2016 Ontario Economic Outlook and Fiscal Review
Chapter I: Creating Jobs and Building Prosperity for Everyone

Section F: Transforming Health Care

Ontario’s “Patients First: Action Plan for Health Care” continues to transform the province’s publicly funded health care system by putting patients first. For patients and their families, this means faster access to better coordinated health care at or as close to home as possible. It also means providing all Ontarians with more health information and ensuring their personal information is kept private and secure. New investments in primary and specialized care, hospitals, mental health services and long-term care across the province — including in northern and Indigenous communities — will help reduce wait times and improve care. Seniors will benefit from savings on out-of-pocket drug costs.

2016 Budget: Jobs for Today and Tomorrow

The 2016 Budget and Ontario’s “Patients First: Action Plan for Health Care” focus on improving the health care experience of patients and their families and achieving the best possible health outcomes for the people of Ontario by:

  • Helping Ontarians get faster access to patient-centred care throughout the province;
  • Offering better coordinated care at or closer to home;
  • Providing information to help people make the best decisions about their health; and
  • Protecting Ontario’s publicly funded health system for the future through evidence-based care and funding.
TABLE 1.6
Regional Health Investment Examples
Region Project Description
Espanola, Dryden, Manitouwadge, Blind River,
Haliburton Highlands
Beginning in 2016, the Province is investing $2.5 million for five rural health hubs in northern and rural communities. The funding will strengthen service integration, coordinating transitions between caregivers and doctors
and making it easier for patients and their families to access their
health care choices.
Champlain (Ottawa, Cornwall, Renfrew, Greater Madawaska) Beginning in 2016, Ontario is investing $2.8 million over three years to provide patients with more access to palliative and end-of-life care in the Champlain region. Hospices offer services that include counselling and day programs for families, caregiver respite, pain and symptom management, end-of-life care, and bereavement support for siblings and parents.
Guelph and Wellington In 2016–17, the Province is investing more than $3 million to expand emergency mental health services in Guelph and Wellington County including $2.4 million for 24-hour mental health nursing and new addictions counsellors for Guelph General Hospital.
Hamilton Hamilton patients will benefit from $10.7 million in new funding this year for Hamilton Health Sciences and $3.8 million for St. Joseph’s Healthcare.
The Province has also invested $1.97 million for local chronic pain programs.
Kingston In 2016–17, patients in the Kingston area will benefit from increased funding of $6.8 million for Kingston General Hospital, $4.0 million for Providence Care and $591,000 for Hotel Dieu Hospital.
North Simcoe Muskoka In 2016–17, the Province is increasing funding by nearly $6.0 million for five hospitals in the North Simcoe Muskoka region including:
  • Collingwood General and Marine Hospital;
  • Orillia Soldiers’ Memorial Hospital; and
  • Muskoka Algonquin Healthcare (various locations).
Toronto and Vaughan
    • As part of an additional $75 million the government is investing in hospice and palliative care across Ontario over the next three years, $625,600 will expand Emily’s House, a children’s hospice in Toronto, to allow approximately 150 patients and their families to receive care.
    • Ontario is also investing about $1 million annually to support 10 new hospice care beds, counselling, programs for families, research and education at Hospice Vaughan Centre of Excellence in Hospice Palliative Care (anticipated to open in 2017–18).

Making Progress

Better Access to Health Care

Primary Care

To help ensure that all Ontarians can get quality health care faster, when and where they need it, the government is continuing to improve access to patient-centred, coordinated primary care across the province. Ontario’s Primary Care Guarantee promised that every Ontarian who wants a primary care practitioner would have one. Today, 94 per cent of Ontarians have a primary care provider, such as a family doctor or nurse practitioner. For the past three years, the number of doctors working in Ontario has grown at a net rate of nearly two new doctors every day and, over the last five years, 11,125 more nurses have been added to Ontario’s health care system.

The Province continues to expand its investment in family health care providers, through an additional $85 million over three years to support the recruitment and retention of nurses, nurse practitioners, social workers, dietitians and other interprofessional health care providers in primary care teams and clinics across the province, including in northern, rural and fast-growing communities. Interprofessional Family Health Teams now provide enhanced access to care in 206 communities and serve more than 3.2 million Ontarians.

The government will continue to improve access to primary care, with more same-day, next-day, after-hours and weekend care, and increased professional scopes of practice, all of which will help reduce wait times and unnecessary emergency department visits.

Reducing Wait Times — Investments in Key Priorities, Hospitals and Cancer Care Services

Ontario has invested almost $2.8 billion since 2003–04 to significantly reduce wait times for priority surgeries, diagnostic procedures and emergency department care. In the 2016 Budget, the government announced an increased investment of more than $345 million for publicly funded hospitals, including a one per cent increase in global base funding.

To assist not only patients, but also their families and loved ones, starting in October 2016, about 900,000 patients and visitors — including 135,000 seniors — are expected to benefit from reduced parking fees and more flexibility when visiting a hospital.

