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Ontario Premier Doug Ford listens to a question from a reporter following a news conference at a Shoppers Drug Mart pharmacy in Etobicoke, Ont., on Jan. 11.Tijana Martin/The Canadian Press

Ontario Premier Doug Ford insists 2023 will be a better year for the province by finding efficiencies and cost savings, pointing to the government’s appeal of wage-cap legislation and a plan to expand surgeries at private clinics.

Speaking to reporters Wednesday for the first time this year, Mr. Ford said the province still has work to do in order to beef up a struggling health care system that has been hit with severe staffing shortages and surgery backlogs.

Bill 124 has been a political flashpoint throughout the COVID-19 pandemic with unions arguing the wage-cap legislation has driven away health care workers.

The legislation, passed by Mr. Ford’s Progressive Conservative government in 2019 as a cost-saving measure, capped compensation increases for roughly 780,000 workers – including employees of universities and colleges, school boards, Crown corporations and agencies – to 1 per cent annually for three years.

The bill was struck down by an Ontario court in November, but the government has launched a legal challenge calling for it to be reinstated.

Mr. Ford defended Bill 124 on Wednesday, arguing it was a measure introduced to manage the province’s finances without cutting services, laying off workers or raising taxes. The province posted a surplus of $2.1-billion in 2021-22, its first since 2007-08, but is projecting a deficit of $12.9-billion this fiscal year.

“I always have to be a prudent fiscal manager with the taxpayers’ money,” he said at a Shoppers Drug Mart in Toronto’s Etobicoke neighbourhood. “We just can’t be out there spending willy-nilly as people are working their backs off. They’re taxed to the brink right now.”

Mr. Ford repeatedly said Wednesday the legislation “has lapsed” but if the government’s appeal is successful, about 30 per cent of public-sector employees would still be subject to the wage cap for a three-year term, including 100,000 hospital workers.

If the decision is upheld, the province could be on the hook for significant catch-up payments to compensate for lost wages. The province’s Financial Accountability Office has estimated that Ontario’s bill for pay hikes denied by the legislation since 2019 could come to $8.4-billion, including $2.1-billion in retroactive pay this fiscal year.

Contract negotiations under way are no longer subject to Bill 124, which Registered Nurses’ Association of Ontario chief executive officer Doris Grinspun said is a positive step, but compensation needs to improve significantly in order to retain workers who are burned out after almost three years of the pandemic. Ms. Grinspun said she understands the Premier’s desire to keep finances in line and taxes down, but not at the expense of front-line workers.

“The most irresponsible thing for the purse is to continue to bring nurses into the system, which we are doing, and to continue to have them leave,” she said.

Despite fighting to reinstate the legislation, Mr. Ford said his government’s goal is to ensure all government employees are treated fairly. His government provided a $5,000 retention bonus to nurses during the pandemic.

The Premier again signalled changes in health care delivery that would boost the number of surgeries at existing private-sector clinics. The government announced its plan to pay for more surgeries outside of hospitals to reduce the backlog in August, but details haven’t been released. Mr. Ford said Wednesday that operations such as knee replacements, hip replacements and cataract surgeries are “no-brainers” that are backlogging hospitals and could be done at other facilities.

“We need to have facilities like that to take the burden off the hospitals,” he said. “People don’t care where they have to go as long as it has the same regulations.”

There is a cap on the number of private facilities allowed to operate in the province and the government hasn’t said whether that will be lifted. Mr. Ford insisted that the use of independent health care clinics would only affect where surgeries are taking place and that they would still be covered through the Ontario Health Insurance Plan.

Responding to the Premier’s comments, Green Party Leader Mike Schreiner said the government should put more focus on improving the hospital system by implementing a nurse retention strategy, including wage increases and better working conditions.

“We need to care for the people who care for us, and we need a health care system that puts people, not private businesses, first,” he said in a statement.