December 4, 2008
RNAO Pre-budget Submission 2009: Time for Bold Leadership
Presented By: Wendy Fucile (RNAO President)
Good afternoon, my name is Wendy Fucile and I am the President of the Registered Nurses’ Association of Ontario (RNAO). We welcome this opportunity to participate in the pre-budget consultation and to convey the views and recommendations of Ontario’s registered nurses.
Nurses work on the front lines, in our hospitals and community clinics, in homes and with those who have no homes. They see the thousands of laid off women and men, those whose retirement savings are evaporating and house values dropping, and those who find themselves relying on local food banks.
Nurses know it’s time for bold action.
Reinvesting in infrastructure and public services is a must. The global economy has entered a period of economic instability unlike any other since the Great Depression, and governments everywhere are responding boldly and decisively.
Federal and provincial governments in Canada cannot afford to stand on the sidelines. We urge Premier McGuinty and Finance Minister Duncan to provide leadership by delivering effective and timely interventions that will reduce the severity of the recession and its effects on Ontarians.
This is not the time to cut essential expenditures, such as Minister Duncan’s announcement that he would slow down on the creation of 9,000 additional nursing positions in Ontario. Such cuts take the province back to the past by creating fear and uncertainty affecting retention and recruitment into the profession. Additional nursing positions are needed now to ensure people right across this province get the quality of care they need.
Attempting to balance the budget by either raising taxes or cutting expenditures would exacerbate the economic downturn. Instead, the province should stay on track and advance its reinvestment agenda, which will help restore confidence in the province. It would be a grievous mistake to conclude that we must now make a choice between the so-called economic and social spheres as if the latter were somehow a luxury to be reserved for sunnier times.
As the government pledged today, this is the time to reduce poverty in the province. An overwhelming majority of people want leadership in reducing the shameful levels of poverty in our communities. A broad-based coalition known as ’25 in 5’ of which RNAO is a proud member, urges that economic investment to alleviate poverty is precisely the stimulus we need to weather the economic storm.
It is shameful that 1.3 million Ontarians face the challenge of living below the poverty line. There is overwhelming research that shows that poverty erodes health and causes people to die prematurely.
Too many Ontarians struggle with food insecurity. One measure of the severity of this growing problem is the 14.3 per cent rise in the number of people served by food banks from 2001 to 2007. A staggering 318,540 Ontarians rely on this assistance every month.
A core problem is social assistance rates, which for many years have been far below any livable or acceptable level. Social assistance rates did increase by nine per cent between 2004 and 2008, however, Ontarians receiving social assistance are still faced with having to choose between buying food and paying the rent. We ask that Government immediately increase, in a substantive way, the social assistance rates so that all Ontarians can live in health and dignity.
People earning the minimum wage are still far below the poverty line. We urge the Government to advance its commitment to increase the minimum wage to $10.25/hour effective immediately and not by 2010.
Simply put, poverty is bad economics. Poverty in Ontario costs the federal and provincial governments between 10 and 13 billion dollars each year. Private and public (or social) costs combined are equivalent to 5.5 to 6.6 per cent of Ontario’s Gross Domestic Product (GDP).
We applaud the government for its commitment to reduce child poverty by 25 per cent in five years, and for consulting broadly on poverty reduction. We urge that commitment be extended to cover all people living in poverty, and not just families and children. Valuable momentum must not be lost. Far from being a time to slow down, an economic downturn is exactly when action to reduce poverty is most needed, and strongly justified. We urge a substantial multi-year funding commitment to support aggressive implementation of Ontario's poverty reduction program.
The environment also demands bold leadership. The evidence of the many links between environment and health is very strong. Like all Canadians, nurses are increasingly concerned about climate change and the impact of environmental toxics on the health of their families. Of particular concern is the safety of children, who are much more vulnerable to toxics. A precautionary approach is urgently needed.
The government has promised a number of steps that together could put Ontario at the forefront of rebuilding and preserving a healthy environment. RNAO will work with government and other stakeholders to help realize this goal in a timely manner. We ask that government:
• Accelerate its plans to reduce greenhouse gas emissions to six per cent below 1990 levels before 2012, and 25 per cent below 2020, to help meet Canada’s Kyoto obligations.
• Accelerate its promise to close all coal-fired electricity plants ahead of its 2014 schedule, in order to protect the health of Ontarians.
• Move during the spring legislative agenda with a toxic reduction law to reduce environmental toxics and carcinogens.