As part of this document, the government is announcing a further $140 million investment to maintain and expand patient access to high-quality services in public hospitals across Ontario as they continue to meet the growing needs of their local communities. With this new investment, all of Ontario’s public hospitals will have received at least a two per cent increase to their base funding in 2016–17. The new funding will help many hospitals sustain and improve access to key services such as elective surgeries and diagnostic imaging, and will help reduce wait times.

Improving Access to Specialists

The Province will establish a more timely, appropriate and transparent specialist referral pathway for patients in Ontario. This will include enhanced public reporting of wait times, and centralized intake and assessment, so that Ontarians will wait less and can receive specialist care closer to home when they need it.

Further Investment in Specialized Cancer Care

In response to increased demand for highly specialized complex services and to expand access and reduce wait times in growing communities across the province, an additional $130 million is being invested over three years in cancer care services.

Since the 2016 Budget, the government has further committed to improving access to highly specialized stem-cell transplantation in Ontario. In addition to investments at the University Health Network, Hamilton Health Sciences and The Ottawa Hospital, the Province plans to build more specialized rooms to treat people with lymphoma, leukemia, myeloma and other blood disorders at Sunnybrook Health Sciences Centre in Toronto.

First Nations Health Action Plan

In May, Ontario launched the First Nations Health Action Plan with an investment of up to $222 million over three years. The action plan, being implemented with Indigenous partners and with an initial focus on the north, will help ensure Indigenous peoples have access to culturally appropriate and effective health care, including primary, hospital and seniors’ care, public health and health promotion, life promotion and crisis support.

Following the initial investment, sustained annual funding of $104.5 million will help improve access to culturally appropriate health services over the long term. As part of this, the Province will continue to work with Indigenous partners to invest a total of $88.5 million over three years, and $54.1 million ongoing, in primary, home and community care, and diabetes prevention and management.

In May, as part of “The Journey Together: Ontario’s Commitment to Reconciliation with Indigenous Peoples,” the government committed to help stop the cycle of intergenerational trauma by investing in mental health and addictions programs and services that will address the needs of Indigenous peoples, families and communities. Ontario also pledged to establish up to six new or expanded Indigenous Mental Health and Addictions Healing and Treatment Centres, working closely with Indigenous partners.

In 2016–17, Ontario has also provided $2 million to fund consultations with 10 First Nation, Métis and urban Indigenous organizations for their input on mental health and addictions issues facing Indigenous peoples across the province. Their advice will continue to be incorporated into implementing “Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy.”

Open Minds, Healthy Minds: Ontario’s Comprehensive Mental Health and Addictions Strategy

Phase 1 of Open Minds, Healthy Minds (from 2011 to 2014) focused on children and youth. Phase 2 of the strategy, with advice from the Mental Health and Addictions Leadership Advisory Council, also includes adults, youth in transition and people with addictions. In addition to approximately $1 billion that the government invests annually in mental health and addictions services, it has invested $83 million more under the strategy since 2014 to support a combined total of 205 community mental health and addictions initiatives for Ontarians, and an additional $4 million for 248 new supportive housing units for people with mental illness and addictions.

Dementia Strategy

The government began consultations across the province this fall to improve access to the best models of care for almost 230,000 people newly diagnosed or living with dementia, and to support their caregivers. The new dementia strategy will build on the current investment of $31 million to strengthen Alzheimer Society chapters across Ontario and will benefit from the $54 million invested annually for Behavioural Supports Ontario (BSO). Behavioural Supports Ontario works to enhance health care services and quality of life for older Ontarians and their families who are living with complex, challenging behaviours associated with dementia or other mental health or neurological conditions, both at home and in long-term care homes.

Low-Income Drug Benefits

The government increased the Ontario Drug Benefit threshold for low-income seniors in August 2016, thereby increasing access for over 170,000 seniors who are now eligible to apply for reduced fees for their prescription medications. Qualified seniors will save about $130 per year, on average, in out-of-pocket drug costs. Under this plan, approximately 30,000 more seniors can qualify every year.

Ontario continues to support a national approach to public drug benefits to ensure equitable access to high-quality prescription drugs for all Ontarians.

Expanded Immunization

Vaccines are widely recognized as one of the most successful and cost-effective investments in health care. Ontario offers free flu vaccines in more than 2,500 pharmacies and free routine immunizations through primary care and public health units. In September 2016, the Province expanded its immunization program to include human papillomavirus (HPV) coverage for more youth, and — with a $68 million investment over three years — to offer free shingles vaccines for seniors aged 65 to 70, saving them about $170 each in out-of-pocket expenses, and helping to reduce emergency room visits and hospitalizations.

Ontario will reintroduce legislation to amend the Immunization of School Pupils Act to protect students and communities with stronger requirements for school vaccine exemptions.

Fertility Services

To expand access to fertility services, the Province is helping more than 5,000 Ontarians per year with all forms of infertility at 52 clinics across Ontario, by contributing to the cost of one in vitro fertilization cycle per eligible patient. As a result, more Ontarians are growing their families.

