Federal government must act as guardian of Canada’s universal health system: Nurses say

March 28, 2023

The billions of dollars promised to Ontario through federal health transfers and a bilateral agreement are at risk of being diverted into for-profit health-care delivery, which in the long-run will bankrupt the health system. This is why Ottawa must take a strong stand to protect the country’s universal, publicly-funded health system says the Registered Nurses’ Association of Ontario (RNAO) in response to Tuesday’s federal budget.

RNAO CEO Dr. Doris Grinspun says Premier Ford’s government is steering Ontario down the road towards for-profit health with its intentions clearly laid out in legislation (Bill 60) currently at the committee stage at Queens’s Park. “People across our province and the country should be outraged because there is an open-ended push towards for-profit provision of health care,” adding the federal government must not remain silent. “There is ample evidence that for-profit care is more expensive and results in poorer health outcomes. It also siphons off nurses and other health professionals to for-profit entities, which will further deepen the health-care workforce crisis for our hospitals.”  

Grinspun says for-profit operators have – by choice and by law – an allegiance to investors and shareholders, which means the needs of patients are placed second. She says the federal government “must act as a guardian for our country’s health system. Canadians expect a publicly funded, not-for-profit health system that exists for everyone.  If we don’t take action, we will see a two-tier system like the U.S.”

The federal government’s budget promise to provide a world-class, universal publicly-funded health-care system cannot be realized without sufficient funding to address the crisis in health human resources (HHR). It also needs to ensure strings are attached to specific dollar amounts to hire more nurses. RNAO says health transfer money earmarked for HHR could remedy the challenges Canadians are facing in waiting rooms across the country by increasing the number of and better utilizing the expertise of registered nurses (RN) and nurse practitioners (NP) in all sectors and settings. Expanding the scope of practice of RNs and NPs and funding more NP-led clinics would also improve access to care for millions of Canadians in urban, rural and remote areas who do not have a primary care provider.

RNAO is pleased Ottawa is delivering on its promise for a national dental care plan, which includes million of Canadians whose annual household income is less than $90,000 and no co-payments for families earning below $70,000. “Oral health is an essential component of one’s overall health and we applaud this initiative because it will reach people who are currently uninsured,” adds Grinspun.   

RNAO says it’s disappointed with the lack of progress on a national pharmacare program. The federal government promised action when it appointed former Ontario health minister Dr. Eric Hoskins to provide advice on how to implement such a plan. To date, no meaningful action has been taken despite a comprehensive roadmap and recommendations released by Dr. Hoskins in June 2019. “Drug costs are a big driver of overall health expenditures,” says Grinspun pointing out that “Canada is one of the few countries with universal health care that doesn’t have pharmacare.”

With the country still in the grips of an opioid crisis that is affecting people, families and communities from coast to coast, RNAO says the federal government's commitment is insufficient. Accidental overdose has claimed 35,000 lives since 2016. “We need to respond to this tragedy in a more robust and urgent way if we are to save the average 20 lives lost each day,” says RNAO’s President Dr. Claudette Holloway.

A measure to address the cost of living such as a one-time grocery rebate for eligible families is welcome. Yet, the budget failed to deliver hope to people who are experiencing homelessness or are underhoused and stretched to find safe, affordable shelter. And for the millions of Canadians struggling to meet rent or avoid eviction, Holloway says “we are dismayed with the lack of a concrete plan to ensure affordable and accessible housing and rental accommodation.”  

“Access to safe drinking water is a human right, and although much progress has been made since the Trudeau government took power – there are still 28 Indigenous communities facing long-term drinking water advisories, some of which stretch back decades,” says Holloway adding that “we don’t see new money in the budget to ensure all Indigenous communities can build the necessary infrastructure to secure access to safe drinking water. This is why nurses urge the government to devote sufficient resources to meet its long-overdue undertaking to lift all water advisories,” urges Holloway.

RNAO applauds substantial investments in clean energy to address climate change. “This is the single biggest issue facing humanity and its effects are transforming our planet and threatening the wellbeing of people. However, investments in gas-fired and nuclear generation are taking us in the wrong direction,” says Holloway. RNAO advises the budget’s tax credits for clean hydrogen be structured with great caution to ensure that every funded project is truly clean. Canada’s carbon footprint remains firmly planted in the fossil fuel industry. “We need to do far more to end our reliance on these sources of energy and that begins by stopping new infrastructure projects and well as ending subsidies to the oil and gas industry,” asserts Holloway.

Nurses welcome measures in the budget that enhance fairness, including an increase in the Alternative Minimum Tax on high income Canadians, implementing a global minimum tax on multinational corporations, implementing a tax on repurchases of equity, fairer taxation of dividends received by financial institutions, and strengthening the general anti-avoidance rule.  “We encourage the government to explore further avenues towards a fairer and more progressive tax system,” says Holloway.

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 we serve. For more information about RNAO, visit or follow us on TwitterFacebook and Instagram.

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Contact info

Marion Zych
Director of Communications
Registered Nurses' Association of Ontario (RNAO)
Victoria Alarcon
Communications Officer/Writer
Registered Nurses' Association of Ontario (RNAO)