Read how the OMA is advocating for doctors and patients with the Ontario government
On Thursday, March 23, 2022, Ontario Finance Minister Peter Bethlenfalvy laid out the government’s budget for the fiscal year 2023-24, or until March 31, 2024.
The budget, Building A Strong Ontario, is focused on strengthening the economy by attracting investment, building infrastructure, lowering costs and delivering better services.
The government is projecting a deficit of $1.3 billion in 2023–24 and is on track to post a surplus of $0.2 billion in 2024–25, three years earlier than forecasted in the 2022 budget. The government is also projecting a surplus of $4.4 billion in 2025–26.
Provisions in the provincial budget align with all five pillars in the OMA’s roadmap for the future, Prescription for Ontario: Doctors’ 5-Point Plan for Better Health Care.
Highlights related to physicians and the health-care system
- Health expenditures are expected to increase by 8.1 per cent from $74.9 billion in 2022-23 to $81 billion in 2023-24. This is also a 4.4 per cent increase in the 2023-24 projection of $77.6 billion from the 2021 provincial budget
- Health spending is expected to grow by an average of four per cent per year between 2023-24 and 2025-26
- The Canada Health Transfer is expected to be $19.2 billion in 2023-24, which represents 23.7 per cent of Ontario’s expected health expenditure for 2023-24
- Starting in fall 2023, the current program that allows pharmacists to prescribe over-the-counter medication will be expanded for more common ailments, including mild to moderate acne, canker sores, diaper dermatitis, yeast infection, pinworms and threadworms, and nausea and vomiting in pregnancy
- Paid COVID‑19 sick leave, a program designed to support people who needed to take time off work to isolate or get vaccinated, will expire effective March 31, 2023
Highlights related to the Prescription for Ontario
- An additional $72 million in 2023–24 to make more surgeries available at community surgical and diagnostic centres
- More than $200 million to connect children and youth to care at hospitals and close to home in their communities, including new funding for surgical and diagnostic wait times, pediatric hospitals and rehabilitation programs, as well mental health and other community-based supports
- $33 million over three years to training more doctors through the expansion of medical school education by adding 100 new undergraduate seats and 154 new postgraduate (residency) to prioritize Ontario residents trained at home and abroad beginning in 2024 and going forward
- $100.8 million over the next three years to accelerate expansion of previously announced 160 undergraduate seats and 295 postgraduate positions by 2028
- $4.3 million to help at least 50 internationally trained physicians get licensed in Ontario with a new Practice Ready Assessment program
- Adding 52 new physician assistant training seats beginning in 2023. The College of Physicians and Surgeons of Ontario will deliver a framework for regulating physician assistants as members in late 2023 and physician assistants will be regulated in 2024
- $22 million to hire up to 200 hospital preceptors to provide mentorship, supervision and training to newly graduated nurses
- As part of the 2021 Ontario Economic Outlook and Fiscal Review, the government announced it would expand nursing education to add 1,500 more seats for registered nurses and registered practical nurses. Ontario is investing an additional $55 million in 2025–26 to deliver on this commitment
- $80 million over three years, starting in 2023–24, to further expand nursing education in universities and colleges by increasing enrolment by 1,000 registered nurse, 500 registered practical nurse and 150 nurse practitioner seats. With these investments, and previously announced funding, 8,000 additional nurses will join the health-care workforce by 2028
- An additional $51 million over three years to support the Dedicated Offload Nurses Program to support timely 9-1-1 response in Ontario communities
- Providing $200 million to extend supports for the Supervised Practice Experience Partnership Program and funded for 2023-24. Since January 2022, more than 2,000 internationally educated nurses have been enrolled through the Supervised Practice Experience Partnership Program and more than 1,300 of them are already fully registered. Last year, the Enhanced Extern Program helped hire up to 5,000 qualified nursing, medical, respiratory therapy, paramedic, physiotherapy, occupational therapy students and internationally educated nurses to work in hospitals across the province
- An additional $425 million over the next three years to support mental health services, including:
- Providing community-based mental health and addictions service providers — funded by the Ministry of Health — with a five per cent increase in base funding
- Supporting mental health programs that are community-led and delivered, making it more convenient for people to connect to mental health services closer to home
- Making a broad range of addictions services available across Ontario that are easy to access and there when needed
- Supporting children and youth by providing access to mental health and addictions services, primary care, and social and community supports to youth aged 12 to 25 through youth wellness hubs
- Supporting children and youth suffering from eating disorders, including inpatient and specialized outpatient services
- Identifying the data and digital health needs of service providers to deliver better care for clients
- Maintaining supportive housing and services for people living with mental health and addictions challenges as they transition from hospital to the community
- Working with Indigenous partners and communities to maintain co-developed programs and services that support Indigenous people’s access to high-quality, culturally appropriate care
- The government is supporting the Runnymede Healthcare Centre’s First Responders Wellness and Rehabilitation Centre to break down barriers in accessing treatment for Post‑Traumatic Stress Injury and other concurrent mental health disorders. The government is making an additional investment of $9.6 million to accelerate the project’s development towards its next round of approval
- An additional $202 million each year in the Homelessness Prevention Program and Indigenous Supportive Housing Program to help those experiencing or at risk of homelessness, struggling with mental health and substance use, those escaping intimate partner violence, and to support the community organizations delivering supportive housing
