Written by : Doly Begum
Co-Chair, Scarborough Health Coalition
A Local Branch of the Ontario Health Coalition
Tommy Douglas, whom many consider to be the greatest Canadian in history, believed that every Canadian deserved the right to quality healthcare regardless of their social and economic circumstances. Known as “the father of Medicare,” Douglas fought relentlessly for a better Canada, which included universal healthcare without prejudice. Douglas’s public healthcare plan was enacted first in Saskatchewan in 1962, and nationally in 1966.
In 2001, a 12 year old girl from Bangladesh witnessed what it meant to be a recipient of universal healthcare regardless of social and economic circumstances. On a cold wintery night, just months after arriving in Canada, 2 pedestrians—my father and his friend—were catastrophically injured in a sudden car accident. Despite having so recently arrived in this country, my family experienced the true essence of public healthcare in Canada. We witnessed a rescue team of dedicated individuals saving my father’s life, which in turn saved the future of a new Canadian family. The ambulance arrived within minutes of the accident. I watched my father’s injured body being carefully carried on a stretcher and into the ambulance. Caught between shock and fear for my father, I watched the kind paramedics pull my mother gently off the sidewalk and into the ambulance to accompany my father. My 9 year old brother and I followed.
This sincere and state-of-the-art care within our medical system became the shining light for the next hours to follow. And then, as is the case with catastrophic injury or illness, hours turned to days, months, and years, as we watched what slowly evolved from acute to rehabilitative treatment. I watched my father lie in hospital beds for years. From brain surgery to bone transplant, from physiotherapy to speech therapy, from using a wheelchair to learning how to once again stand on his feet, I truly believe the support and care we were privileged to receive in Canada would not have been possible anywhere else in the world. As Canadians we can be proud of that.
Over the years, the healthcare system improved in technological advancements, however cuts to healthcare funding levels led to cuts in beds, staffing and treatment programs, causing significant deterioration in terms of real care, which puts patients first. This healthcare underfunding has been worsened further by absence of budget adjustments to address growth in both the general population and the aging population. From family doctor check-ups to emergency room visits, the wait times are appalling. The Globe and Mail reports that in 2017, roughly 1 in 5 Ontarians “had trouble last year finding a family doctor. That figure jumps to 26 per cent for patients living outside major urban centres, according to the telephone survey of 662 adults done … by the Ontario College of Family Physicians.”
The picture is even worse when it comes to family health services. Family doctor wait times in Ontario are absolutely preposterous. Imagine a taxicab driver or a cleaner or a restaurant worker suffering from back pain. They are the sole breadwinners of their families, they work long shifts with no paid time off, and every hour wasted in a family clinic’s waiting room costs them lost wages which they cannot afford. Do they refrain from visiting the family doctor and allow the back pain to worsen into what may become a chronic injury? While low-income or average wage earners literally cannot afford to take an entire day or half-day off to see the family doctor, many Canadian residents and citizens are potentially threatened with job repercussions or loss for taking time off for unnecessarily lengthy healthcare appointments—an especial worry for working parents. This has significant negative long-term impacts for the individual patient and the patient’s family as well as the healthcare system. Minor illnesses are left untreated, causing more serious long-term problems.
Long-term care and nursing homes have also suffered from dramatically inadequate funding impacting bed shortages, horrendously long wait-lists, poor diet, and unsafe staffing levels, all while failing to address our increasing needs for care in this area. Similarly, programs to support the elderly, disabled or ill within their own homes range from non-existent to a patchwork collection of inadequate services requiring hours of work and professional advice just to coordinate. Palliative care programs are dramatically underfunded. Respite programs to support caregivers trying to keep family members with dementia or significant needs in the home are underfunded to non-existent. The wait lists for long-term care facilities are estimated at 20,000 and have persisted for more than two decades.
One of the most critical components of my father’s recovery was rehabilitation services, including physiotherapy and at-home personal support. Earlier this year, the
Wynne government forcefully pushed an agenda to restructure these care sectors through Bill 41: Patients First Act. This bill was alarming to community care agencies, stakeholders and Ontario family doctors who care for about 155,000 patients everyday. More importantly, the changes made in our health system did not take into consideration the actual needs and voices of patients in the Province. Patients First Act has been criticized as the “Patients Last Act.”
Fundamental reform is necessary to support home and community care along with strong regulations that listen to doctors and patients while ensuring that taxpayer dollars go directly into necessary healthcare services without being siphoned off for corporate profits.
Furthermore, due to contracting out and for-profit privatization of home care, most of the funding necessary does not make it to patient care. The Auditor General of Ontario found $8 billion in higher costs due to the privatization of Ontario’s hospitals and other public infrastructure. The privatized P3 (public private partnership) program means that new hospitals are so expensive that for each one new high tech acute care hospital planned, multiple local community hospitals are to be closed. This will create longer waits for patients in emergency rooms, check-ups, and follow-up appointments. It will both increase the hallway-patient care that has become the new norm for patient treatment in many hospitals, and place additional time and economic strain on families forced to now travel to regional healthcare centres instead of receiving local health services within their own communities.
Decades of privatization and cuts to public hospital funding have resulted in what is now being called a healthcare system in crisis. The Province needs at least a 5% increase in order to keep pace and overturn the loss. Ontario has the fewest hospital beds, nurses and staff per capita of any province . . . and patients are suffering as a result. We need a commitment going forward to stable, multi-year funding that is enough to maintain services and rebuild capacity.
Since 2006, hospital funding has been less than the rate of inflation or frozen at 0% which has caused the system to fall way behind its needed level. We have among the best healthcare education programs in North America, committed and capable public healthcare professionals, and an abundance of public healthcare experts who are being prevented from performing their work to their own highest standards due to lack of adequate funds. We need proper funding of necessary healthcare services, not private corporations pressuring further harmful restructuring to increase their private profits at the expense of critical public healthcare services.
After years of significant campaigning by the Ontario Health Coalition, this year our healthcare received a funding increase by the rate of inflation, (2%) for base operating funding, with an additional 1% for larger more specialized hospital programs. However, the increase in population growth, ageing, and the demand for care shows that this funding increase is not even close to enough.
Canada’s healthcare is portrayed as a model for the rest of the world. We must fight to protect it! Each and every individual deserves a reasonable standard of living and access to fundamental human rights. Quality public healthcare is a human right which benefits all of society.