As a field with a high-pressure working environment, that is often overlooked and underappreciated, it has always been challenging to attract and retain healthcare workers across Canada. This shortage of workers was only further exacerbated as a result of the pandemic, which left large gaps in patient care resulting in increased demand post-pandemic as well as a large group of burnt-out workers choosing to exit the field entirely. Now, with COVID-19 in the rearview, the Government of Ontario is turning its attention to retaining and attracting healthcare workers to the province.
Throughout the last several years the Government, and specifically the Ministry of Health and the two different Ministers tasked with managing the portfolio since the PC’s took power have introduced a wide range of policies and programs to increase healthcare human resources in the province to support the already overwhelmed healthcare system.
These initiatives have included:
- Introduction of ‘As of Right’ rules: This new initiative allows healthcare workers who are already licensed or registered in other provinces to begin work immediately upon arrival in Ontario, without first registering. This program is the first of its kind in Canada, and will allow workers to simultaneously complete their registration while working in Ontario.
- Practice Ready Ontario: This program allows internationally-trained family physicians to take part in a 12-week clinical field assessment. If the physician passes the clinical assessment, they will be eligible to practice in the province and sign on to a three year contract to work in the province. This program is expected to add 50 physicians to Ontario in 2024.
- Ontario Learn and Stay Grant: This grant provides funding for students studying in priority programs in high-need communities that covers the cost of educational expenses, in exchange for the students working in the communities post-graduation. In Budget 2023, the government extended the program to include nursing, medical laboratory technologist, and paramedic programs in specific communities.
- Supervised Practice Experience Partnership Program: This program offers internationally trained nurses the opportunity to undertake a supervised clinical assessment in order to demonstrate their knowledge, and meet their practice and language proficiency requirements to begin practicing in Ontario. In Budget 2023, the government indicated that 1,300 nurses had already been fully registered in Ontario.
- Expanding enrollment opportunities in post-secondary education: To advance long-term increases to the healthcare workforce, the Ontario government has focused on expanding seats within healthcare programs, with a specific focus on nurses and physicians. In Budget 2023, the province promised to add 154 postgraduate medical training seats, on top of the 295 additional seats announced the previous year.
POLITICAL CONTEXT
Overall, healthcare work retention is an issue plaguing all provinces across the country. In the first quarter of 2023, Statistics Canada reported 11.3% of health occupations were vacant, with the top 3 occupations with the highest increase in vacancies being within the healthcare sector.
In order to address this issue, all provinces have been employing various strategies and initiatives to attract health care workers from both within Canada and internationally. For example, British Columbia has offered to cover application and assessment fees for internationally-trained nurses, Manitoba organized a 5-day recruitment mission to hire healthcare workers from the Philippines and Nova Scotia created an Office of Health Care Professionals Recruitment to drive its recruitment efforts.
As the most populous province, Ontario faces significant backlogs and shortages that require solutions. Healthcare retention is just one piece of the puzzle, as the government has brought forward wide ranging healthcare programs and initiatives throughout the last year to address wait times, procedure backlogs and access to community services. Much of its current recruitment and retention efforts were first released in Bill 60, also known as “Your Health: A Plan for Connected and Convenient Care”. While much of the coverage around this bill focused on its expansion of community-delivered services, it also included an entire pillar focused on hiring more healthcare professionals.
Overall, the opposition reaction in Ontario to the government’s initiatives have focused primarily on opposing the expansion of private delivery and Bill 124. The Ontario NDP has indicated that the government must repeal Bill 124, the bill which caps public sector wage increases to 1% per year, in order to stabilize the healthcare workforce. Additionally, they have called on the government to end the use of for-profit nursing agencies to staff the healthcare system.
Healthcare continues to be a top priority for the Ontario government as, according to Angus Reid, it is currently ranked the second most important issue among voters in Ontario, only preceded by cost of living. Within this polling, most Ontarians feel the government has done a poor job handling the issue (77%), indicating a need to continue prioritizing healthcare.
WHAT IS THE GOVERNMENT SAYING?
“Our government is growing our health care workforce to make it easier for people to connect to the care they need for years to come. These new initiatives will allow international physicians to work sooner, support experienced nurses to share their skills and knowledge, and explore innovative ways to grow our workforce for future generations.” – Sylvia Jones, Minister of Health
WHAT ARE EXPERTS SAYING?
“Ontario’s hospitals appreciate the programs introduced…to reduce barriers for internationally educated physicians, provide additional support to new, early career and internationally trained nurses, and allow hospitals and other system providers to develop innovative models of care to maximize capacity and strengthen access to care. Ontario’s hospitals are grateful for the ongoing investments made by the Government of Ontario that have had a meaningful impact on strengthening the province’s health care workforce. Hospitals will continue to work with the Ministry of Health, Ontario Health, and other partners to identify and implement new ideas and solutions in the time ahead.” – Anthony Dale, President and CEO, Ontario Hospital Association
NEXT STEPS
Overall, it seems that the government’s initial strategies have had some success. The government has reported that over 15,000 new nurses registered to work in Ontario in 2022.
As of Right rules took effect on July 24th, 2023, thus it is not yet clear the success of this program and how it will further bolster Ontario’s healthcare capacity. The outcomes of this initiative will be closely monitored by other provinces, as Ontario is the first to implement this type of policy.
With the PCs still leading provincial polls paired with a reported low satisfaction on its handling of the healthcare file, the government is likely to continue to prioritize healthcare and hopefully, achieve long-term success to further advance its approval ratings.