Memo to Prime Minister Paul Martin from Registered Nurses' Association of Ontario
Joan Lesmond, RN, BScN, MSN President, Registered Nurses Association of Ontario (RNAO)
Doris Grinspun, RN, MSN, PhD (cand), O. Ont. Executive Director, Registered Nurses Association of Ontario (RNAO)
Health Summit Negotiations: Advice on substance and strategy
Sept. 10, 2004
As the health summit approaches amid a din of dissenting voices about the direction of health-care reform, the Registered Nurses Association of Ontario (RNAO) calls on you to demonstrate courage and leadership during the upcoming negotiations. We ask you to cut through the chatter to the pivotal issues that you and the premiers need to address to seal a deal that will sustain and strengthen Medicare and ultimately improve the health of all Canadians.
As trusted advocates for healthy public policy, RNAO respectfully advises:
- Have the courage to take on the thorny issue of for-profit health-care delivery. Be guided by the research on the merits of not-for-profit health care and the minefields of for-profit health-care delivery. It clearly shows that not-for-profit delivery of health care is less expensive and more effective. For-profit delivery provides no new services and will only increase public waiting lists while shifting resources from public services to profits.
As registered nurses, we see and feel the impact of experiments in privatization on patient care and our work environment. We know that patient–focused care has better outcomes than profit-focused care.
Tell the provinces that while you respect the need for flexibility and regional accommodation, you intend to exercise the federal government’s right and responsibility to insist that adequate, stable and predictable federal funding comes with conditions. Insist that national standards be met and monies for priority areas, such as reducing waiting times for diagnosis and treatment, increasing the number of health-care professionals, and expanding Medicare to include home care, will not flow to provinces that privatize health care. If the premiers balk, remind them that you have the facts and the evidence on your side when it comes to costs, quality of care, and value for money. Remind them of the Romanow report and the millions of Canadians whose views and values were reflected in it.
Respond positively to the provinces’ proposal for a national Pharmacare plan. It makes good policy sense – increased buying power will yield lower costs, for example, and approvals will be streamlined -- and will cement a federal presence in the delivery of health care. Do not be distracted by phony either/or choices about funding a national Pharmacare program versus funding improvements to waiting times, nursing shortages, home, primary and elder care. You can do both. A national Pharmacare plan would not increase costs – it would merely shift them. In fact, this transfer of costs to the federal government would likely decrease the cost of prescription drugs. And it would free up resources in provincial budgets, allowing for investments in an array of agreed-upon priorities. Of course without conditions on federal health-care funding, provinces could spend these resources on a wide range of other priorities, including tax cuts. That is why setting standards and conditions is so crucial.
You can’t improve access and reduce waiting times without a significant investment in human capital. That necessitates strategies to address the shortage of nurses, key players in delivering health services. You must work with the premiers to help retain nurses and to attract new ones by reducing workloads and ensuring that at least 70 per cent of all RNs have permanent, full-time positions.
If you take up the challenge the premiers are presenting to you, and show true national leadership by protecting Medicare from privatization, you will have the support of Canadians who have consistently identified health care as their top public policy priority. They are looking for an end to federal-provincial wrangling. They are weary of arguments on health-care reform and eager for action. In their unanimous support and commitment to a national Pharmacare plan, the premiers have provided you with an opportunity to follow through on your election promises to move toward a national drug program and fix Medicare for a generation.
Good luck in your deliberations which we are very pleased are proceeding with the transparency Canadians deserve.
PLEASE NOTE: RNAO President Joan Lesmond and RNAO executive director Doris Grinspun will be in Ottawa Sunday, Sept. 12 to Wednesday, Sept. 15 to attend the Health Summit and related activities. They are available for interviews. To arrange one, please call (416) 829-6657.