In its second mandate, the government has delivered significant progress in banning the cosmetic use of pesticides. Legislation has been passed and the associated draft regulations, if accepted as passed, will greatly improve protection from pesticides. So far government has allocated $10 million over four years. RNAO would advise increasing this budget to ensure appropriate public education and adequate monitoring and enforcement.
Climate change continues to be an overriding concern of Ontarians in general, and nurses in particular. On the emission of greenhouse gases, the government must move promptly on its relevant promises, including phasing out polluting and greenhouse gas emitting coal-fired generating stations and funding massive and badly-needed expansions in public transit, renewable energy and energy conservation. RNAO urges that any highway expansion be subject to full assessments of environmental and social costs.
RNAO also advises against resorting to an expansion of nuclear power, as it has proven to be costly, prone to delays and overruns, and it carries serious health and safety risks. Even maintaining the current level of nuclear energy supply will entail costly new plants or refurbishment of existing plants. A more cost-effective use of that money – and one that would produce cleaner, safer and more timely electricity for Ontarians – would be on energy conservation, energy efficiency programs, and the generation of power from renewable sources.
Carbon must be priced fairly to encourage greener solutions. One example is a carbon tax that would work to reduce greenhouse gas emissions. It has been implemented in a number of countries, including Finland and Sweden, and Quebec and British Columbia have now done so as well.
Strengthening public health care is a key priority. In difficult economic times we are reminded why Canadians cherish their public health-care system. In the United States, health-related bankruptcies are skyrocketing. There are tremendous savings in the Canadian single-payer system. Unlike their American counterparts, Canadian providers only deal with one payer, and face lower administrative and overhead costs.
Competitive bidding must be fully cancelled, as experiments in the health-care sector have proven disastrous both in Ontario and internationally. It has resulted in disruptions in continuity of care and caregiver for patients and decreased morale amongst caregivers. It is a flawed process based on a flawed philosophy, which costs more and delivers less.
Finally, RNAO remains gravely concerned about the program of alternative financing and procurement (AFPs) for hospitals and other public infrastructure. We have presented the government with a full analysis and demonstrated that AFPs do not serve citizens and taxpayers well. RNAO calls for the abandonment of AFPs as a method of financing and procurement for hospitals and other public infrastructure.
Access to primary care remains a challenge for more than 1 million Ontarians who do not have a primary health care provider. This includes 30 per cent of Ontarians who live in northern and under-serviced communities. Nurse practitioners (NPs) are ready to serve. They have the knowledge, skills and legislative authority to diagnose and treat many common illnesses. They can prescribe medications, and order and interpret a variety of diagnostic tests.
The government’s allocation of $38 million over three years to create 25 additional NP-led clinics by 2011, is an important commitment, and the RFPs in October 2008 for the first three of these clinics is welcome in communities of Sault Ste. Marie, the Erie St. Clair Local Health Integration Network (LHIN) and the Northwest LHIN catchment area.
Ontarians need government to move at a much faster pace. Just in Belleville and the surrounding county, approximately 20,000 citizens have no access to primary health care. This number threatens to expand as the number of current health care providers approaches retirement and the local population continues to grow in size and age. Government already has a full and solid proposal for an NP-led clinic in Belleville, as well as other communities and we see no rationale to postpone approving these. Thus, RNAO is asking that at least 10 additional NP-led Clinics be approved for funding early in the new year. The public needs these clinics, communities are ready for them and Nurse Practitioners are eager to serve.
The government should also keep commitments to release the necessary funding to increase the hours of direct care in long-term care, and improve the funding for home care to allow older persons and others to live and age with dignity in their homes.
Finally, it is vital to strengthen the nursing workforce. RNAO is very pleased that the McGuinty government is committed to the Nursing Graduate Guarantee to provide every new Ontario nursing graduate with an opportunity for full-time employment. We are also delighted with the commitment to achieve the goal of 70 per cent of all nurses working full-time by 2010. Both of these are initiatives RNAO proposed in 2003 and we are proud of our joint progress. Today, we are retaining more new graduates in Ontario than ever before, and we are at 64.7 per cent full-time employment for all working RNs.
In closing, the economic downturn is a time of great challenge, for the people of Ontario and for our government. It is also a time of opportunity, to lead by investing in our people, and building stronger and healthier communities. Nurses urge the McGuinty government to act now by putting the needs of all Ontarians, and especially those most vulnerable, at the forefront of the government’s upcoming budget.
For more information, please see our downloadable report .