COPE ONTARIO HEALTH CARE REPORT (July 2022)
COPE Ontario is instituting a regular health care report for COPE members four (4) times a year. The health care report will keep COPE members updated on the changes occurring in health care and the impact of changes on COPE health care workers.
The next issues of the COPE Health Care Report for 2022 will be in October and December. In 2023 the health care report will be quarterly.
New Health Minister:
The Ministry of Health of Ontario is the ministry responsible for the administrating the healthcare system in Ontario. On June 20, 2019, the Ministry of Health and Long-Term Care were split into two (2) separate ministries, the Ministry of Health and the Ministry of Long-Term Care.
Premier Doug Ford unveiled his new cabinet on Friday, June 24, 2022. The new Minister of Health is Sylvia Jones, who will also be the Deputy Premier of Ontario.
She takes over from the former Minister of Health Christine Elliot who did not seek re-election after serving in the role for more than two (2) years of the COVID-19 pandemic. Sylvia Jones is the member representing Dufferin-Caledon and has held this seat since she was first elected following the 2007 general election.
She was appointed to the provincial cabinet after the Conservative Party formed government in 2018, and has been the Minister of Tourism, Culture and Sport, Minister of Community Safety and Correctional Services and the Solicitor General of Ontario.
She attended Fanshawe College, where she received a diploma in radio broadcasting. She also worked as an executive assistant to former Progressive Conservative (PC) leader John Tory. The Ministry of Health consumes almost half (75 billion) of provincial program spending.
Ministry of Long-Term Care:
The Ministry of Long-Term Care’s role in health care is to ensure that Ontarians have access to quality long-term care in a safe, home-like environment.
Minister of Long-Term Care:
Paul Calandra will remain as the Minister of Long-Term Care. He has served as a Minister in the Ontario cabinet since 2019. He has been the government house leader for the Progressive Conservatives since 2019, Minister of Legislative Affairs and Minister of Long-Tern Care since 2022. He represents Markham-Stouffville in the Legislative Assembly of Ontario.
Canada Health Act:
The Canada Health Act is a statute of the Parliament of Canada, adopted in 1984, which establishes the framework for federal financial contributions to the provincial and territorial health insurance programs, commonly known as “medicare.” The Canada Health Act is federal legislation that provides the foundation for the Canadian health care system. The Act is administered by Health Canada, the federal department with primary responsibility for ensuring and improving the health of Canadians. The Act also establishes certain principles and sets out the criteria and conditions that each health insurance plan, such as OHIP, must meet in order to receive funding. These requirements are public administration, universality, comprehensiveness, and accessibility. Extra billing is also banned by the Act. In order to qualify for federal funding, provinces and territories must provide coverage for all “insured health services” which includes hospital services, physician services, and surgical-dental services provided to insured persons, if they are not covered by any other program. “insured persons” is defined as anyone who is a resident of a province or territory and lawfully entitled to be or remain in Canada.
The provinces and territories administer and deliver most of Canada’s health care services, with all provincial and territorial health insurance plans expected to meet the national principles set out under the Canada Health Act. Each provincial and territorial health insurance plan covers medically necessary hospital and doctor’s services that are provided on a pre-paid basis, without direct charges at the point of service.
The role of the Ontario government in health care includes:
- Administration of health insurance plans;
- Planning and funding of care in hospitals and other health facilities; such as services provided by doctors and other health care professionals;
- Planning and implementation of health promotion and public health initiatives; and
- Negotiation of fee schedules with health professionals.
Section 15 of the Canada Health Act allows the federal government to withhold all or part of the transfer payment to a provinces and territories for non-compliance with the Act.
Hospital Sector Update:
Several COPE collective agreements have been resolved for the next period of time up to and including March of 2024, e.g., Smooth Rock Falls Hospital and the Smooth Rock Falls Detoxification Centre,
Dryden Regional Health Sciences Centre March 31, 2023
Thunder Bay Regional Health Sciences Centre is proceeding to interest arbitration.
Sensenbrenner Hospital and London Health Sciences Centre are currently in negotiations.
The Canadian Union of Public Employees (CUPE) and the Service Workers International Union (SEIU) have been bargaining with centrally with Hospital Employers. Negotiations have reached an impasse and an arbitration date has been set for either late June or early July. The arbitration award when issued will affect approximately 70, 000 health care workers in the hospital sector primarily service and clerical worker and Registered Practical Nurses.
The Ontario Public Sector Employees Union (OPEU) have been bargaining in the hospital sector centrally for paramedical workers and received an interest arbitration award on July 7, 2022. Their current collective agreement expired on March 22, 2022. The new collective agreement is for the period April 1, 2022, until March 31, 2025. This award affects approximately 12, 536 employees in 59 different hospitals
The wage increases awarded were 1% in each year of the collective agreement, as per Bill 124, effective April 1, 2022, 2023 and 2024. Slight increases were also awarded for evening and weekend premiums in each year of the agreement. The Board of Arbitration also awarded language dealing with the elimination of a bargaining unit position.
