Ontario Health Coalition: Questions For Candidates
The following Questions for Candidates were provided by the Ontario Health Coalition:
We have provided you with questions below for candidates who come to your door or for use in all candidates’ meetings (below and attached). These questions include background and extra information for your own knowledge. Often there are time limits for questions in all candidates’ meetings. Please feel free to use these questions as a guide and a resource: shorten them, make them your own with local examples, or edit as you need. If you need more information, sources or data, please go to www.ontariohealthcoalition.ca. The specific link for fact sheets on the topics covered here is this: https://www.ontariohealthcoalition.ca/index.php/briefing-note-fact-sheets-health-care-privatization-fact-sheets-information/
Privatization
The ownership and control our public and non-profit health care services are being handed over to for-profit corporations. To understand what this means, we need only to look at the reprehensible behaviour of the for-profit long-term care industry that took millions of dollars each month in profits from our long-term care homes even while thousands of their residents died during COVID of disease and neglect. The Ford government is in the process of giving tens of thousands of new and redeveloped long-term care beds licensed to for-profits for the next 30 years — even those with terrible records of negligence and substandard care. In addition, we have seen unprecedented privatization of public health care services including vaccinations and COVID testing; privatization of the core services of our local public hospitals including surgeries and diagnostic testing; privatization of primary care by giving public funding to for-profit chains like Shoppers Drug Mart; privatization of mental health and addictions, and more.
Will you stop the for-profit privatization of our health care?
- Services in Immediate Crisis
In those communities where your local hospital has had closures of vital services such as all inpatient beds (eg. Town of Durham, Thessalon) or closures of your local emergency department /hospital urgent care centre.
Will you commit to reopening (inpatient beds and/or emergency department) and providing the necessary resources to keep these services open?
- Illegal Patient Charges in Private Clinics
In the private clinics, patients are now routinely being charged thousands of dollars for surgeries or hundreds of dollars for medically unnecessary add-ons that they are often manipulated into paying. To date, the Ford government has mostly expanded the privatization of cataract surgery however, plan is to expand privatization to diagnostics, hip and knee surgeries and others. Doug Ford promised that no one would ever pay with their credit card, “only their OHIP card”. However, patients are being charged the highest costs we have ever seen – more than $10,000 — for their eye surgery in the private clinics. This is illegal under Ontario’s Commitment to the Future of Medicare Act. Anyone caught charging patients should be fined and face escalating penalties up to incarceration if they do not stop, yet nothing is happening to stop the private clinics.
Will you roll back the privatization of surgeries and diagnostics and provide those services in our public non-profit hospitals? Will you enforce Ontario’s medicare laws against the private clinics that are charging patients for needed surgeries and tests, and manipulating patients into paying for unneeded surgeries and tests?
- Hospitals
Ontario funds its hospitals at the lowest rate in Canada, and as a consequence has the fewest hospital beds left per person of any province. (That means hospital beds staffed and in operation.) As a result, patients are left waiting on stretchers in hallways for beds because all the units inside the hospital are full. Heading into the pandemic, staffing shortages were becoming worse, leaving staff staggering under the weight of impossible workloads and limiting Ontarians’ access to care. Through the pandemic we have lost health professionals, nurses, physicians and staff in all kinds of other roles that matter greatly to patient care. Today, Ontario has the fewest nurses per patient of any province. Profiteering staffing agencies that are charging predatory rates to hospitals and long-term care homes are now taking more than a billion dollars per year.
What would you do to address the crisis in Ontario’s public hospitals? Will you commit to nurse-to-patient staffing ratios in hospitals to address the nurse staffing crisis? Will you stop the for-profit staffing agencies?
- Small and rural hospitals
Before 2018 emergency department closures were almost non-existent. In 2023, the Ontario Health Coalition found that there were 1,199 closures of local emergency departments, birthing units and ICUs. By 2024, CBC reports that Ontario broke all records for emergency department closures. These service closures are mostly occurring in small and rural hospitals, though some larger hospitals have been impacted also.
What would you do to ensure that small, rural and local hospitals’ services are protected? For example, would you commit to a moratorium on the closures? Would you ensure that no more local hospital services are downsized, closed or otherwise shut down? Will you commit to reopening the closed services?
- Long-Term Care
There are more than 43,000 people on wait lists for long-term care. There is no question we need more long-term care, but the Ford government is in the process of giving the majority new 30-year contracts and expansions to for-profit LTC companies rather than building them as public and non-profit. The biggest winners of new beds and redevelopments are the same for-profit long-term care chain companies that were responsible for catastrophic death rates and inadequate care before and during the pandemic (and that continues). In addition, the comprehensive annual surprise inspections were cancelled in 2018 after Ford was elected, and they have never been brought back. By the last publicly reported numbers, less than 200 of more than 600 long-term care homes have had a comprehensive annual surprise inspection and many LTC homes with terrible records of inadequate care have never been held accountable.
