CUPE warns of a deeper crisis if the Ford government sticks to its insufficient plan and does not invest in improving hospital capacity and staffing levels
The crisis in the province’s hospital sector will only worsen over the next four years, unless Ontario makes significant investments to improve staffing levels and capacity, warns a new report released today by CUPE’s Ontario Council of Hospital Unions (OCHU/CUPE).
Citing the latest available data, The Hospital Crisis: No Capacity, No Plan, No End estimates that the province must improve bed capacity and staffing levels by 22% each to meaningfully address needs of an aging and growing population over the next four years.
Across Ontario, that equates to about 8,170 more hospital beds and 60,000 additional staff. In Toronto, capacity would need to go up by about 2,270 beds and staffing levels by approximately 11,960 more hospital workers.
However, based on the Ford government’s current trajectory plans, staffing and capacity across Ontario will grow by less than 4% each (as opposed to 22%) over the same duration.
Recently, health minister Sylvia Jones has repeatedly touted the government’s plan to grow capacity by 3,000 beds over the next 10 years. However, CUPE says that is well short of what is needed. The union says that the government’s plan would achieve only a 0.79% annual increase in capacity even as official projections show an annual 1.5% population growth rate over the next decade.
“The government must address the untenable situation in our public hospitals on a war footing,” says Michael Hurley, the president of OCHU/CUPE, which represents 40,000 hospital workers across the province.
“We are in a deep crisis with no signs of improvement as we continue to fail patients and workers alike. You’ve got services being reduced because of staff shortages, you’ve got patients being treated on stretchers because of lack of capacity, you’ve got people waiting for services for long periods or being turned away from services, you’ve got people being discharged prematurely. It’s unacceptable.”
OCHU/CUPE cites recent Statistics Canada data showing hospital staffing levels have only increased by 0.4% annually since 2020, despite the increasing burden of work as a result of the COVID-19 pandemic.
Consequently, staff have been saddled with heavy workloads, which combined with wage suppression, has led to high turnover as evidenced by vacancy rates in the first quarter of 2023 increasing by about 300% since 2015.
“The ongoing retention and recruitment challenges will only worsen if the government fails to address working conditions and compensation,” Hurley says. “Staff-to-patient ratios are extremely poor and getting worse. There are so many patients as demand for hospital care continues to grow, and the workloads continue to intensify. The conditions are so unsatisfactory that staff feel like they are failing patients and they just can’t do it anymore.”
Ontario has 38% less inpatient staffing in hospitals compared to the Canadian average. If Ontario’s staffing reached the same level as the rest of the country, it would have 33,778 more full-time staff including inpatient workers and support staff.
The OCHU/CUPE report makes several recommendations to address staffing issues including the provision of more full-time work, improvement in real wages, and banning the use of agency staff.
Improving staffing levels would also help address capacity issue in Ontario’s hospitals, according to the OCHU/CUPE report. Since 2022, there have been more than 145 emergency room closures due to staffing shortages with no sign of abatement in 2023.
However, the report says the problem goes beyond staffing shortages as Ontario’s hospital capacity per capita has sharply declined over the past three decades. Based on the most recent CIHI data, Canada as a whole has 7.7% more hospital beds per capita than Ontario. The result is very high hospital bed occupancy, cancelled surgeries, and increased usage of unconventional spaces to treat patients with a 22% increase in “hallway healthcare” since Ford’s election in 2018.
Compounding the problem of population growth outpacing investment in healthcare is the fact that health care needs are sensitive to age, Hurley says. The population of people aged 65 and over is growing at twice the rate of the rest of Ontario’s population and they are the ones who tend to use hospitals the most.
While the most recent government budget has greatly expanded funding for long-term care and home care (both predominantly for-profit), the Financial Accountability Office of Ontario’s projections indicate no significant improvement in these subsectors that would help take pressure off hospitals.