Fix Ontario Health Care: An Open Letter to the Premier, Minister of Health, and Minister of Long-Term Care

October 21, 2022

Following the release of the Ford government’s “Plan to Stay Open”, we heard from a number of CDM members expressing their concern and outrage.

Canadian Doctors for Medicare Board Members working in Ontario drafted an open letter to the Premier, Minister of Health and Minister of Long-Term Care in Ontario in response to their plan.

While we understand that long-term solutions are required to address the current situation, we also know that some steps can be taken immediately to relieve the strain on our system and improve the care Ontarians receive on a daily basis.

We are calling upon the government to repeal Bill 124 and Bill 7, invest in not-for-profit delivery of care and primary care so that everyone has a patient-centered home, and take adequate measures to control infectious diseases like COVID-19 and Influenza.

The letter, copied below, was sent to the Premiers and Ministers on Monday, October 31st with more than 100 signatures from Ontario physicians and medical students. To download a copy of the letter, click here. To view the original form and sign your name, click here.

Fix Ontario Health Care: An Open Letter to the Premier, Minister of Health, and Minister of Long-Term Care

TO:
The Honourable Doug Ford, Premier of Ontario
The Honourable Sylvia Jones, Minister of Health
The Honourable Paul Calandra, Minister of Long-Term Care

Emergency departments are overwhelmed, facing closures and overcrowding. Hallway medicine has become a daily reality. But the emergency department is just the “canary in the coal mine”, a symptom of upstream dysfunction in our health care system.

We are writing as Ontario-based physicians and medical trainees to express our grave concerns regarding Ontario’s “Plan to Stay Open.” This plan not only fails to adequately address the underlying reasons our health care system is in crisis, it will further degrade a system that is already under-staffed and over capacity. It will further worsen existing inequities and further marginalize our most vulnerable patients.

We understand that the long-term solutions to the current situation will require a prolonged effort. However, some steps can be implemented immediately to improve the care Ontarians receive on a daily basis.

At Canadian Doctors for Medicare, we believe that reforms must be rooted in a commitment to publicly-funded health care.

We call upon your government to take the following actions immediately:

Repeal Bill 124. While we are encouraged by the commitment to stabilize private nursing agency fees and reduce barriers for the entry of internationally educated nurses, a focus on recruitment alone without addressing retention will perpetuate the revolving door of nurses leaving the system. A recent survey showed that the primary reason nurses are leaving the profession is wage dissatisfaction. An overwhelming majority of nurses (91%) feel they are not being fairly compensated. Repeal Bill 124 immediately and provide all health workers affected by it, including nurses, with fair wages.

Invest in not-for-profit delivery of care. The evidence shows that outsourcing health care delivery to private for-profit entities results in worse health outcomes at a higher cost to the public. We understand the need to reduce the surgical backlog. Using specialized surgical clinics that can perform a high volume of certain surgeries efficiently may be part of how we do that. However, there is no reason why these centres need to be operated on a for-profit basis, using public funds to pay shareholders or investors. We ask you to commit to focus public investments into health care services that are operated on a not-for-profit basis, consistent with the best available evidence.

Repeal Bill 7. Sending frail elders and people with disabilities to long-term care facilities without consent is a violation of their basic human rights. Many of these individuals are in the last years - sometimes even months - of their lives. Many require their family members and caregivers to be close by and accessible in order to provide essential care such as feeding, helping to take medications, assisting with translation, and care planning. By coercing patients into long-term care facilities which are not of their choosing or that could be far away from their communities, we will see more suffering, and even premature death, in a population which is already extremely vulnerable. As nearly 100% of older Ontarians wish to receive care in their own homes for as long as possible, we ask for your government to further increase investment in home care which would allow more hospitalised patients to return and even remain in their own homes.

Invest in primary care so that everyone in Ontario has a patient-centered medical home. Health care systems built on robust primary care have better outcomes, lower costs and better equity. Everyone in Ontario needs a relationship not just with a single family physician, but with a primary care team. Team-based primary care allows patients to access professionals like nurses, dieticians, and physiotherapists to more comprehensively address their health care needs. Improving access to primary care can alleviate strain on our emergency departments by helping to address the root causes of what sends patients to the ER in the first place.

Take measures to control infectious diseases. The COVID-19 pandemic is not yet finished and we are about to enter influenza season, yet we are significantly lagging on rates of booster and paediatric vaccinations. With yet another wave expected in the fall, we need to take proactive measures to prevent the spread of infectious diseases like COVID-19 and influenza. We implore you to consider not only the individual impacts of increased disease transmission, but also the repeated strain it places on a health care system already in crisis.

We welcome the opportunity to discuss the urgent need for action with you further.

