Provincial budget

• Health expenditures are expected to increase by 0.6 per cent from $84.5 billion in 2023-24 to $85.0 billion in 2024-25. The 2024-25 health expenditure projection of $85.0 billion in the 2024 budget is a one per cent increase compared to the 2024-25 projection of $84.2 billion from the 2023 provincial budget
• Health spending is expected to grow by an average of two per cent per year between 2023-24 and 2025-26
• An additional $546 million over three years for team-based primary care building on the $110 million for interdisciplinary primary care teams announced on Feb 1, 2024. This additional funding is expected to provide team-based primary care to approximately 600,000 people
• The Canada Health Transfer is expected to be $19.28 billion in 2023-24, which represents 22.8 per cent of Ontario’s expected health expenditure for 2023-24

• An investment of $546 million over three years, with the intention of attaching 600,000 Ontarians to team-based care
• Supporting York University in establishing a new medical school in Vaughan. This will be the first medical school in Canada primarily focused on training family doctors
• The government is investing $50 million over three years to enhance and stabilize health-care capacity within Northern and rural communities. This investment will go towards improving recruitment, retention, education and care models to support residents in Northern Ontario. This includes supporting the expansion of existing rural generalist pathways for physicians

There was no initiative announced in the 2024 budget. The OMA is committed to ongoing work with the government to tackle this issue.

• 2024 budget invests an additional $2 billion in home and community care over three years to accelerate investments to increase compensation for personal support workers, nurses and other front-line care providers, and to stabilize expanded services
• Expanding palliative care services in local communities by adding up to 84 new adult beds and 12 pediatric beds, bringing the total to more than 750

• The province has allocated $965 million, including a four per cent increase in total base hospital operations, towards maximizing and expanding surgical procedures to lower wait times
• The government has also committed to funding Northern hospitals in order to address health human resources shortages, staffing costs and emergency department closures
• An approximate $50 billion over 10 years in health infrastructure, including close to $36 billion in capital grants, will be put towards more than 50 hospital projects that would add about 3,000 new beds
• $500 million over 10 years for small hospital projects and community health programs. Additionally, $620 million over 10 years will go towards the Health Infrastructure Renewal Fund and Community Infrastructure Renewal Fund

• $743 million over three years as an investment to address immediate health-care staffing needs, including increasing nursing educational spots and investments to increase and stabilize the emergency department nursing workforce. This includes $128 million for 2,000 registered nurse and 1,000 registered practical nurse seats in colleges and universities
• An additional 700 education seats for medical radiation and imaging technologists, medical laboratory technologists, medical lab technicians and medical radiation extenders

• $396 million over three years to improve access to and expand health and addictions services as well as continue the Addictions Recovery Fund
• The budget also included proposed changes to strengthen fines in the Tobacco Tax Act

• $155 million in 2024-25 to increase the construction funding subsidy, to support the cost of developing or redeveloping a long-term care home
• Specialized long-term care beds: $46 million over three years, starting in 2024-25, to support the continued operation of 59 Behavioural Specialized Unit beds added in 2023-24, and to add more than 200 net new BSU beds to expand care for individuals with complex needs

• Innovative health-care technologies: $12 million to establish a new Health Technology Accelerator Fund to help health-care service providers buy and use promising new technologies to improve patient care. This fund will provide innovators, including Ontario-based companies, more opportunities to partner with the health-care system to promote early adoption
• Improving health-care equity: An approximate $94 million over three years will go towards promoting the health and well-being for Indigenous and Northern communities, as well as $50 million dedicated towards improving culturally responsive and safe care for women and children. Additionally, $152 million over the next three years to support individuals facing unstable housing conditions and dealing with mental health and addictions challenges
• $45 million over three years to enhance the Northern Health Travel Grant Program. Residents of these communities who travel more than 100 kilometres to consult with medical professionals and receive care will be eligible for enhanced supports including an additional $75 per night accommodation allowance

This initiative is a legacy-defining opportunity for this government. Currently, 2.3 million Ontarians do not have a family physician, and this will balloon to 4.4 million by 2026 unless something is done. Let’s work together to ensure everyone has access to a family physician by:

1. Expanding access to team-based care for all Ontarians when and where they need it
2. Building a sustainable northern and rural physician workforce strategy

Only 25 per cent of Ontarians have access to government-funded teams, which consist of inter-professional health-care providers, each working to their full scope of practice to provide comprehensive primary care services to patients in their community. That means 10.5 million Ontarians are not part of team-based care. Investing in primary care is a cost-effective strategy to reduce expensive emergency department visits and lengthy and unnecessary hospital stays. In early 2023, the government announced a $30-million investment to create new primary care teams. This is just a fraction of the amount required and the sector is still eagerly waiting to learn which teams will be awarded funding, which was announced almost a year ago. We strongly recommend the government moves quickly with the necessary investments to ensure that at least 50 per cent of Ontarians have access to team-based care by March 31, 2026.

We must ensure doctors can spend time being doctors and caring for patients. We know the average family physician spends almost 40 per cent of their work week on administrative tasks that take them away from patients and impacts their quality of work life. Let’s make sure the physicians we have now are focusing on what they do best, providing patient care. To do this, we encourage the government to move forward on the following:

1. Create a centralized intake and referral system by March 31, 2025
2. Streamline forms and reduce sick notes and referral letters
3. Fund the use of artificial intelligence scribes
4. Improve Health Report Manager by March 31, 2025

These efficiency initiatives will help reduce non-clinical work for physicians and improve access to care for patients. Developing a centralized referral system will help eliminate long wait times for surgery, diagnostic tests, specialist consults and many other barriers to accessing care. The government has an opportunity now to work with physicians to scale a centralized intake and referral system to cover the province and demonstrate results by 2026. With this system, patients can choose the shortest wait time in their area or a preferred surgeon/specialist, based on known wait times. Patients would no longer be left waiting for weeks or months for their physicians to repeat the search-and-referral process multiple times until a successful referral is made.

Far too many Ontarians are languishing in hospital beds when they could be discharged and better cared for elsewhere. One significant cause of hospital overcrowding is a lack of access to home care, long-term care and palliative care. For example, a patient with dementia requiring supportive care provided by a long-term care home ends up living in a hospital due to a lack of available resources in the most appropriate setting. This bottleneck of patients, referred to as alternate-level-of-care, has existed in Ontario for many years, with its root causes remaining unresolved. The pandemic made a bad situation even worse and now the consequences of inaction are more urgent than ever. We urge the government to:

1. Appropriately fund home care and home-care providers
2. Explore and expand programs that provide hospital-level care in patients’ homes
3. Embed care co-ordinators and home care within primary care and Ontario Health Teams
4. Provide long-term care homes with equipment to prevent unnecessary hospital transfers
5. Ensure all Ontarians have access to palliative care when they need it

Hospital care is important when necessary, but up to 20 per cent of acute care beds are occupied by patients who should be in another level of care or at home with support. The above initiatives are directed at ensuring patients are receiving the most appropriate care in the best setting to optimize their outcomes and overall use of the health-care system.