Would you commit to ending for-profit long-term care and building the needed new capacity in public and non-profit homes? Would you restore annual comprehensive surprise inspections immediately, and follow up with real enforcement? What would you do to improve long-term care?
- Home Care
The Ford government dismantled the entire governance of our home care system in Ontario and moved it under its Super Agency (Ontario Health). The restructuring is not over. Our concern is that care coordination and the other last public parts of home care may be privatized. Already, the majority of home care is privatized and it is rife with staffing shortages that mean people do not get care, even when they are assessed as being eligible for it. In our view, we need to rebuild a new public non-profit home care system.
What is your plan for home care in Ontario?
- COVID and Public Health
As you know, COVID is not over. The evidence regarding the health care burden of long COVID across hospitals, long-term care, primary care and home care is mounting. Every month there is a new study tracking the increased health care use of people who have long COVID. In some European and other jurisdictions, they have gone much further than us in preventive measures such as indoor air cleaning, public education, reporting, and infection prevention and control measures. Here, the Ford government is pushing forward with amalgamating Public Health Units even while we are in a health care crisis.
This question is about Public Health and COVID. Would you stop the mergers of Public Health Units? What would you do to reduce the spread of COVID?
- Paramedics
Across the province, paramedics are deeply concerned about inadequate paramedic staffing. In a number of regions, the shortages lead to longer response times or closed bases. It imperils timely emergency care for patients. Other problems include offload delays – in which ambulances are lined up at the hospital emergency departments and paramedics get tied up waiting to transfer their patients to the triage nurses — and Code Zeros (when all ambulances are in use and unable to respond to new calls).
What will you to do address these issues?
- Primary Care
Two-and-a-half million people in Ontario now cannot find access to primary health care – which is the front door of medicine. It includes family doctors, nurse practitioners, teams, and community health centres or aboriginal health centres. The non-profit, democratic, community-based model of primary care is community health centres. They employ teams of health professionals, nurse practitioners and doctors to provide care. A number of CHCs have had their core budgets frozen for years despite long wait lists and some communities have been waiting for years to get proposals for CHCs to be approved. We also have a model of publicly-funded nurse practitioner-led clinics in Ontario also, but they have not been expanded. Instead, Shoppers Drug Mart and Telus are privatizing both online primary care (virtual care) and opening new for-profit primary care clinics.
What would you do to stop the privatization of primary care and improve access to care? Would you support expanding non-profit Community Health Centres? Will you provide public funding for non-profit nurse practitioner clinics and stop for-profit ownership and user fees in those clinics?
- Mental Health and Addictions
The inadequacy in mental health services in Ontario worsened significantly through the pandemic. Ontarians who require support and treatment face long waits for services, privatization, closures of safe consumption sites and stigma.
Will you commit to eliminating the wait lists for mental health and addictions treatment? Will you restore public non-profit safe consumption sites and stop the privatization of addictions treatment and increase capacity in public non-profit addictions treatment and harm reduction?
- Social Determinants of Health
What will you do to address the social determinants of health, especially supportive housing and affordable housing, and increased ODSP?
- Budget Policy
For decades, the advocates of downsizing and privatization have tried to claim that health spending is out of control. In fact, Ontario ranks consistently dead last among provinces in funding for public health care overall and in funding for public hospitals. As a percent of our provincial economy – that is as a percent of provincial GDP – we are well below of the average of the other provinces. There is a long way to go, even to get to the average of the other provinces. We need that funding to improve public non-profit health care across the continuum of care from hospitals to home care, from long-term care to primary care. This question is critical to all of that because without the resources – funding and staff – we cannot have enough care for Ontarians’ needs.
Will you commit to improving funding for public health care and do you have concrete plans for how you would do this?
- Democracy, Improving Public Health Care under the principles of Compassion & Equity
The trend of eradicating elected public boards that are responsive to local communities started with the Harris government and has become much worse since. Today, Ontarians do not have elected public hospital boards. There are no elected regional health planning agencies. As more services become privatized, there is no democracy, public access to information and accountability. Today, there is no accountability to the public and the centralization of services, removal of local care, failure to plan to meet communities’ needs goes against what the vast majority of Ontarians want. Even in community care, for-profit ownership has grown and democracy in governance has decreased. In addition, health legislation is being passed without public hearings — or with very few public hearings — and all amendments proposed by public interest groups are ignored. The current “Ontario Health Teams” are unelected, completely unaccountable groups of health care provider companies – for-profit and non-profit. They do not have public meetings. There is no accountable board of directors. Non one is elected. Plans are not available for public scrutiny. There is no public input. For 50 years, until now, Ontario has had one form or another of regional health planning bodies. This is the most undemocratic it has been in the last half century, at least.
Have you given any thought to restoring democracy in our health care? Will you commit to restoring democratically elected local public hospital boards? Will you commit to creating public non-profit regional health planning agencies that are open and accountable to the public?
- Overall Vision
What is your vision for improving public health care under the principles of compassion and equity upon which our Canadian system of public health care for all was founded?