Signatories
Melanie Bechard, MD MPH - Chair, Canadian Doctors for Medicare, Pediatric Emergency Medicine, Ottawa
Hasan Sheikh, MD, CCFP-EM, MPA - Vice Chair, Canadian Doctors for Medicare, Emergency and addiction medicine physician, Toronto, University of Toronto
Danyaal Raza, MD, CCFP - Past Chair, Canadian Doctors for Medicare, Family Medicine, Toronto, University of Toronto
Amit Arya, MD, CCFP (PC), FCFP - Canadian Doctors for Medicare board member, Palliative Medicine, Toronto, Assistant Clinical Professor, McMaster University
Nili Kaplan-Myrth, MD, CCFP, FCFP, PhD - Canadian Doctors for Medicare board member, Family Physician, Ottawa
Joel Lexchin, MD, CCFP(EM), FCFP - Canadian Doctors for Medicare board member, Emergency physician, Toronto, University Health Network
Yipeng Ge, MD - Canadian Doctors for Medicare board member, Public Health Resident Physician, Boston MA, Harvard University
Bernard Ho, MD, CCFP(EM) - Canadian Doctors for Medicare board member, Emergency Medicine, Toronto
Devon Wilton - Canadian Doctors for Medicare board member, Medical Student, Hamilton, McMaster University
Andriy Katyukha, MD - Canadian Doctors for Medicare board member, Internal Medicine Resident Physician, Toronto, University of Toronto
Jasmine Gite, MD - Canadian Doctors for Medicare board member, Family Medicine, Hamilton
Sandy Buchman, MD CCFP (PC) FCFP - Palliative Care Physician, Toronto, University of Toronto
David Fisman MD MPH FRCPC FCAHS - Internal medicine, Toronto, University of Toronto
Suzanne Shoush, B. Eng, MC, CCFP - Family Physician, Toronto, Indigenous Health Faculty Lead, DFCM, University of Toronto
Gordon Guyatt, MD, FRCPC - Internal Medicine, Hamilton, Distinguished Professor, McMaster University, Order of Canada
Ritika Goel, MD MPH CCFP - Family Physician, Toronto, University of Toronto
Naheed Dosani, MD, CCFP(PC), BSc - Palliative Care Physician, Toronto, Assistant Professor, Department of Family & Community Medicine, University of Toronto
Samir Sinha, MD, DPhil, FRCPC - Geriatrician and Professor of Medicine, University of Toronto
Nanky Rai, MD MPH CCFP - Family Physician, Toronto, Parkdale Queen West Community Health Centre
Samantha Green, MD, CCFP - Family Physician, Toronto, University of Toronto
Abdu Sharkawy, MD FRCPC - Infectious Diseases Consultant, Toronto, University Health Network, University of Toronto
Edward Xie, MD MSc CCFP(EM) - Emergency Physician, Toronto
Maria del Junco,MD - Family physician, Toronto
Cathy Vakil, MD, CCFP - Family doctor (retired), Kingston, Queen's University
Catherine Oliver, MD - Family physician (retired), Toronto
Raymond Viola, MD, CCFP - Palliative care/primary care, Kingston
Pat Smith, MD, FCFP - Family Medicine, Dundas, McMaster University, Hamilton Health Sciences
Beverley Jackson, MD, CCFP - Family physician, Toronto
Jesse McLaren, MD, CCFP(EM) - Emergency physician, Toronto, University of Toronto
Abeera Shahid, MD candidate - Medical student, Ottawa, University of Ottawa
Paul Das, MD, MSc, CCFP (EM) - Family Medicine, Emergency Medicine, Toronto University of Toronto
Isser Dubinsky, CCFP(EM) - Emergency physician, Toronto, U of T
Gail Graham, MD FRCPC FCCMG - Medical Genetics, Cumberland
Rachelle Sender, MD, CCFP, FCFP - Family Medicine, Hamilton, HHS
May Cohen, CCFP - Family Physician (retired), Toronto, McMaster University
Deborah Copes, MD - Family Medicine (retired), Toronto
Nancy Olivieri, MD, FRCPC - Professor, Pediatrics, Medicine and Public Health Sciences, Toronto, University of Toronto
Ginny Edwards, MD,FRCPC - Psychiatry, Toronto
Christina Mills,MD FRCPC - Public Health, Waterloo
Rahel Ahmed, MD - Family medicine, Scarborough
Wendy Reimer, MD - Family Physician, Kitchener
Marcella Jones, MD, MPH, CCFP-EM - Physician, Emergency and Family Medicine, Toronto
Laura Pellow, MD, CCFP - Family medicine, Waterloo
