If the board room lacks answers, try the lunch room

How to fix health care was the big news from the province in the wake of this year’s Association of Municipalities of Ontario conference.

Health Minister Sylvia Jones announced a number of initiatives, the most contentious one being using private clinics (with OHIP footing the bill) for certain procedures, to reduce the backlog of surgeries cancelled during COVID. Other key initiatives are the province assuming the cost for the exam and registration of internationally educated nurses, a process that can cost up to $1,500; and moving patients who no longer need hospital treatment to a long-term care facility “not of their choosing” until a bed becomes available at their facility of choice.

Significant in its absence is any mention of getting rid of Bill 124, which has become a sore point for nurses. Of all the people who have worked on the health-care front lines during the COVID-19 pandemic, it is only nurses (and nurse practitioners) who have been limited to that one per cent wage increase.

If this was supposed to be the innovative “think outside the box” solution to our health-care crisis, that box must be more fragile and tinier than anyone thought.

The notion of shipping off patients to nursing homes against their will is not new. It was discussed long before COVID, as a way to get rid of the people they once called “bed blockers.” Now they call them “alternative level of care” patients. The concept was formalized during COVID, but not much came of it, perhaps because someone had figured out those three- and four-patient rooms at some nursing homes were contributing to the devastating death toll from the virus among the elderly.

New support for qualifying internationally educated health-care professionals for employment in the Ontario system also came to the forefront during COVID. It is almost criminal that Ontario has had highly qualified and experienced doctors and nurses driving cabs for a living for years. The province footing the bill for exams and registrations is a good start, but the system is still designed to keep people out.

As for using private clinics to deal with the backlog of surgeries – this sounds like another push for more privatization in health care, definitely not a new theme for a right-wing provincial government.

The point that seems to have been missed in most of the flurry of solutions for our health-care woes is that private sector clinics, public hospitals, long-term care homes both public and private, private nursing agencies, and companies that provide home care, all draw from the same pool of people. Right now, that pool is not deep enough to meet the needs of health care in this province.

There are literally thousands of nursing job vacancies, and tens of thousands of patients who have no family doctor. Each week brings announcements of temporary closures of hospital emergency rooms because the experienced hospital nurses needed to staff the ERs are taking desperately needed vacations, or have opted for the more civilized hours and conditions, not to mention higher pay, offered by private agencies.

There are untold numbers of nursing home residents and hospital patients who would have preferred to remain in their own homes, and could have, had decent home care been available. It is not, especially in rural areas.

Using private clinics to reduce the surgery backlog is the same as using agency nurses to fill in gaps in hospital staff schedules. It is a very expensive short-term solution to a long-term problem. While it is a solution, it is siphoning off money that could be spent on letting nurses participate in the fair collective bargaining process they want.

Our premier and health minister have spoken about “thinking outside the box.” So far, we have seen little that is new, innovative or anywhere near outside the box.

Perhaps the time has come for provincial health care officials to listen to what is being discussed not in the private sector board rooms, but public hospital, clinic and paramedic lunch rooms.