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2023 Ontario Budget – Building a Strong Ontario
An overview of the Ontario government’s budget

March 24, 2023

Overview
Yesterday the government released their 2023 Ontario Budget, Building a Strong Ontario. This budget focuses on five pillars:

1. Building Ontario’s Economy for Today and Tomorrow
2. Building Highways, Transit and Infrastructure Projects
3. Working for Workers
4. Keeping Your Costs Down
5. Better Services for You

“With the budget’s significant focus on ways to combat the affordability crisis and tumultuous economic times, the government has made a strategic decision in this budget to shift the public dialogue from health care to those files.”- Enterprise Canada’s Health Care Analysis

This budget was largely a reinforcement of “Your Health: A Plan for Connected and Convenient Care”. Introduced in February 2023, it focused on three pillars: The Right Care in the Right Place, Faster Access to Care, and Hiring More Health Care Workers.

Most relevant, the provincial budget recommitted to connect Ontarians to additional primary care teams by investing $60 million over two years. We have confirmed this is the same $30 million that was announced in February, carried over 2 years resulting in a total investment of $60 million dollars. While this is a step in the right direction, we are disappointed there was not more of a commitment over the longer term.

The health human resources crisis that currently exists was acknowledged through additional investments in nursing, medical school education and home care, but none were made for primary care nor any mention of dropping the appeal to retain Bill 124. However, much needed support in mental health and addictions was welcomed.

For additional information, please read:

• Enterprise Canada’s Full Budget Analysis
• Enterprise Canada’s Health Care Analysis
• 2023 Ontario Budget, Building a Strong Ontario
• Highlights of the 2023 Budget, Building a Strong Ontario

Summary of Health Care Investments:

Team-Based Care:

• $60 million over two years to expand existing teams and create up to 18 primary care teams in communities with the greatest need ($30 million was previously announced for 2022-2023 and this commits this funding into 2023-2024).

HHR Recruitment and Education:

• The government is providing an additional $3.3 million over the next three years, beginning in 2023–24, to expand access to dual credit opportunities in health care‐related courses for an additional 1,400 secondary students.
• The province is expanding the Ontario Learn and Stay Grant to add more health care professionals in underserved and growing communities. Applications will open this spring for the 2023–24 academic year, targeting up to 2,500 postsecondary students who enrol in – nursing programs in Northern, Eastern and Southwestern Ontario; medical laboratory technologist/medical laboratory sciences programs in Northern and Southwestern Ontario; and paramedic programs in Northern Ontario.
• $200 million in 2023-2024 to extend supports to address immediate health care staffing shortages, as well as to grow the workforce, including investments in the Enhanced Extern Program and the Supervised Practice Experience Partnership Program
• $100.8 million over the next three years to expand and accelerate the rollout of undergraduate and postgraduate seats.
• $33 million over three years to add 100 undergraduate seats beginning in 2023, as well as 154 postgraduate medical training seats to prioritize Ontario residents trained at home and abroad beginning in 2024
• $51 million over three years to support the Dedicated Offload Nurses Program to support timely 911 responses by hiring health care workers focused exclusively on transferring ambulance patients to hospital care, allowing paramedics to respond to more calls.

Home Care and Seniors Supports

• $569 million in 2023-2024, including nearly $300 million to support contract rate increases to stabilize the workforce. (part of the government’s previous commitment to invest up to $1 billion over three years for home care.)
• $174 million over two years, starting in 2024-2025, to continue the Community Paramedicine for Long-Term Care Program to serve all eligible seniors across Ontario.  
• The government is investing an additional $5 million annually for three years starting in 2022–23 to support 6,500 people with dementia to live independently in their homes and to be engaged in their community. (Previously announced in 2022 budget)

Hospital and Long-Term Care Capital Investments

• The government is making a multibillion-dollar investment in hospital infrastructure. This is included in a 10-year plan to invest more than $48 billion in hospital infrastructure, including over $32 billion for more than 50 hospital projects that would add 3,000 new beds. (Previously announced in 2022 budget)
• A four per cent increase in base operating funding for hospitals.
• $72 million in 2023-2024 to increase surgeries at community surgical and diagnostic centres. (This builds on $300 million as part of the surgical recovery strategy and $18 million for diagnostics and surgeries in existing facilities.)
• $5.5 million in 2023-2024 to build new Behavioural Specialized Units in long-term care homes, including approximately 70 new specialized beds, to expand care for individuals with complex needs.
• $1.2 million to the Ontario Personal Support Workers Association to promote the PSW profession in the long-term care sector to help with recruitment.

Access to MHA

• $425 million over three years, including a five per cent increase in the base funding of community-based mental health and addictions service providers. (Builds on an investment of $3.8 billion over 10 years included in the Roadmap to Wellness.)
• $202 million each year in the Homelessness Prevention Program and Indigenous Supportive Housing Program to help those experiencing or at risk of homelessness, struggling with mental health and substance use, those escaping intimate partner violence, community organizations that deliver housing services.

Other Health Care

• The government commits to expanding the scope of practice for pharmacists to cover additional minor ailments including mild to moderate acne, canker sores, diaper dermatitis, yeast infections, pinworms and threadworms, nausea and vomiting in pregnancy.
• The government is investing $3.1 million in 2023–24 for an expansion of the Ronald McDonald House Charities Ottawa House.
• To support children and youth with complex special needs, the government is investing $12 million over three years to fund 14 additional beds at Safehaven, a not‐for‐profit organization providing residential and respite care at community sites in the Greater Toronto Area.

This budget only goes a little further for primary care teams. Most critical will be our support to government as they roll out the investment in primary care to focus on those communities with higher rates of patients not attached to teams and/or those that have historically faced greater barriers to funding to meet population health needs.

We will be in close communication with Ministry officials, especially considering the context of the recent federal-provincial agreements and their implications for primary care. We will keep members apprised of ongoing developments and urge each of you to stay in touch with your local MPPs as local advocacy could be a game changer in influencing the development of this expansion. #ItTakesATeam