April 23 – The Minister of Finance released the 2015 Ontario Budget, providing a blueprint for government spending for the 2015-2016 fiscal year Retention and recruitment in primary care AFHTO attended the budget lock-up along with our colleagues from AOHC and NPAO. While we are very disappointed there wasn’t a formal commitment in the budget to address primary care retention and recruitment, we remain optimistic that there’s still an opportunity to move on this issue within this fiscal year. Conversations with Minister Hoskins’ political staff during the budget lockup confirmed the Minister is committed to making progress on this issue in the next few months. This is evidenced by the Minister’s statement earlier in the legislature when he said he’s looking at this issue of retention and recruitment and knows it affects NPs and other health care practitioners. We need to make sure MPPs remain aware of this issue and the urgent need for action to resolve it. All members are encouraged to meet with and/or write to your local MPP. To help you do this, click here to access advocacy tools and resources. Budget overview The key themes in the 2015 Ontario Budget are infrastructure, skills training, business environment, and strengthening retirement security. In the 370-page budget document, 10 pages are devoted to an Effective Health Care System for All (pp.161-170) and another 15 pages on key determinants of health – Renewed Poverty Reduction Strategy (pp.171-177) and Assistance for the Vulnerable (pp.178-185). Health care highlights This is a restraint budget for health care. Annual growth in overall health care spending is cut in half from last year – projected to be 1.2% in 2015/16, then 1.9% in the two subsequent years – well-less than inflation and population growth. The commitment to increase home and community care funding continues. Click here for a 2-page summary of the health care highlights from government relations firm Santis Health. Primary care The Faster Access to Primary Health Care section (pp.163-4) confirms one of AFHTO’s core messages – “primary care is the foundation of a strong health care system.” This section also confirms government’s intent to move toward a population-based approach to primary care. The Budget says, “government plans to continue organizing primary health care providers and teams around the needs of the population across the province,” and “To better align key initiatives, maximize investments and ensure that Ontarians have a health care system that is both high quality and sustainable, the government is moving forward to establish a comprehensive capacity planning framework.” There is no additional funding announced in this budget for primary care; there is just a re-announcement of funds to expand access to physiotherapy in primary care settings. The only new announcement for primary care is that “government is removing the barriers to direct referrals to specialists by nurse practitioners.” This is welcome news that will increase the efficiency of teams and timeliness for patients who need specialist care. Pension plans and compensation As employers, many FHTs and NPLCs are asking about the Ontario Retirement Pension Plan (ORPP). When it comes to pensions, AFHTO’s advocacy goal is sufficient funding to enable primary care teams to offer the HOOPP plan, as stated in the AFHTO-AOHC-NPAO recommendations for primary care recruitment and retention. HOOPP is the standard pension plan for much of the healthcare workforce, and therefore the ideal for recruiting and retaining staff. As individual employers, members may want to consider the ORPP as an alternative – see pages 138-145 of the 2015 Ontario Budget. The section – Ontario’s Plan to Eliminate the Deficit (pp.203-223) – confirms government’s continuing focus on Managing Compensation Costs (pp.210-213). It states, “Any modest wage increases must be offset by other measures to create a net-zero agreement.” This section announces the launch of Program Review, Renewal and Transformation (PRRT) to “assess outcomes in an effective, efficient and sustainable way …. Using evidence to inform better choices and improve outcomes.” The emerging evidence of the value delivered by team-based primary care – such as through the Conference Board’s FHT Evaluation and our collective work on Data to Decisions – has helped to gain support across the Ministry of Health and Long-Term Care for the need to address the crisis in primary care retention and recruitment. We know AFHTO members will continue to demonstrate and improve the value delivered, and with your contact with your MPPs, we will continue to build the political will to act. To help you do this, click here to access advocacy tools and resources.
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