The Honourable Kathleen Wynne
Premier of Ontario
111 Wellesley St. West
Toronto, ON M7A 1A1
November 25, 2013
Dear Premier Wynne,
We are writing to you in follow-up to our letter of October 15, 2013, to you and to Minister Deb Matthews (please see attached). To date we have not heard back from you.
Ontario’s registered nurses have watched with growing concern as their employment opportunities have dwindled in recent years. Many have lived through the previous cycle of layoffs when Premier Mike Harris likened nurses to hula hoops, and we wish to avoid a repeat at all costs.
RNs believed this was all behind them. The Nursing Task Force Report seemed to usher in an era of stabilizing the nursing workforce. In successive elections, the Liberal government committed to delivering 8,000 (2003 election) and 9,000 (2007 election) nursing positions. Ontario’s RN/population ratio reversed its downward trend, meaning that RN workloads became more sustainable and health system clients had greater access to RN services. The change was significant, both before and after the 2003 election. Then the 2008 recession hit and RNs felt the pain first, with the bulk of spending restraints coming at their expense, as announced in the 2008 fall economic statement.
Premier Wynne, a dangerous downward spiral trend is in rapid progress. From the start of 2009, RN/population ratios fell continuously. And of course, the burden fell particularly on new RN graduates, 12.9 percent of whom were unemployed and seeking nursing employment in 2012. A further 4.1 percent of new RN grads were working outside of nursing and seeking nursing employment. This is alarming and wasteful because we know from the 1990s that when new nursing graduates are unable to find nursing employment, they move away – especially to the US. Once they move away, it is very difficult to bring them back, even if there are jobs available because they put down roots in their new communities. Ontario invests substantially in educating its nurses, and other jurisdictions like the US are only too glad to take them because of the quality of the education and close equivalence of Canadian credentials to American credentials. It is not surprising that almost 6,000 Ontario RNs are working in nursing outside of Ontario, over 3,000 of whom work south of the border. Add to that an unknown number of RNs from Ontario who work out of province and who have not kept up their Ontario registrations. This brain drain will sharpen even further, as Canadian BScN graduates will be taking the US exam to register with our regulatory bodies.
Data from the Canadian Institute for Health Information confirm the magnitude of the gap that has opened up between Ontario and the rest of the country. Around 1990, the Ontario RN/population ratio was very similar to the Canadian average. After that time, the Ontario ratio fell precipitously until 2002 while the ratio in the rest of the country fluctuated around its 1990 levels. The Ontario ratio made up some of the gap, rising until the start of 2009. But after that, it started to fall. As of 2012, Ontario has 69.9 RNs/10,000 population vs. 83/10,000 in the rest of the country. Ontario needs almost 17,60 more RN positions to catch up to the national ratio. That would be an 18.6 per cent increase.
RNAO welcomes the move away from restraint signaled in the 2013 fall economic statement. This is long-overdue, given the persistent stagnation of employment in Ontario after the severe recession. Targeting jobs and growth is an important and helpful signal to the economy. Given that RNs took
the first hit from spending restraints, and given that they and their patients have experienced a deteriorating RN/population ratio for three consecutive years, it is time for government to take strong measures to reverse that trend. Not acting now will endanger the public.
Premier, we ask for an urgent meeting with you.
Doris Grinspun, RN, MSN, PhD, LLD(hon), O.ONT
Chief Executive Officer, RNAO
Rhonda Seidman-Carlson, RN, MN
Deb Matthews, Minister of Health and Long-Term Care
Tim Hudak, Leader of the Progressive Conservative Party of Ontario
Christine Elliott, Health Critic, Progressive Conservative Party of Ontario
Andrea Horwath, Leader of the New Democratic Party of Ontario
France Gélinas, Health Critic, New Democratic Party