Spring budget provides much needed expansion of primary care - Urgent investment missing to address the drug toxicity crisis

March 26, 2024

Efforts to bolster the province’s nursing workforce are being met with optimism by members of the Registered Nurses’ Association of Ontario (RNAO). We welcome measures announced in Tuesday’s budget by Finance Minister Peter Bethlenfalvy, including $546 million over three years for primary care expansion that covers 600,000 Ontarians.
“This additional funding recognizes the role of the bilateral health agreement with the federal government in opening up access to primary care in Ontario. RNAO now expects the government to grant approval for additional nurse practioner-led clinics (NP) as many proposals await funding,” says RNAO President Dr. Claudette Holloway.  

“RNAO also calls on Minister Sylvia Jones’ approval of an alternative funding model for NPs in independent practice that would enable them to serve Ontarians, without the need to charge a fee – a practice RNAO opposes,” adds Holloway, noting that more than two million people living in Ontario don’t have access to a dedicated primary care provider. “Capitalizing on the education and expertise of NPs is central to solving access to primary care for everyone, including equity-deserving populations, and people living in rural and remote communities.”  

“The modest increase in funding for home health care, while welcome, is insufficient to bring the salaries of home care nurses in line with those who work in acute care. This is vital to enable people to safely continue their recovery at home after surgery, and to help seniors remain vibrant members of our communities as long as possible,” says Holloway. “And, if we want to transform the health system to where it needs to be, it requires a shift in focus from institutional care to community care, as outlined in RNAO’s Enhancing Community Care for Ontarians 3.0 report.”
Welcome news is the $128 million to permanently add 2,000 RN seats and 1,000 RPN seats –  urgently needed given the nursing shortage affecting Ontarians. “We are delighted to see these increases, and we expect to see a corresponding increase to the number of NP seats given the shortage of family doctors and the critical role of NPs in addressing access challenges,” says Holloway. 

“The funding announced for hospitals must be earmarked to open operating rooms 24 hours a day, seven days a week to clear wait lists,” says RNAO CEO Dr. Doris Grinspun, adding that “there is no need for investor-driven, for-profit surgical clinics when we have nurses and physicians already working in our publicly funded hospitals. For-profit surgical clinics cost more and undermine the essential publicly-delivered services upon which Ontarians rely.” 

Not all is well with this budget, says Grinspun. Building a Better Ontario offers no help and no comfort for those suffering with substance use. While deaths due to drug toxicity continue, the government’s inaction is costing lives. RNAO is demanding that Premier Doug Ford implement a province-wide harm reduction strategy. It also wants the government to fulfill its initial promise to fund 21 consumption and treatment services (CTS) sites, and fund additional ones in communities that have identified a need such as Belleville.

Recognizing that housing is both a crucial determinant of health and a fundamental human right, Grinspun notes that “increasing density and moving away from urban sprawl is important to keep people housed in our province. In addition, RNAO urges the government to spend one per cent of the provincial budget on housing, with a focus on meeting its commitments to affordable and accessible housing builds under the bilateral housing agreement with the federal government.”

Grinspun is shocked the budget was largely silent on addressing the climate crisis – the most formidable determinant of health we face. “While we should be phasing out the use of fossil fuels, the province is moving in the wrong direction with an increasing reliance on gas-fired electricity plants, at a time when the cost of renewable forms of energy such as wind and solar is going down.” 

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 X (formerly Twitter)Facebook and Instagram.

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Contact info

Marion Zych
Director of Communications
Registered Nurses' Association of Ontario (RNAO)