Ontario will need 33,200 more nurses and 50,853 more personal support workers by 2032, the government projects — figures it tried to keep secret but were obtained by The Canadian Press.
The government recently won a fight in front of the Information and Privacy Commissioner to keep those figures under wraps after denying access to them to Global News following a freedom-of-information request from the outlet.
But the same FOI office made the information available to The Canadian Press through a separate request, a situation critics say exposes the frailties and arbitrariness of the access-to-information system.
The projections of nurses and PSWs the province will need — above and beyond those currently being educated through the system — are not surprising to the unions representing workers in the health-care system, who have been sounding the alarm for years about shortages.
But it is telling that the government tried to keep the public from seeing those numbers, said Sharleen Stewart, the president of SEIU Healthcare, the largest union representing long-term care workers.
"It's the government that has to have the will to address it," she said.
"When they're hiding it so that we don't solve the problem by increasing wages and improving the conditions of work and conditions of care in the workplace, then they're obviously not serious about solving this problem for seniors of our province."
Global News in 2022 requested information on health human resources from the Ministry of Health's transition binder, a document prepared to give new ministers important information.
One page of a briefing titled "Health Workforce Challenge by Numbers" showed some overall information about the recruitment and, more so, retention challenges for nurses and PSWs in particular. But the actual numbers showing estimated shortages in 2022, 2023, 2024, 2027 and 2032 were all redacted.
When Global News appealed that to the Information and Privacy Commissioner, the government argued that releasing that information would harm the province's financial and economic interests because unions would use the numbers to argue for higher wages.
Of course they would, said Ontario Nurses' Association president Erin Ariss.
"It goes to a basic economic principle of supply and demand, and we've been saying all along that there are not enough nurses to staff the system that we have," she said.
"Health care is in a crisis, but there are solutions to this and part of the solution would be telling the public exactly what is happening in all sectors of health care, and not trying to avoid accountability."
The commissioner concluded that even though there was a "compelling public interest" in disclosing the health-care shortages, it didn't outweigh the ministry's economic concerns.
James Turk, the director of the Centre for Free Expression at Toronto Metropolitan University, said that decision itself is "deeply troubling."
And the fact that the same numbers one freedom-of-information co-ordinator felt would harm Ontario's economic interests were deemed fine to release by a different co-ordinator within the same ministry shows how much discretion is in the system, he said.
"The access to information staff who deal with these issues, some of them view their role as to make available to the public what should be made available to the public," Turk said.
"Others see their role as guarding Fort Knox, and protecting the leadership of the department from the exposure of anything that might be embarrassing."
The Canadian Press requested a copy of the Long-Term Care transition binder after Stan Cho was named minister in September. Access was granted in February, and one of the pages — with no redactions — fully lays out the expected shortages.
In 2022, the province needed 6,000 more nurses across all health-care sectors, the document shows. In 2023, the need rose to 10,110 and this year it was expected to be 13,200. By 2027 the province is expected to need 20,700 additional nurses, growing to 33,200 by 2032.
When it comes to personal support workers, the province needed 24,100 more in 2022, and 30,900 more in 2023. This year the need was expected to be 37,700, which was projected to rise to 48,977 in 2027 and 50,853 in 2032.
Liberal health critic Adil Shamji said the health-care staffing shortages are "devastating" and he is troubled that the government's justification for initially withholding the information was due to economic interests.
"At the end of the day, health care is supposed to be about one thing, and one thing only: patient interests," he said. "I worry about why the FOI system is being weaponized to prioritize financial interests over patient interests."
Green Party Leader Mike Schreiner said the case shows the FOI system needs to be reformed.
"There needs to be more consistent standards across the board," he said.
"The fact that what appears to be similar requests were put forward with completely different responses is really unacceptable. I think the people of Ontario deserve more honest answers and more transparency from this government."
NDP Leader Marit Stiles suggested the government didn't want the numbers released because they show growing shortages.
"Anyone who's had to wait for hours in a packed emergency room, or seen a loved one suffer from neglect in a long-term care home because there weren't enough staff to care for them will be upset to see this government hiding the fact that nurse and PSW shortages are expected to get a whole lot worse," she wrote in a statement.
A spokesperson for Health Minister Sylvia Jones said in the past two years Ontario has registered 32,000 new nurses and added nearly 25,000 PSWs in the past three years.
"We know more needs to be done, that’s why as part of our 2024 budget, our government is investing $743 million to continue to grow our workforce through increased enrollment and retention programs...and an additional $2 billion to continue our work growing, and modernizing, the home and community care sector."
Banner image: The sign in front of SickKids hospital in Toronto, Monday, Feb. 20, 2023. THE CANADIAN PRESS/Frank Gunn
This report by The Canadian Press was first published May 13, 2024.