- Accelerating funding of previously announced investments in 2023-24 to $569 million, including $300 million to support contract rate increases to stabilize home and community workforce
- Over the next year, the government will work with home care partners on making improvements to modernize the system, remove barriers and make it easier to more directly connect people to care at home and in the community
- Ontario is taking steps towards:
- Integrated care co-ordination, through Ontario Health Teams, to better align care providers, reduce duplication and make care more responsive to people’s needs
- Flexible care planning and delivery that focuses on addressing improving health outcomes for people
- Needs-based care that focuses on people’s individual health needs and not on hours of care or the number of visits
- $110 million over three years to fund, train, co-ordinate and improve Ontario Corp. and the province’s emergency preparedness. This added investment will create:
- An Emergency Management Preparedness grant
- An Emergency Response Fund, to provide urgent relief for municipalities, First Nations and communities often needed in the first 24 to 72 hours after an emergency
- An emergency preparedness program created with emergency management partners. Supported by a year-round public education campaign, improvements to training development and delivery
- Annual funding to support communities with nuclear roles and responsibilities. Enhance their ability to protect Ontario’s health, safety and welfare
- Improving Ontario Corp.’s volunteer portal and IT systems to support data and information sharing with emergency management partners
- $60 million over two years to create up to 18 new teams and help bridge the gap in accessing interprofessional primary care for vulnerable, marginalized and unattached patients. Expansion will support integration and sustain direct service delivery in existing teams
- A new multi-year claims modernization plan to upgrade the business processes and IT infrastructure that manage claims for Ontario’s health plans. This plan will include a market sounding so companies can bring forward solutions to make these processes and systems more effective, efficient and responsive to patients and health-care providers
- The government is also exploring a new innovation pathway that, in collaboration with Supply Ontario, would review promising new innovations and provide funding to health service providers so they can procure the innovations across the health system. The innovation pathway could also help remove barriers to earlier adoption of new technologies by funding clinical assessments
Real GDP growthOntario’s real GDP growth is expected to be 0.2 per cent in 2023-24, 1.3 per cent in 2024-25 and 2.5 per cent in 2025-26.
Employment growthOntario’s employment growth is expected to be be 0.5 per cent in 2023-24, one per cent in 2024-25 and 1.7 per cent in 2025-26.
CPI inflation growth
Ontario’s CPI inflation growth is expected to be 3.6 per cent in 2023/24, 2.1 per cent in 2024-25 and two per cent in 2025-26.
2023 pre-budget submission
The COVID-19 pandemic tested Ontario’s health-care system in unprecedented ways, highlighting the cracks that existed before the virus arrived in the province in early 2020. As we emerge from the acute or crisis phase of the pandemic, Ontario’s health-care system is in dire need of immediate solutions to improve patient access to care and increase capacity.
The Ontario Medical Association’s Prescription for Ontario is a roadmap for the future, containing 87 recommendations in five priority areas, including 12 recommendations addressing the unique needs and challenges in northern Ontario:
- Reduce wait times and the backlog of services
- Expand mental health and addiction services in the community
- Improve and expand home care and other community care
- Strengthen public health and pandemic preparedness
- Give every patient a team of health-care providers and link them digitally
The Prescription for Ontario sets out what the government, together with health-care stakeholders, can do in the next few years to strengthen our system. The plan is meant to be implemented in an integrated fashion, starting in the short term and completed over the longer term.
But there are three things we can do now that will make a difference to patients:
- Help retain doctors by reducing the administrative burden
- Increase system capacity and improve patient access to care by creating a centralized wait list and referral system for surgeries so that patients with the greatest need go to the front of the wait list
- Move more palliative patients out of hospitals into the community, embed care co-ordinators in primary care and equip all long-term care homes with IV and diagnostic equipment to reduce transfers to hospitals
On Feb. 14, the OMA submitted its 2023 pre-budget recommendations and urged the Ontario government to include our solutions in its 2023-24 budget.
The solutions would cost about $320 million for 2023-24.
In Prescription for Ontario, the OMA acknowledged Ontario’s annual health-care spending has not kept up with year-over-year demand for the past 30 years. Ontario would need an investment of about $5 billion dollars to reach the average of provincial per capita spending.
The OMA has supported the province’s call to increase the Canada Health Transfer payment to 35 per cent from 22 per cent of total health-care spending. Ontario said it would accept the new federal funding offer, including an immediate top-up to the transfer payment, even though the amount was lower than what was requested.
This new funding, together with the provincial budget surplus, should more than cover the cost of our immediate solutions, and serve as a down payment to implement all 87 recommendations contained in our Prescription.
2023 northern Ontario pre-budget submission
The OMA’s northern district chairs, Dr. Stephen Cooper and Dr. Stephen Viherjoki, contributed to the province’s pre-budget consultation process. On Tuesday, Jan. 31, both chairs appeared before Ontario’s legislative Standing Committee on Finance and Economic Affairs to present the top priorities of doctors in northern Ontario and to take questions from elected officials. The district chairs spoke about the need to address critical northern health-care issues, including the shortage of doctors, long wait times and pressures on hospitals. Dr. Cooper and Dr. Viherjoki also voiced that timing is critical, and that immediate action must be taken.