The Ontario Nurses Association (ONA) The current hospital central agreement expires March 31, 2023.
Home and Community Health Care Update:
Bill 175 which was proclaimed on July 8, 2022, repeals the Home and Community Services Act and results in most details being dealt with through policy or regulation. As a result, the Ministries of Health and Long-Term care will fund Ontario Health. Ontario health will then fund numerous Ontario Health Teams (OHT) and Health Service Providers (HSP). They will then contract for home care. Home care providers will employ home care workers and take over coordination responsibilities, which are currently provided by Local Health Integration Networks (LHINs).
Bargaining is occurring with several of the Home Care programs.
Bargaining is currently taking place between COPE Local 550 the Toronto Central LHIN. The parties are awaiting a date for conciliation.
Bargaining between several Counselling Centres and COPE has either been completed or is currently underway.
Public Health Update:
Bargaining with the Public Health employers and COPE Locals will be commencing later this year.
Privatization of Healthcare in Ontario – Part 1
Medicare is a publicly funded single-payer system that is a source of national pride in Canada. Proponents of privatization of healthcare believe that private healthcare should be allowed to operate alongside Canada’s publicly funded Medicare. Among the Organizations for Economic Co-operation Development (OCED) countries with publicly funded healthcare Canada is considered middle of the road with a 70% :30% public-private split of healthcare expenditures. It was not that long ago that virtually all Canadian medical care existed in the public sphere. Further privatization of Canada’s healthcare system will siphon talent and resources away from Canada’s already overstretched public health system. Many advocates of further privatization of healthcare argue that private healthcare should be allowed to operate alongside Canada’s public funded Medicare system.
Ontarians should be aware and concerned about the continuation of privatization of social and public services that the Ford government continues to impose on the public. The government continues to claim that privatization will save taxpayers money, although there is abundant evidence that privatization does not save money, and that it almost always results in a lower quality of service. Some examples of privatization by the current provincial government include the contracting out of the care co-ordination role for home care and the continuation of privatization of long-term care homes. The Ford government is currently in the process of privatizing 18,000 long-term care beds over the next thirty (30) years. They have also passed legislation to privatize the remaining parts of homecare. The Ford government has also expanded the private sector’s role in COVID-19 testing and vaccination.
On July 15, 2022, the Court of Appeal for British Columbia ruled that access to health care should be based on need not ability to pay. In addition, the Court said that allowing private care would endanger the public health care system. Dr. Brian Day, an orthopedic surgeon and chief executive officer of Cambie Surgeries Corp., has been fighting for over thirteen (13) years to loosen access to private medical care ,has again lost the battle in the Court of Appeal.
On February 1, 2022, Christine Elliot the Minister of Health for the Province of Ontario while announcing the resumption of procedures and surgeries after the Omicron wave stated “we are opening up pediatric surgeries, cancer screenings, making sure that we can let Independent Health Facilities (IHF) operate private hospitals, all of those things are possible because we do have the capacity. “This means that the government is going to permit private clinics operate private hospitals. Under current legislation for profit hospitals (private hospitals) have been prohibited since 1973. According to the Ontario Health Coalition this signals that the Ford government plans unprecedented for-profit privatization of health care which would be a mortal blow to the public health system.
In Ontario there are currently about eight hundred (800) Independent Health Facilities that primarily provide diagnostic services such as x-rays, ultrasounds and sleeping studies. About 25 IHF’s provide other services including surgeries such as cataract and plastic surgery, and dialysis. IHF’s provide these services at no charge to patients who are insured under the Ontario Health Insurance Plan) OHIP).
IHF’s are independently owned and operated, and 98% of them are for profit corporations. It is estimated that about half of them are owned by or controlled by physicians.
Expanding the privatization of health care leads to increases in staffing shortages driving skilled health care workers from public hospitals to private clinics.
Private hospitals\clinics take easier and less complex cases, leaving patients with more complex and serious conditions to wait longer for treatment in understaffed and underfunded public hospitals. Private hospitals\clinics also charge user fees and extra bill patients for medically necessary services.
Part 2 of the article on Privatization of Ontario’s Health Care system will appear in the October issue of the COPE Ontario Health Care Report.
COPE HEALTH CARE SECTOR MEETINGS:
COPE Ontario is holding regular health care Sector meetings. The next health care meeting is scheduled for September 23rd, 2022, from 6 pm until 7:30 pm.
If you would like to attend the regular healthcare sector meetings, please notify Pina @copeontario.ca and she will send you the zoom meeting link for the September 23rd meeting.
COPE Ontario represents approximately 6,000 workers in various public and private sectors such as Health Care, Education, Financial Services and Labour Organization, Non-Profit and Government Agencies throughout the Province of Ontario.