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

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:

  1. 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.

  2. 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.

  3. 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.  

  4. 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.

  5. 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.

 
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Signatories

  1. Melanie Bechard, MD MPH - Chair, Canadian Doctors for Medicare, Pediatric Emergency Medicine, Ottawa

  2. Hasan Sheikh, MD, CCFP-EM, MPA - Vice Chair, Canadian Doctors for Medicare, Emergency and addiction medicine physician, Toronto, University of Toronto

  3. Danyaal Raza, MD, CCFP - Past Chair, Canadian Doctors for Medicare, Family Medicine, Toronto, University of Toronto

  4. Amit Arya, MD, CCFP (PC), FCFP - Canadian Doctors for Medicare board member, Palliative Medicine, Toronto, Assistant Clinical Professor, McMaster University

  5. Nili Kaplan-Myrth, MD, CCFP, FCFP, PhD - Canadian Doctors for Medicare board member, Family Physician, Ottawa

  6. Joel Lexchin, MD, CCFP(EM), FCFP - Canadian Doctors for Medicare board member, Emergency physician, Toronto, University Health Network

  7. Yipeng Ge, MD - Canadian Doctors for Medicare board member, Public Health Resident Physician, Boston MA, Harvard University

  8. Bernard Ho, MD, CCFP(EM) - Canadian Doctors for Medicare board member, Emergency Medicine, Toronto

  9. Devon Wilton - Canadian Doctors for Medicare board member, Medical Student, Hamilton, McMaster University

  10. Andriy Katyukha, MD - Canadian Doctors for Medicare board member, Internal Medicine Resident Physician, Toronto, University of Toronto

  11. Jasmine Gite, MD - Canadian Doctors for Medicare board member, Family Medicine, Hamilton

  12. Sandy Buchman, MD CCFP (PC) FCFP - Palliative Care Physician, Toronto, University of Toronto

  13. David Fisman MD MPH FRCPC FCAHS - Internal medicine, Toronto, University of Toronto

  14. Suzanne Shoush, B. Eng, MC, CCFP - Family Physician, Toronto, Indigenous Health Faculty Lead, DFCM, University of Toronto

  15. Gordon Guyatt, MD, FRCPC - Internal Medicine, Hamilton, Distinguished Professor, McMaster University, Order of Canada

  16. Ritika Goel, MD MPH CCFP - Family Physician, Toronto, University of Toronto

  17. Naheed Dosani, MD, CCFP(PC), BSc - Palliative Care Physician, Toronto, Assistant Professor, Department of Family & Community Medicine, University of Toronto

  18. Samir Sinha, MD, DPhil, FRCPC - Geriatrician and Professor of Medicine, University of Toronto

  19. Nanky Rai, MD MPH CCFP - Family Physician, Toronto, Parkdale Queen West Community Health Centre

  20. Samantha Green, MD, CCFP - Family Physician, Toronto, University of Toronto

  21. Abdu Sharkawy, MD FRCPC - Infectious Diseases Consultant, Toronto, University Health Network, University of Toronto

  22. Edward Xie, MD MSc CCFP(EM) - Emergency Physician, Toronto

  23. Maria del Junco,MD - Family physician, Toronto

  24. Cathy Vakil, MD, CCFP - Family doctor (retired), Kingston, Queen's University

  25. Catherine Oliver, MD - Family physician (retired), Toronto

  26. Raymond Viola, MD, CCFP - Palliative care/primary care, Kingston

  27. Pat Smith, MD, FCFP - Family Medicine, Dundas, McMaster University, Hamilton Health Sciences

  28. Beverley Jackson, MD, CCFP - Family physician, Toronto

  29. Jesse McLaren, MD, CCFP(EM) - Emergency physician, Toronto, University of Toronto

  30. Abeera Shahid, MD candidate - Medical student, Ottawa, University of Ottawa

  31. Paul Das, MD, MSc, CCFP (EM) - Family Medicine, Emergency Medicine, Toronto University of Toronto

  32. Isser Dubinsky, CCFP(EM) - Emergency physician, Toronto, U of T

  33. Gail Graham, MD FRCPC FCCMG - Medical Genetics, Cumberland

  34. Rachelle Sender, MD, CCFP, FCFP - Family Medicine, Hamilton, HHS

  35. May Cohen, CCFP - Family Physician (retired), Toronto, McMaster University 

  36. Deborah Copes, MD - Family Medicine (retired), Toronto

  37. Nancy Olivieri, MD, FRCPC - Professor, Pediatrics, Medicine and Public Health Sciences, Toronto, University of Toronto

