The Registered Nurses' Association of Ontario (RNAO) is deeply concerned with a Fall 2020 budget that shows signs of a government tiring of fighting the COVID-19 pandemic. In the midst of a ferocious resurgence, what is needed is a budget that reflects the urgency of our circumstances and the need to protect the health, economic and social well-being of Ontarians – especially those who are most vulnerable to the devastating impacts of this virus.
RNAO points to the government's decision to delay the implementation of four hours of direct care for nursing home residents until 2024-2025 as a failure to take proper care of the province's most vulnerable population. "There is no excuse for postponing the urgently needed staffing increase in the province's nursing homes," says RNAO President Morgan Hoffarth. "The evidence is well-known, confirmed in report after report over more than two decades, and captured in RNAO's Nursing Home Basic Care Guarantee. More than 2,000 seniors and eight staff have already died from COVID-19-related illnesses in Ontario's nursing homes, leaving families and staff in anguish. The government says it supports a minimum of four worked hours per resident, per day as necessary for the health and well-being of nursing home residents, but its timetable to act on this promise will only lead to more preventable deaths. We can't – and shouldn't have to – wait more than four years to meet minimum safety standards for this province's most vulnerable seniors," says Hoffarth.
RNAO CEO Dr. Doris Grinspun called on the provincial government to negotiate national long-term care standards with First Ministers and use the consequent federal transfers to invest in the care of Ontario's nursing home residents: "Without question, federal health transfers to Ontario have been slipping to unacceptable and harmful levels. RNAO accurately predicted this would be the case from the moment the federal government, under Stephen Harper, decided not to renew the Accord. The recent openness by the federal government to tie transfers to negotiated long-term care standards is something the Ontario government should jump on, if they are serious about the commitment to four worked hours of hands-on, direct nursing and support care." As of Nov. 4, as many as 89 long-term homes in Ontario were experiencing COVID-19 outbreaks.
While the necessary funding and minimum care standards for dignified and safe care in the long-term care sector have been put off until after the next provincial election, the budget's details on home care were also inadequate. RNAO called for a 20 per cent boost to home care funding in order to relieve pressure on both the hospital and long-term care sectors and enable Ontarians to receive healthy and safe care in their own home and community. "We regret that significant investments in the hospital sector and the trend to place nursing homes under the administration of hospitals is taking us away from building a robust community care sector," says Grinspun. "The real promise of this government's health system transformation plans – a plan RNAO fully supported and one that now seems to be fading away – centred around Ontario Health Teams (OHT) that would strengthen community care and be anchored in primary care," added Grinspun. RNAO's Best Practice Spotlight Organization (BPSO) OHT program has been working with fledgling OHTs to ensure they provide evidence-based, seamless care across all sectors, including person- and family-centred care and transitions in care, using RNAO's world-renowned best practice guidelines.
RNAO notes that the COVID-19 pandemic has disproportionately affected seniors, in addition to racialized and lower-income populations. "We expected provisions in this budget to address the profoundly unequal effects of the virus. People experiencing homelessness need safe shelter and housing, as well as protection from eviction," says Grinspun. "Long before this pandemic struck, we had an affordable housing crisis across this province. This budget does not make the investments needed to get us to a more resilient and caring place."
While more than 3,000 Ontarians have lost their lives to COVID-19-related illnesses over the last 10 months, the pandemic has exacerbated the province's other public health crisis: the growing number of opioid overdoses. RNAO is disappointed that the budget offers no response to this crisis, which is claiming more than five lives each day. "Our government committed to fund 21 consumption and treatment service sites two years ago. While the need for these sites far outstrips the 21 promised, the government has yet to deliver even on this modest promise," says Hoffarth. "These are preventable deaths, and modest investment in harm reduction services across the province would save hundreds of lives."
The Registered Nurses' Association of Ontario (RNAO) is the professional association representing registered nurses, nurse practitioners, and nursing students in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses' contribution to shaping the health system, and influenced decisions that affect nurses and the public they serve. For more information about RNAO, visit our website at RNAO.ca or follow us on Twitter and Facebook.