Yesterday the Executive Directors of AFHTO, AOHC and NPAO reviewed their joint report – Compensation Structure for Ontario’s Interprofessional Primary Care Organizations with key members of MOHLTC’s staff – ADMs Susan Fitzpatrick and Suzanne McGurn, Provincial Chief Nursing Officer Debra Bournes, Melissa Farrell (Director, Primary Health Care Branch), Phil Graham (Manager, Family Health Teams Unit), and John Amodeo (Director, Health System Labour Relations and Regulatory Policy Branch). This report was released on June 17 and was built upon the group’s earlier report – Toward a Primary Care Recruitment and Retention Strategy for Ontario – February 2012. This meeting was the first step in what will be a lengthy, systematic process to develop sufficient political support to induce government to make the policy and funding decisions needed to enable the interprofessional primary care models (AHACs, CHCs, FHTs and NPLCs) to implement the compensation structure our three Associations have adopted. However, we are working in a time of fiscal restraint wherein current government policy does not allow for new funding to be made available for public sector compensation increases. The purpose of this first meeting with Ministry officials was to brief the Ministry about the methodology and findings with the goal that the Ministry can confirm the credibility of this report. The Ministry agreed to task an internal technical group to further review the methodology used to develop the recommended compensation structure. They will advise the associations of any concerns by the middle of August. This is an important first step. While we recognize that the Ministry will not official endorse the report, they will be asked to comment on the validity and credibility of the report internally to the Minister and her staff when this issue is raised. Next the Associations will set up a meeting with the Minister’s staff to review the report, hopefully before the end of the summer. Following this the process of meeting with key members of the provincial legislature will begin. We will keep you informed on the timing of these meetings. This report presents indisputable evidence that:
- Compensation levels in primary care are below market – averaging 15.6% for all non-physician positions, and ranging up to 30% below market.
- The gap between market and actual compensation is growing – it has increased by an average of 4.9% from 2009 to 2012.
- Lack of pensions is a key barrier to labour mobility – primary care organizations cannot provide both the HOOPP plan and a reasonable benefits package within the imposed financial limit of 20% of salary.
- Pay equity challenges are a real risk – two types of positions (registered dietitians and nurse practitioners) have been consistently found to be funded at a salary grade below that of comparable health professions. These positions also post the highest vacancy rates in primary care – 19% and 14% respectively. Health promoters were also found to be in the wrong band.
Rigorous market study conducted by the Hay Group has established a recommended salary structure. It places all positions into 13 pay bands, with 3 market exceptions. Each band has a recommended salary range and steps for proceeding from minimum to maximum within the range. To access the report and its supporting documentation, please click on the following links:
- Compensation Structure for Ontario’s Interprofessional Primary Care Organizations – Report to the MOHLTC – Final June 2013-updated January 2014
- Toward A Primary Care Recruitment and Retention Strategy for Ontario – February 2012
- Developing a Provincial Compensation Structure for IPCOs Final Report June 2013
- Developing a Provincial Compensation Structure for IPCOs Technical Report June 2013
- Pay Equity Guidelines for IPCOs –May 2013
- Costing Analysis for IPCO Compensation Structure – June 2013
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