Ontario is poised to break down barriers by allowing nurses and doctors from across Canada to immediately start working in the province under their current credentials without registering with its regulatory colleges.
Making the announcement in Windsor on Thursday morning, Premier Doug Ford said that when the Legislature resumes next month his government will introduce a bill to implement new “as of right” rules to help workers overcome delays that have made it difficult to practise in the province.
If the legislation passes, Mr. Ford said Ontario would be the first province to automatically recognize the licences of out-of-province health care workers.
Currently, prospective health care workers moving to Ontario from other regions within Canada need to apply and register with a governing body. The registration process with the College of Nurses of Ontario (CNO) can take between three and 18 months.
More than 10,500 applications are with the CNO right now, but only 195 – accounting for less than 2 per cent – are from other provinces. As of Jan. 1, there were 182,195 nurses registered in Ontario, up by more than 5,000 from 2022.
Mr. Ford did not provide a specific target for how many workers the province is hoping to gain by removing the registration requirement, but said it would bring “much-needed reinforcements” to the front lines of Ontario’s health care system.
“A doctor from British Columbia or a nurse from Quebec who wants to come and work in Ontario shouldn’t face barriers or bureaucratic delays to start providing care,” Mr. Ford said. “We need as many people as possible.”
The plan is just part of the province’s effort to attract more health care workers, which also includes covering the cost of exam and application fees for retired or internationally trained nurses, and paying the tuition for nurses who commit to working for at least two years in an underserved community.
This latest move could be a detriment to other provinces that have also been grappling with staffing shortages and heavy patient volumes in recent months, forcing some emergency rooms to shutter temporarily. A November report from the Canadian Institute for Health Information found Ontario was 24,000 nurses short of the national average per capita.
Only health care professionals who have provided safe and ethical health care in other jurisdictions will be eligible, Mr. Ford said, but no details were provided about screening or enforcement plans.
In a statement, CNO spokeswoman Kristi Green said the college will be working with the province on any changes in the system to ensure patients receive safe care.
The government will also propose legislation that would allow health care workers, including nurses, paramedics and respiratory therapists, to take on other responsibilities if they are needed to fill staffing vacancies and have the knowledge and skills to do so. Mr. Ford said this will help hospitals temporarily increase staff when they are experiencing high-patient volumes, and ensure they are able to fill the most in-demand positions.
The Ontario Nurses’ Association said it is deeply concerned about both proposals and the lack of detail on any checks and balances. Association first vice-president Angela Preocanin questioned how hospitals and other health care settings will determine whether staff have the right skills to take on different roles outside their scope.
“This is certainly not a well-planned solution to the staffing crisis,” she said in an interview. “This is going to hurt nurses and patients.”
Ms. Preocanin called on the government to instead retain and recruit nurses by spending more on the public health care system. She said that starts with dropping the appeal of Bill 124, controversial legislation that capped public sector wage increases – including those for nurses – to 1 per cent annually for a three-year period. The bill was struck down by an Ontario judge in November but the government has filed an appeal.
Mr. Ford announced the proposals to increase staffing levels just days after the province released plans to boost publicly funded surgeries in private clinics, and to allow for more clinics to open starting next year, including for-profit facilities. Those changes are intended to address the backlog of surgeries that grew during waves of the COVID-19 pandemic, when many procedures were put on hold.
Critics of those plans say they will only worsen staffing challenges in hospitals, as for-profit clinics can lure nurses with better working hours.
The Premier and his Health Minister, Sylvia Jones, did not provide specifics on how the province plans to address those concerns when asked about them at the announcement on Monday. They did say applicants for any new licences would be required to submit staffing plans meant to ensure hospitals aren’t affected.
Speaking about the shift to more privately delivered surgeries, Mr. Ford said the goal is to take the “loads off the backs of hospitals” and gets patients access to care faster.
The cost to the province has also been raised as a concern by critics, who argue that private clinics could charge more to cover overhead costs that hospitals don’t have.
Asked directly whether the province will be paying more for procedures done at such centres, Ms. Jones said there is a “formula for compensating” that is based on the number of patients cared for.