  38. Ginny Edwards, MD,FRCPC – Psychiatry, Toronto

  39. Christina Mills,MD FRCPC- Public Health, Waterloo

  40. Rahel Ahmed, MD - Family medicine, Scarborough

  41. Wendy Reimer, MD - Family Physician, Kitchener

  42. Marcella Jones, MD, MPH, CCFP-EM - Physician, Emergency and Family Medicine, Toronto

  43. Laura Pellow, MD, CCFP - Family medicine, Waterloo

  44. Rebecca Hicks, MD, CCFP - Family physician, Toronto

  45. Mark Cornfield, MD FRCPC – Psychiatry, Port Rowan

  46. Claire Heslop, MD, FRCPC - Emergency Medicine Physician, Toronto

  47. Amna Majeed - Medical student, Toronto, University of Toronto

  48. Vanessa Redditt, MD - Family Physician, Toronto, University of Toronto

  49. Erin Frotten, MD, CCFP - Family medicine, Hamilton

  50. Geneviève Rochon-Terry, MD CCFP - Family Physician, Toronto, University of Toronto

  51. Judith Peranson, MD, MPH, CCFP, FCFP - Family Physician, Toronto

  52. Liana Kaufman, MD CCFP - Family Physician, Toronto, Unity Health Toronto

  53. Eileen Nicolle, MD CM CCFP - Family Medicine, Toronto, University of Toronto

  54. Nicholas Prudhomme, FRCPC - Emergency Physician, Ottawa

  55. Alice Gray, FRCPC - Emergency Medicine, Toronto

  56. David Gruber, MD, CCFP(EM) - Emergency physician, Toronto

  57. Megan Landes, MD -  Emergency Medicine, Toronto

  58. Nisha Kansal, MD, CCFP - Family Physician, Ottawa

  59. Nena-Rae Watson, MD, CCFP - Family Medicine, Toronto, Staff physician, St. Michael Hospital; lecturer U of T

  60. Kathryn Dorman, MD MSc CCFP - Family Physician, Toronto, University of Toronto

  61. Zainab Najarali, CCFP(EM) - Emergency Medicine, Toronto

  62. Anand Sinha, MD, CCFP - Family Medicine/Palliative Care, Toronto

  63. Helen Tam-Tham, MD - Family Physician, Toronto, University of Toronto

  64. Michelle Cohen, MD, CCFP, FCFP - Family physician, Brighton, Queen's University

  65. Trevor Morey, MD CCFP - Family physician, Toronto

  66. Semir Bulle, MD - Psychiatry resident, Toronto, University of Toronto

  67. Gaibrie Stephen - Family Physician, Emergency Medicine, Toronto

  68. Brooks Fallis, MD, FRCPC - Critical Care Physician, Toronto

  69. Yoni Freedhoff, MD, CCFP - Family Medicine, Ottawa, University of Ottawa

  70. Daniel Rosenbaum, MD, FRCPC - Psychiatrist, Toronto, University of Toronto 

  71. Katrina Hui, MD, MS, FRCPC - Psychiatrist, Toronto

  72. Amanda Rosenblum - Palliative Care MD, CCFP(PC), Toronto, University of Toronto 

  73. Sabrina Lin, MD - Family Medicine Resident Physician, Toronto, University of Toronto

  74. Rakhshan Kamran, MD/PhD Candidate - Toronto, McMaster University

  75. Paige Guyatt - Medical Student, Hamilton

  76. Madeline Rampton - Medical Student, Hamilton

  77. Emily Koseck, BSc - Medical Student, Kingston

  78. Sarah Klapman - Medical student, Kitchener

  79. Rithvika Ramesh - Medical Student, Hamilton, McMaster University

  80. Yasmin Dini - Medical Student, Hamilton, McMaster University 

  81. SoroushNedaie - Medical Student, Hamilton, McMaster University

  82. Aravinth Jebanesan - Medical Student, Ottawa, University of Ottawa

  83. Junaid Ishaq - Medical Student, Hamilton, McMaster University

  84. Sean Lazaro - Medical Student, Mississauga, McMaster University

  85. Sophia Zhang - Medical Student, Hamilton, McMaster University

  86. Karen Zhao - Medical Student, Hamilton, McMaster University

  87. Victoria Shi - Medical Student, Waterloo

  88. Omolara Soyinka - Medical Student, Hamilton

  89. Michaela Beder, MD FRCP - Psychiatry, Toronto, University of Toronto

  90. Christine Moon, MD-PhD(C) - Kingston, Queen's University

  91. Kate Reeve, MHSc, MD, CCFP - Family Physician, Toronto

  92. Rebecca Rajakaruna, MD, CCFP - Family Physician, Toronto

  93. Austyn Roseborough - Medical Student, London, Western University 

  94. Claudia Gomez, FRCPC - Anesthesiologist, Ottawa

  95. Ashley Lubberdink, MD, FRCPC - Emergency Physician, Mississauga

  96. Artin Ghassemian, MD, FRCPC - Hematology, London

  97. Laura Muldoon, MD, MPH - Family Physician, Ottawa, University of Ottawa

  98. Mary Boulosm MD - OB/GYN Resident, Toronto, University of Toronto

  99. Nitin Mohan, MD, MPH - Public Health Professional, Oakville, Western University

  100. Yasaman Yazdizadeh - Medical student, Toronto

  101. Oksana Motalo, FRCPC - Hematology, Kingston 

  102. Jill Rudkowski, MD, FRCPC - Critical Care, Hamilton, St. Joseph’s Healthcare Hamilton & McMaster University 

  103. M. Hashim Khan, MBBS, MPH, FRCPC - Respirologist, Toronto

  104. Sadia Mehmood - Medical Student, London, Western University

  105. Lauren Welsh, MD, CCFP-AM - Family Medicine, Toronto

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