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Nurses tend to a COVID-19 patient in the Intensive Care Unit at the Bluewater Health Hospital in Sarnia, Ont., on Jan. 25.Chris Young/The Canadian Press

Here’s a story about the disconnect between life and politics: Ontario held a provincial election barely two months ago, and health care was hardly discussed. At the sole provincewide leaders debate, attention was instead focused on such important matters as whether Premier Doug Ford should be allowed to bring a binder of notes on stage.

“There’s nothing wrong with putting notes to make sure you’re organized,” Mr. Ford said. “People don’t care about that.”

Count us among those who could not care less whether a premier, prime minister or minister needs to consult notes to remember what their government’s plan is. The issue isn’t who can best perform the neat trick of successfully memorizing and reciting every item in their plan for, say, Canada’s growing health care crisis. The issue is whether they actually have a plan for Canada’s growing health care crisis.

Tuesday is Speech from the Throne day in Ontario, and health care – the biggest item in every province’s budget – has to be Urgent Action Item No. 1. We don’t mean to single out Ontario: from coast to coast to coast, timely, high-quality health is in peril. It is no exaggeration to say that medicare itself is in peril.

The tip of the iceberg is popping up in the country’s emergency rooms, and the hospital wards and operating theatres beyond. Consider what happened last weekend in Ottawa: Montfort Hospital shut down its emergency department overnight on both Saturday and Sunday owing to “an unprecedented shortage of nurses,” while the nearby hospital in Carleton Place closed its ER for 24 hours, also owing to lack of staff.

Situations like this have been breaking out across the country. For the sake of public confidence, not to mention their own political health, each provincial government needs a plan to put an end to this, and they need to share it with their fellow citizens. Now.

When it comes to long-term health care system reform, the shelves groan with decades worth of reports and blueprints. Many are ready to begin being put into action. Some of those reforms could help address the pileup in the ERs, and they could be put in place in a matter of months.

For example, every Canadian needs to be able to access primary health care, when and where they need it. Problem: even though more than 85 per cent of Canadians have a family doctor, their doctor generally doesn’t work nights or weekends and, being human, they also take holidays. So millions of Canadians often find they have no choice but to go to one of this country’s overwhelmed and overburdened ERs.

But if family physicians operated in group practices – if most in fact had to operate in group practices – then they’d be organized so that many physicians and nurse practitioners were sharing the load, and the odd-hours shifts, allowing primary care offices to be open on nights and weekends. That would allow Canadians to get what they want and need: an emergency visit with a doctor without the ER.

It’s an example of how things can be improved, not by adding resources, but by better managing them.

But beyond that, Canada also has a shortage of health care workers. There were staffing issues before the pandemic, but after two-and-a-half years of COVID, the system is being sucked into a cycle of understaffing leading to burnout leading to resignations leading to more understaffing.

Provincial governments need urgent plans to reverse that cycle, particularly in nursing. In the long run, Canada has to educate more nurses of all sorts; it also needs to educate more nurse practitioners, who can do all the things family doctors do, and sometimes better. But expanding the training pipeline today, though necessary, won’t produce its first new nurse for years. And Canada’s needs thousands more nurses, right now.

That means this country has to recruit experienced nurses overseas, and give them instant Canadian accreditation. It has to cut through red tape to accredit foreign-trained nurses (and doctors) already living here, but not yet allowed to work. And it has to find ways to encourage all those nurses who left the profession to return.

There has to be a plan, nationally and in each province, to make this happen. And it has to happen quickly – ideally in a matter of weeks. Mr. Ford can bring as many briefing books as he wants to his next press conference. Just so long as there’s something in them.

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