Canada’s public health system is collapsing, and some frontline health care workers are now speaking out with dire warnings that it’s now or never to save Canada’s public system.
Dr. Naheed Dosani, a palliative care physician and assistant professor at the University of Toronto’s faculty of medicine, says we’ve reached “a boiling point.”
“I have never seen my colleagues so frustrated, angry, and demoralized,” he says.
Perhaps most unnervingly, he believes that provincial governments across Canada are deliberately undermining public health care in order to plant the idea that the only solution is to privatize it.
“The way private health care is brought up in these discussions is insidious. You get the impression, at least in Ontario, that our government is letting our public system collapse to make people frustrated, to make people think that a private system would be better, to make people feel like they want to give up on an equitable system for all,” he says.
When asked recently if the Ontario government is considering privatization, Health Minister Sylvia Jones said only that “all options are on the table.”
“The goal of privatization is to provide profits to shareholders,” Dosani says. “The goal of public health systems is to provide health care to people.”
Lifelong nurse Dr. Veronique Boscart estimates that 70 per cent of her colleagues are in the process of leaving or have already left the profession.
The goal for most frontline health workers right now is just keeping their patients alive and preventing mass casualty situations in ICUs — Boscart describes a system hanging on by a thread.
“We’re beyond the worst-case scenario,” says Boscart, the executive dean for the School of Health and Life Sciences at Conestoga College in Kitchener, Ontario. “When I nurse, I have to choose who’s getting a meal, who’s getting medication, and who dies with dignity. If I am the only nurse in a nursing home with close to 200 residents, how am I going to do all that?”
She says she sometimes goes home after a 12- to 24-hour shift with no breaks and having eaten only from a vending machine, and just cries.
She’s reached a point where she’s open to any and all options, she says, even if that means taking money from the private sector.
“I don’t really know anymore. I used to say, ‘Absolutely not.’ And right now I’m thinking, well, but what’s the solution? What’s the solution? We have hundreds of thousands of delayed surgeries.”
But she does offer a solution: governments could easily increase the availability of nurses by lifting restrictions on the number of students accepted into nursing programs. So far, however, they’ve refused, she says.
“I have the faculty, I have the infrastructure, and I have more than the ability to train every possible nursing student to become a fully-fledged nurse,” she says. “The government limits the seats I have available.”
“We’re now rapidly losing experienced nurses, who say, ‘I can’t do this anymore.’ This is a scary situation.”
Signs of collapse are being seen across the country. In New Brunswick, at least two people died waiting for emergency care, and people in extreme pain are forced to wait hours for an ambulance. Some patients are waiting days to be seen by a doctor. For the first time in Canadian history, ICUs are closing in almost every province.
Recently, premiers met to address the crisis and “hear new ideas.” They kept using the word “innovation” and telling the media that the current system is “not working.”
Dosani says that’s code for privatization.
For-profit companies are already exploiting the staffing crisis in nursing. With the public system hamstrung by legislated pay freezes and retroactive pay cuts, it is now bleeding nurses to private firms that can afford to pay them better. Those companies then provide the same staff back to the same hospitals at a huge markup. Some companies even charge surge pricing, not unlike Uber and Ticketmaster.
It’s a strategy that is being marketed across Canada as the only choice left.
“It has become so common that if things continue at this pace, there will be more temporary-agency nurses working in our hospitals than permanent nurses,” Dosani says.
He cites this as an example of the trend toward for-profit care, which will “bankrupt” the public system.
Ultimately, he says, it’s about pushing U.S.-style, privatized health care in Canada.
“Costs for everyone, especially the working class, will skyrocket. Just look at the U.S., how a medical illness can lead to poverty and homelessness. We are seeing our governments use our hard-earned tax dollars in ways that drive profit for companies that are exploiting the situation we’re in,” Dosani says.
But it’s not like the money to save the public system isn’t there.
In Ontario, the provincial government is still sitting on billions of COVID relief money that it refuses to spend. The province received $8.5 billion in additional funds from the federal government in 2020-21, almost all of it a one-time cash to deal with COVID-19. Even as the pandemic raged, “penny-pinching” Premier Doug Ford’s Progressive Conservatives spent $5.6 billion less than planned in the government’s 2020 budget — including $3.5 billion less than planned on health care.
“The system was already crashing pre-pandemic. Now that we are crawling out of the immediacy of the pandemic, the bare bones of the system are exposed. It’s a disaster,” Boscart says.
For Dosani, the time has come for widespread collective action — by his colleagues in health care as well as everyone that supports a publicly funded health system.
“Solidarity and action to protect our public health system is what’s needed, and we are gonna need every single person that works in our healthcare system to make a statement,” he says.
“I implore colleagues from all different health disciplines, who have different roles within the healthcare system, whether that is frontline, union related, or administrative, to now come together, not just to support the future of our roles and jobs within health care, but the protection of our future healthcare system, and to protect the health of all Ontarians.”
“We will need to be loud, and the louder and more together that we are, the more impactful we will be.”