Ontario Health Coalition

The increase in private for-profit ownership and control in Ontario’s health system has been growing steadily for at least a decade. More recently, it has grown by leaps and bounds with the introduction of private hospitals (P3s), private diagnostic clinics, private homecare, and increased privatization in long term care. Worldwide evidence shows that for-profit healthcare drives up costs through duplication, higher administrative costs, outrageous executive salaries, increased advertising, and profit-taking. Higher costs lead to a reduction in the scope of services that can be provided in the public health system and have a dramatic impact on its accessibility, comprehensiveness and universality. The protection and extension of public Medicare relies on the stopping of the privatization of the health system.

Stop For-Profit (P3) Hospitals

Conservatives

Will create more for-profit (P3) hospitals. Will extend privatization in hospitals to a range of services including laundry, dietary, maintenance, ownership, management, patient records, laboratories, diagnostic clinics and others.

Liberals

Oppose for-profit P3 hospitals. No clear plan to fund the construction and redevelopment of hospitals publicly.

NDP

Oppose for-profit P3 hospitals. Have promised to build public hospitals in Ottawa and Brampton where the first P3s are proposed.

Conservatives

Will build more for profit MRI/CT clinics.

Liberals

Oppose for-profit MRI/CT clinics. Will return the recently built private clinics to the public system.

NDP

Oppose for-profit MRI/CT clinics. Will return the recently built private clinics to the public system.

Conservatives

Will continue with for-profit homecare.

Liberals

Will continue with for-profit homecare.

NDP

Access to publicly covered services has been compromised due to deep cuts to hospital budgets in the mid-1990s, poorly managed health restructuring and poor planning for human resources needs. Planning for population need, stabilizing and improving access to needed services, and ensuring publicly funded coverage are necessary to restore and strengthen public medicare in Ontario. We have identified some key "hot spot" health issues to assess the parties’ intentions as reviewed below.

Conservatives

Have introduced a bigger second tier by allowing for-profit clinics to charge out-of-pocket and allow queue-jumping for so-called medically unnecessary scans. Will continue with privatized, two-tier clinics. No promise to provide operating funds for communities that have raised money themselves for public scanners.

Liberals

Support the recommendations of the Romanow Commission that call for putting all streams of people waiting for diagnostic scans onto the same waiting list and serving that waiting list according to need, not payment. Will pass a Commitment to Medicare Act to prohibit two-tier Medicare & commit to building capacity in the public system.

NDP

Support the recommendations of the Romanow Commission that call for putting all streams of people on waiting lists for diagnostic scans onto the same waiting list. Will stop two-tier access. Will enhance capacity in the public system. Will entrench public health care in law.

Conservatives

Have cut the accessibility of home support services to tens of thousands of Ontarians. 115, 000 patients were removed from care lists from 2001 —2003. There is no promise in their platform to restore access to these services for frail & elderly Ontarians.

Liberals

NDP

Promise to increase homecare hours. Promise to bring homecare & long term care under the principles of universality & accessibility in the Canada Health Act.

Conservatives

There is no promise to do this. Fees will continue to increase over next two years.

Liberals

Commit to a seniors’ strategy that will cancel the recent fee increase. No clear commitment on improving public funding in the platform but the party is on the record calling for improved funding.

NDP

Promise to cancel the fee increase and increase public funding & accountability. Commit to ensuring that increased funding goes to residents’ needs, not profit.

Conservatives

There is no promise in their platform to do this.

Liberals

Commit to implementing standards of care at undefined levels and providing regular inspections.

NDP

Commit to implementing standards of care at undefined levels and increasing personnel in facilities. There is no clear platform commitment to increasing inspections, but the party is on the record calling for regular, unannounced inspections.

Conservatives

Deep cuts to hospital budgets (almost $1 billion) in the Conservatives’ first term in office, unstable funding and late announcements of hospital budgets have led to huge cuts in hospital staff & nurses, and an increasingly casualized (part time & temporary) workforce. Since the Conservatives were elected the number of Ontarians without access to a family physician has grown to an unprecedented 900,000. The party platform promises incentives for medical & nursing students to work in underserved areas, expansion of family health networks, and increased immigration of international physicians & nurses. The party reiterates promises to improve the predictability of funding for hospitals but leaves the level of funding in question as it will be based on factors such as the economy, federal funding, and performance. This leaves hospitals at risk for budget cuts just when they may need funding the most.

Liberals

Promise to increase medical & nursing school enrollment, make medical school tuition more affordable, provide incentives to choose family medicine, and help international physicians to practice here. Promise to create more full-time nursing and nurse practitioner positions. Promise to create 150 family health teams of physicians and other health professionals.

NDP

Conservatives

Since elected in the mid-1990s, Community Health Centre budgets have been frozen. There is no promise in their platform to create more centers or improve funding to them.

Liberals

Will create a system of support and incentive for family physicians to practice in care teams but do not commit to creating or improving CHCs with a full range of services and democratic community control.

NDP

Promise to build 100 new Community Health Centres and expand existing CHCs

Conservatives

The massive hospital cuts brought in by the Conservatives led to the closure of approximately 9,000 critical, acute and chronic care beds and the lay off of approx 25,000 staff positions in hospitals. In the ensuing crisis, some beds were re-opened and hospitals attempted to attract back nurses and other staff who had been cut. Hospital funding is routinely announced late and is unpredictable, leading to casualization (more temporary & part time) workforce, and hospital debt. The Conservatives have promised to announce hospital budgets on time & provide multi-year funding. However, they have tied funding to economic performance, federal-provincial relations and hospital performance. This does not assure predictability of funding.

Liberals

Promise stable multi-year funding, a moratorium on emergency room closures, and a re-opening of 1,600 beds.

NDP

No clear promise on this in the party platform. However, the party is on record opposing the funding and bed cuts and criticizing the Conservatives’ late budget announcements.

Conservatives

Since elected, the Conservatives have promoted privatized services which restrict public access to information and remove democratic control. In 2001, they passed legislation wiping out community memberships and Boards for homecare, replacing them with political appointees. The Conservatives oppose Romanow’s recommended Health Council that would monitor and report on health spending. They propose an appointment of a Health Quality Auditor to see how provincial money is spent, but do not promise to disclose this information to the public or improve public access to information about health spending. Since elected, they have undertaken massive changes to the health system with little or no public consultation & input. There is no proposal to improve democratic control over the system.

Liberals

Promise to create an independent Health Standards Council to report on performance to Ontarians. Promise to give the Provincial Auditor authority to audit all health care agencies and deliverers. There is no clear promise to revoke the Conservatives’ legislation that wiped out community boards and memberships of Access Centres that govern homecare. However, the Liberals are on the record as opposing this legislation when it was passed.

NDP

Promise to restore community control over homecare & make funding in long term care transparent and accountable. Propose an independent Health Care Standards Commissioner to set standards of care, enforce standards and patient rights and report on what is happening in the health system. Promise a patients’ bill of rights and whistleblower protection for staff who report on poor management practices.