No end to the ER crisis without investments and addressing workers’ concerns

Posted on January 17, 2024 in Health Delivery System

Source: — Authors: , – Opinion/Contributors
January 17, 2024.   By Michael Hurley, Sharleen Stewart and Kelly-Anne Orr, Contributors

We recently estimated that dealing with those pressures and bringing back the quality of care in our hospitals to an acceptable standard would require a $1.25 billion annual investment after offsetting costs of inflation.

The recent auditor general’s report provided another sober reminder of the intensification of Ontario’s hospital crisis, as this government’s health care management sinks to new lows. Emergency room shutdowns were unheard of in Ontario until last year, when an alarming 145 closures caused much pain and misery for patients seeking urgent care.

That unfortunately failed to jolt the government into action, setting the stage for an ignominious record of ERs and other hospital services shuttering nearly 1,200 times in 2023. As the auditor general noted, these closures are predominantly happening due to staffing shortages.

Staffing issues are also contributing to the surgical wait-list comprising 107,000 people currently waiting beyond maximum clinical guidelines, including thousands of children suffering consequences of delayed procedures. Fullscreen

This tells us that without health care workers, there is no health care system. It also tells us that employers and the government cannot continue to discount their voices, and their pleas to address unsustainable workloads, workplace violence, and unconscionable wage suppression.

As representatives of more than 70,000 hospital workers in an ongoing round of central bargaining, our unions have put forward proposals that will help improve staff retention, reduce attrition costs for hospitals, and prevent the destabilization of teamwork that negatively impacts patient care.

We are calling for staff-to-patient ratios for nurses and personal support workers across units including ICUs, emergency rooms, and palliative care. Hospital staffing ratios were implemented in California over two decades ago, with evidence of better patient care and lower mortality rates. Research from California also shows improved retention, and lower rates of burnout and job dissatisfaction.

Recently, the British Columbia government negotiated staffing ratios with the nurses’ union and agreed to phase-in a minimum staffing standard over three years. This is an important precedent in Canada, and the Ontario government must follow B.C.’s lead.

Staffing ratios will offer hope to a workforce chronically deprived of it, reflected in an attrition rate exceeding 10 per cent. But they need to be supplemented with fair compensation increases, to offset inflationary pressures compounded by over a decade of subpar wage improvements.

In a recent workforce survey, more than half of CUPE hospital workers said they were dissatisfied with compensation. Considering the heroic sacrifices of staff over the course of the COVID-19 pandemic, and the additional workloads in dealing with higher demand over the past few years, a significant boost in compensation is essential to maintain morale.

These measures require considerable government investment, which necessitates a reversal of fiscal restraint borne of ideology rather than prudence.

However, some may wish to impose the austerity ideology even as inflation, aging, and population growth necessitate at least a 5 per cent annual real dollar funding increase.

We recently estimated that dealing with those pressures and bringing back the quality of care in our hospitals to an acceptable standard would require a $1.25 billion annual investment after offsetting costs of inflation. But so far, the Ford government is letting the hospitals deteriorate while it sits on $5.4 billion in contingency funding.

If this government is serious about addressing the hospital crisis, it must commit to historic investments immediately. The auditor general’s report makes it clear that we don’t have time to waste, as hundreds of thousands of lives are at stake with people languishing on surgical wait-lists and unable to rely on emergency rooms.

But if we continue to see inaction from Ford, the Tories must get ready for a battle as the festering anger within our members will only lead to escalating actions, and a protracted fight for public health care that will be supported by Ontarians of every stripe.

Michael Hurley is president of CUPE’s Ontario Council of Hospital Unions, Sharleen Stewart is president of SEIU Healthcare and Kelly-Anne Orr is assistant to the national officers at Unifor.

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