The first step for Ontario’s Health Minister is admitting the system is in crisis

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The vacuously comforting, deceptive words Ontario Health Minister Sylvia Jones uttered in response to the crisis plaguing the province’s health care system should be blasted over loudspeakers across Ontario’s emergency rooms (the ones that are still open).

“Let’s be clear: There is not a crumbling system in the province of Ontario.”

Her voice will bellow over triage in Queensway Carleton Hospital, where some Ottawa patients were rerouted this past weekend after two hospitals in the region were forced to close their ERs.

“We have a very strong health care system,” she will declare over the nursing station at St. Joseph’s Healthcare in Hamilton, where workers are being run off their feet to make up for critical staffing shortages and a 100-per-cent acute care occupancy.

“To suggest it is in crisis is completely inappropriate.” Her voice will rattle down the hallways at Mackenzie Health in Richmond Hill, Ont., where patients waited an average of 24.8 hours for a hospital bed in June – more than five hours longer than the provincial average. Her words will be a salve on the wounds of those waiting in triage – the only treatment they will get for hours – after hailing cabs to get to the ER, since no ambulances were available.

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When asked whether the current health care situation in Ontario is unprecedented, Ms. Jones replied, ”No, I’m sorry, it is not,” which is both incorrect and not the winning defence she thinks it is. (Don’t despair, good people of Ontario: our health care system has always been on the verge of collapse!) It is true that the province has faced ER shutdowns before, but it has never faced such a confluence of compounding crises: record-high waits for ward admissions, record-high health care sector vacancies, unprecedented lengths and numbers of “level zero” events where there are no paramedics available to answer emergency calls, and a massive backlog of diagnostic procedures and surgeries that have already put lives at risk and quality-of-life in peril.

Perhaps the minister didn’t want to incite panic by acknowledging the obvious, in the same way the captain of the Titanic might try to calm his guests by telling them that the fish swimming around their ankles were part of that evening’s entertainment. But that approach only works if your patrons are dumb socialites who can’t see that you’ve left shore with too few lifeboats. The catastrophe that is the current state of Ontario’s health care system is visible to anyone who interacts with it, which eventually, will be everyone. The minister only makes herself seem appallingly uninformed by pretending otherwise – or worse, like she is trying to deliberately downplay the situation for political reasons.

The throne speech the Ontario government delivered on Tuesday both peddled the illusion that the province’s health care system is functioning adequately (“Ontario’s health system continues to provide care to those who need it”), while also acknowledging that it is experiencing “significant pressures, including an exhausted work force and increasingly stressed emergency departments.” It provided few specifics on plans to fix the system other than to note that the province “will not be limited by conventional thinking that stifles innovation and preserves a status quo that struggles to respond to growing challenges and changing needs.”

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That last part offers an optimistic signal that the Ford government might be willing to actually implement bold reforms that strike at the heart of the inefficiencies plaguing the health care system: the silos that slow down patient care, for example; the billing structures that, among other things, disincentivize medical students from entering family practice; the concentration of surgical procedures in hospitals rather than outpatient ambulatory centres, and so on. But that optimism is easily deflated by a health minister who won’t even admit to the scale of the problem. If Ms. Jones can’t even bear to say the word “unprecedented,” how bold are her government’s reforms really going to be?

Even if Ms. Jones admits that the Titanic is sinking and gets behind some radical changes, meaningful improvements will still take years. But there are things the government can do in the short term to try to improve the situation in hospitals, such as lifting or amending the much-loathed Bill 124, which caps wage increases for nurses (and other public sector workers) at 1 per cent. The cost savings Ontario might have initially foreseen with this legislation is being offset by hospitals having to pay for private agency nurses or the doubling of normal staff wages to keep services running. The first step for the government of Ontario, however, is admitting it has a problem – and yes, an unprecedented one.

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