More Coordinated Care at Home and in Communities

More Integrated Home and Community Care

Ontario is continuing to increase funding for high-quality home and community care by about five per cent per year to 2017–18, including a $250 million increase in 2016–17. As part of that commitment, in July 2016, the government allocated $100 million to enhance support for home-care clients with high needs, including $80 million for enhanced home care and $20 million for caregiver respite. The minimum base wage for eligible personal support workers, the backbone of the home and community care sector, increased to $16.50 per hour as of April 2016.

Home-care patients and those who care for them will benefit from approximately:

  • 350,000 additional hours of nursing care;
  • 1.3 million additional hours of personal support;
  • 600,000 additional hours of respite services for caregivers; and
  • 100,000 additional hours of rehabilitation.

The proposed Patients First Act has been reintroduced as Bill 41. Pending approval by the legislature, the Act would better enable coordinated access to timely and seamless primary, home and community care by expanding the role of Local Health Integration Networks to better plan the care in their communities. Ontario is also developing a capacity planning framework to help provide the right coordinated care in the most appropriate setting — hospital, long-term care home or community — and to reduce the need for unnecessary patient stays or readmissions, starting with a dementia planning model.

Ensuring Safety and Quality of Life for Long-Term Care Home Residents

Over the past 10 years, Ontario has nearly doubled long-term care home funding to about $4 billion per year. Going forward, the Province will provide an annual increase of two per cent for the next three years, and additional funding to encourage operators to redevelop more than 30,000 long-term care beds across Ontario by 2025, ultimately eliminating four-bed ward rooms.

Greater Choice in Hospices and Palliative Care

The government has pledged to provide Ontarians with greater quality, choice, access and equity in community-based palliative and end-of-life care, along with more supports for caregivers. It has invested an additional $75 million in residential hospices and palliative care over the next three years, including support for existing hospices, plus up to 20 new hospices. This funding is in addition to the $80 million already invested in hospice and palliative care, almost doubling the number of palliative care beds, including in rural areas. These investments are improving end-of-life care, helping Ontarians reach the end of life’s journey peacefully.

Medical Assistance in Dying

In February 2015, the Supreme Court of Canada struck down the federal law prohibiting medical assistance in dying in certain circumstances. In response to the court’s decision, on June 17, 2016, the Canadian Parliament passed legislation that now guides how medical assistance in dying can be provided.

Individuals and their families can consult with their doctors or nurse practitioners as they contemplate end-of-life decisions. Ontario’s health regulatory colleges, such as the College of Physicians and Surgeons of Ontario, have established professional guidelines to help support patients who request medical assistance in dying.

Ontario has also established a referral service to connect physicians with other doctors who are able to complete a patient consultation and assessment. The government plans to propose legislative amendments to enable implementation and is committed to ensuring that care is provided appropriately, safely and with compassion. Medical assistance in dying is covered by existing provincial health programs, and the related drugs are available at no cost.

Better Health Information

Stronger Accountability, Transparency and Privacy

The Healthy Menu Choices Act, 2015, amended in April 2016, will help Ontarians make better informed decisions about their food choices by requiring calorie information to be posted in certain chain restaurants and grocery stores as of January 1, 2017.

In May, Ontario amended the Personal Health Information Protection Act, 2004, to strengthen patient privacy, accountability and transparency by increasing sanctions against privacy breaches and affirming patients’ rights to access information about their own health care.

Protecting Patients’ Health and the Health Care System

Pain Management and Preventing Opioid Abuse

Opioid misuse is the third leading cause of accidental death in Ontario. To prevent opioid addiction and overdose, the government’s new comprehensive opioid strategy includes modernizing prescribing and monitoring practices, improving the treatment of pain and connecting patients with more high-quality addiction treatment and harm reduction services. The Province is investing $17 million annually to create or enhance 17 chronic pain clinics across Ontario to improve timely, appropriate patient care.

Under the strategy, the government has expanded free access for patients to naloxone, an anti-opioid drug, to prevent overdose deaths. Dr. David Williams, Ontario’s chief medical officer of health, now designated as the first-ever provincial overdose coordinator, will launch a new surveillance and reporting system to identify the risks associated with opioid use and overdose in the province. As well, evidence-based standards on appropriate opioid prescribing will be released by the end of 2017–18.

In fall 2016, the government will be consulting with families, caregivers, health care providers, academics and people with lived experience to seek input on the strategy.

As of October 2016, Suboxone, a treatment used to relieve opioid withdrawal symptoms, has been made more widely available under the Ontario Drug Benefit Program. Suboxone has a lower risk of overdose than methadone.

Preventing Sexual Abuse of Patients

To reinforce its zero tolerance policy on the sexual abuse of patients by any regulated health professional, the government has announced plans to bring forward legislative amendments in fall 2016 and take additional action to strengthen accountability based on the recommendations of the Minister’s Task Force on the Prevention of Sexual Abuse of Patients.

Ontario’s Patient Ombudsman

In July 2016, Christine Elliott, Ontario’s first patient ombudsman, began investigating unresolved patient complaints about treatment in public hospitals, long-term care homes and Community Care Access Centres. The ombudsman will report publicly and make recommendations to the Minister of Health and Long-Term Care.