Rebecca Hicks, MD, CCFP - Family physician, Toronto
Mark Cornfield, MD FRCPC - Psychiatry, Port Rowan
Claire Heslop, MD, FRCPC - Emergency Medicine Physician, Toronto
Amna Majeed - Medical student, Toronto, University of Toronto
Vanessa Redditt, MD - Family Physician, Toronto, University of Toronto
Erin Frotten, MD, CCFP - Family medicine, Hamilton
Geneviève Rochon-Terry, MD CCFP - Family Physician, Toronto, University of Toronto
Judith Peranson, MD, MPH, CCFP, FCFP - Family Physician, Toronto
Liana Kaufman, MD CCFP - Family Physician, Toronto, Unity Health Toronto
Eileen Nicolle, MD CM CCFP - Family Medicine, Toronto, University of Toronto
Nicholas Prudhomme, FRCPC - Emergency Physician, Ottawa
Alice Gray, FRCPC - Emergency Medicine, Toronto
David Gruber, MD, CCFP(EM) - Emergency physician, Toronto
Megan Landes, MD - Emergency Medicine, Toronto
Nisha Kansal, MD, CCFP - Family Physician, Ottawa
Nena-Rae Watson, MD, CCFP - Family Medicine, Toronto, Staff physician, St. Michael Hospital; lecturer U of T
Kathryn Dorman, MD MSc CCFP - Family Physician, Toronto, University of Toronto
Zainab Najarali, CCFP(EM) - Emergency Medicine, Toronto
Anand Sinha, MD, CCFP - Family Medicine/Palliative Care, Toronto
Helen Tam-Tham, MD - Family Physician, Toronto, University of Toronto
Michelle Cohen, MD, CCFP, FCFP - Family physician, Brighton, Queen's University
Trevor Morey, MD CCFP - Family physician, Toronto
Semir Bulle, MD - Psychiatry resident, Toronto, University of Toronto
Gaibrie Stephen - Family Physician, Emergency Medicine, Toronto
Brooks Fallis, MD, FRCPC - Critical Care Physician, Toronto
Yoni Freedhoff, MD, CCFP - Family Medicine, Ottawa, University of Ottawa
Daniel Rosenbaum, MD, FRCPC - Psychiatrist, Toronto, University of Toronto
Katrina Hui, MD, MS, FRCPC - Psychiatrist, Toronto
Amanda Rosenblum - Palliative Care MD, CCFP(PC), Toronto, University of Toronto
Sabrina Lin, MD - Family Medicine Resident Physician, Toronto, University of Toronto
Rakhshan Kamran, MD/PhD Candidate - Toronto, McMaster University
Paige Guyatt - Medical Student, Hamilton
Madeline Rampton - Medical Student, Hamilton
Emily Koseck, BSc - Medical Student, Kingston
Sarah Klapman - Medical student, Kitchener
Rithvika Ramesh - Medical Student, Hamilton, McMaster University
Yasmin Dini - Medical Student, Hamilton, McMaster University
SoroushNedaie - Medical Student, Hamilton, McMaster University
Aravinth Jebanesan - Medical Student, Ottawa, University of Ottawa
Junaid Ishaq - Medical Student, Hamilton, McMaster University
Sean Lazaro - Medical Student, Mississauga, McMaster University
Sophia Zhang - Medical Student, Hamilton, McMaster University
Karen Zhao - Medical Student, Hamilton, McMaster University
Victoria Shi - Medical Student, Waterloo
Omolara Soyinka - Medical Student, Hamilton
Michaela Beder, MD FRCP - Psychiatry, Toronto, University of Toronto
Christine Moon, MD-PhD(C) - Kingston, Queen's University
Kate Reeve, MHSc, MD, CCFP - Family Physician, Toronto
Rebecca Rajakaruna, MD, CCFP - Family Physician, Toronto
Austyn Roseborough - Medical Student, London, Western University
Claudia Gomez, FRCPC - Anesthesiologist, Ottawa
Ashley Lubberdink, MD, FRCPC - Emergency Physician, Mississauga
Artin Ghassemian, MD, FRCPC - Hematology, London
Laura Muldoon, MD, MPH - Family Physician, Ottawa, University of Ottawa
Mary Boulosm MD - OB/GYN Resident, Toronto, University of Toronto
Nitin Mohan, MD, MPH - Public Health Professional, Oakville, Western University
Yasaman Yazdizadeh - Medical student, Toronto
Oksana Motalo, FRCPC - Hematology, Kingston
Jill Rudkowski, MD, FRCPC - Critical Care, Hamilton, St. Joseph’s Healthcare Hamilton & McMaster University
M. Hashim Khan, MBBS, MPH, FRCPC - Respirologist, Toronto
Sadia Mehmood - Medical Student, London, Western University
Lauren Welsh, MD, CCFP-AM - Family Medicine, Toronto