The federal government's budget contains progressive measures that address social determinants of health such as child care, affordable housing, infrastructure funding for Indigenous communities and a $15 minimum wage. It also pledges to continue programs that have lessened the socio-economic impacts resulting from the pandemic, especially on those most vulnerable. It does not move fast enough on national standards for long-term care (LTC) and offers no progress for a national pharmacare program.
The Registered Nurses' Association of Ontario (RNAO) says promises outlined by Finance Minister Chrystia Freeland are welcome and, if realized, will help individuals and families, especially those who have experienced the cracks of inequity aggravated by the COVID-19 pandemic.
"A $15 minimum wage – championed by nurses in Ontario – sends a strong message and creates pressure for the provinces to do the same. Of major importance is the commitment to affordable and accessible child care. Nurses are among those who know the challenges of finding reliable care for their families," says RNAO CEO Dr. Doris Grinspun. "We know how the economy has been impacted by the virus and that is precisely why those affected by the downturn need help the most," adds Grinspun, acknowledging the ongoing need for federal pandemic subsidy programs for wages and rent.
RNAO praised Ottawa's $6 billion five-year commitment to Indigenous communities for infrastructure projects for clean water, housing and other projects. Access to safe drinking water is a basic human necessity, and it is shameful there are still children in our country that have never been able to drink water from their taps," Grinspun says.
Improvements in long-term care (LTC) are critically important. RNAO is pleased to see $3 billion dedicated to improving the lives of residents, over five years, starting in 2022-23 – although the hope was for immediate investment. "This promise came after the first wave of COVID-19 and the urgency for residents has only grown. What message are we sending to the families of more than 15,000 LTC residents who died of COVID-19 across Canada – including 4,409 in Ontario," asks Grinspun. She says RNAO will "actively contribute to the Health Standards Organization and Canadian Standards Association on development of national standards to improve the quality of life in LTC." RNAO's expert work on evidence-based clinical guidelines for nurses and other health-care workers will help advance national standards. So will the association's Nursing Home Basic Care Guarantee, which models a minimum of four worked hours of direct nursing and personal care for each resident per day.
RNAO is disappointed that the budget failed to outline next steps and new funding for the government's long promised national pharmacare program. "Access to medicine is a human right. Every developed country in the world with universal health-care coverage includes pharmacare. No one, especially in these precarious economic times, should have to make a choice between getting a prescription filled and putting food on the table or paying the rent," says RNAO President Morgan Hoffarth. "We can and must do better on advancing pharmacare."
The pandemic has also highlighted public policy failures involving all levels of government – the decade-old opioid overdose crisis and a crisis of even much longer duration, homelessness. The budget does little to respond to the devastating impacts of either crisis. In spite of a 74 per cent increase in opioid-related deaths last reported on September, 2020, the federal government continues to respond with helpful but insufficiently funded measures.
RNAO commends the investments in affordable housing but would have liked to see faster and higher amounts, for "Reaching Home," the federal government's homelessness strategy. "The pandemic has reinforced the importance of having a place to call home and respecting housing as a human right. Any recovery from the pandemic must be a recovery for all because housing is a fundamental determinant of health," says Hoffarth. She adds that across the country, more than 250,000 people have no place to call home – a reality that puts them at great risk of illness and disease.
RNAO says more attention must be made to the revenue side of the budget. While we welcome the budget's proposed luxury taxes, they are not sufficient to fund the important measures required to ensure greater health equity in Canada. RNAO calls on the federal government to implement an annual wealth tax and an inheritance tax, more resources to fight those who engage in tax avoidance and tax evasion, and other measures to ensure that there is a fairer distribution of the enormous wealth generated by the Canadian economy. This includes implementing the planned digital services tax sooner and at a higher rate than announced by Minister Freeland.
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 RNAO.ca or follow us on Facebook and Twitter.