her to know the Ford government has this information and chose "not to act on it."

"It's a dishonour to every person who needs to access health care in Ontario," said Robinson. 

says the association has been fighting to get the staffing crisis in health care acknowledged by the Ford government.

She says Ontario has the lowest nurse-to-population ratio in all of the country and nurses are switching to the private sector.

That's why the government needs to withdraw its appeal of the court's ruling, she says.

"They could channel that funding into sitting down with us and giving us an appropriate contract, something that entices nurses to come back."

Documents a 'slap in the face,' opposition says

The Ontario NDP and the Greens also called on the government to withdraw its appeal. Both parties' statements described the documents as a "slap in the face" to health workers. 

Liberal MPP and health critic Dr. Adil Shamji said the internal documents add strength to opposition parties' arguments against Bill 124. His critiques came from his experience in the field, he says.

Shamji says the government needs to do a better job of prioritizing accountability and transparency. He says the documents indicated there was more data on nurse vacancy rates that was redacted, despite it being a public-interest issue.

"They now have to answer to their own documents, to their own ministerial briefings," said Shamji.