Ontario will be short 33,000 nurses and PSWs by 2028, financial watchdog projects

Ontario is projected to be short 33,000 nurses and personal support workers by 2028 despite Premier Doug Ford's investment in the sector, the province's fiscal watchdog said in a special health-care report released Wednesday.

The Financial Accountability Office (FAO), which is a body that provides independent analysis on the state of Ontario's finances, also says the government will be short $21 billion to cover its commitments over a six-year period to expand hospitals, long-term care and home care.

Ontario's health-care system has buckled in recent years with severe staffing shortages that have led to temporary emergency room closures, a massive surgical backlog and fed-up patients.

And according to Financial Accountability Officer Peter Weltman, "challenges are expected to persist across Ontario's health-care system.

"Relative to projected growth in demand, by 2027-28, Ontario will have less hospital capacity, similar home-care capacity and less long-term care capacity compared to what it had in 2019-20," wrote Weltman in the report.

Weltman said the current shortage of nurses and personal support workers will persist for the next six years.

"These nurse and PSW shortages will jeopardize Ontario's ability to sustain current programs and meet program expansion commitments," Weltman wrote.

Demand would 'more than offset' investments: FAO

While the Doug Ford government has committed to making "significant" investments in these areas, the FAO says even if it were to see them all through, it would be "more than offset" by demand for health services, particularly as the population ages.

In addition to the nurse and PSW shortage, the FAO predicts the province is likely to be short 500 beds out of the estimated 7,500 beds needed just to serve the growth in demand for hospital services.

The financial watchdog says the province could address the funding shortfall by incrementally spending more in upcoming budgets and a boost from Ontario's ballooning contingency fund.

Premier Doug Ford took issue with the report, calling it a "snapshot in time."

"We're throwing everything in the kitchen sink at health-care," Ford said at a news conference Wednesday.

He called the report "frustrating" and said the fiscal watchdog did not take into consideration Ontario's pending health-care deal with the federal government that will see $8.4 billion in new money plus $776 million in a one-time top up to address "urgent needs."

Province says it 'broke records' on nurse registration last year

A spokesperson for Health Minister Sylvia Jones says the province is investing heavily in health care, has reduced wait times for key surgeries and "broke records" by registering more new nurses in 2022.

Hannah Jensen says they will use money from the pending health-care deal with the federal government to hire more nurses and sign up more people with family doctors. 

But the Ontario NDP, the official opposition, says the FAO report shows Ford has "fundamentally failed Ontarians."

"Year after year, Ford has refused to fund the health care services that all Ontarians deserve, and support the health care workers who care for us in times of need," said France Gélinas, NDP health critic in a release.

"Unless Ford makes a change right now, Ontario will have less hospital capacity and less long-term care capacity in 2028 than we did a decade ago."

Report comes as province pushes plan to reform health care

Nursing shortages caused emergency departments to shutter temporarily for days or even weeks at a time last year. There were at least 145 unplanned emergency department closures across the province in 2022, Weltman wrote.

In 2022-23, the average length of stay for patients admitted to an emergency department was 20.9 hours, a 34 per cent increase compared to the five-year period before the pandemic hit, the report said.

The fiscal watchdog also said that as of September there were 250,000 people on the province's surgical wait list. Weltman said the province has yet to return to pre-pandemic levels of surgeries performed despite Ontario's $858 million investment on the issue.

Ford and the health minister's office refuted that, saying the wait list was now down to about 203,000 people, close to pre-pandemic numbers.

Pediatric hospitals were also overwhelmed in the fall as they dealt with thousands of really sick children in intensive care units and emergency departments.

Nearly 12,000 children are awaiting surgery and more than half of them have waited beyond the clinically recommended time.

Ford said the report shows why change is needed in the health care sector, citing his recent push to expand private surgery clinics. The province is in the midst of a plan to reform health care and alleviate strain on the system.

As part of its reform efforts, the province has tabled legislation that will see more cataract surgeries performed in private clinics. It is also creating a new surgical system for hip and knee replacement procedures to be done in private clinics.

Ford has said patients will not have to pay for the services, but critics have warned of upselling by the private clinics.