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‘Devil is in the details’: Province unveils health-care remedy

Posted: March 12, 2023

(March 10, 2023)

By: Jessica Smith Cross, BradfordToday


Local nurses are describing the province’s proposed contract as “a slap in the face.”File Photo

Editor’s note: This article originally appeared on The Trillium, a new Village Media website devoted exclusively to covering provincial politics at Queen’s Park.

The Ontario government is planning to allow health-care professionals to “work outside of their regular responsibilities” in order to ease the impact of the severe shortage of nurses, doctors and other health-care workers.

The announcement came Thursday after critics of the Ford government said they’re concerned that the health minister’s latest bill will “deregulate” health professionals in the province and allow lower-paid, lower-trained workers to take on duties performed by doctors and nurses today.

“It means that a physician working in a for-profit surgical suite could very well hire his mother-in-law hairdresser, bring her into his office and call her a nurse, and that hairdresser that he will call the nurse could start your IV, could put in a catheter, and could give you a narcotics, and could do a whole bunch of restricted acts,” said France Gélinas, the NDP’s health critic, alongside the Ontario Health Coalition, a group that advocates for public health care, at a press conference Thursday.

A government spokesperson confirmed plans to increase the scope of practice of regulated health professions to allow different kinds of health-care workers to do more things, but offered examples of changes under consideration that are far narrower than the critics fear.

“Our government’s Your Health Act, if passed, will increase staffing levels on a short-term basis to manage periods of high patient volume by allowing health-care professionals to work outside of their regular responsibilities,” said Hannah Jensen, a spokesperson for the health minister.

She noted the government has made some changes in that area already: as of this year, pharmacists can prescribe medication for 13 common ailments, and as of last month, nurse practitioners can order MRI and CT tests for their patients.

Jensen offered a list of other changes under consideration, including allowing nurse practitioners to order and apply defibrillators and electrocardiograms, a test checking the heart’s activity, and allowing registered nurses to prescribe medication.

The last one has been a long time coming: the Registered Nurses’ Association of Ontario (RNAO) has been calling for RNs to be allowed to prescribe since 2012. Earlier this month, the RNAO accused the government of dragging its heels on the issue.

The legislation will also allow health-care workers who are licensed in other provinces to work in Ontario immediately, or “as of right.”

The government’s critics remain concerned that the changes will ultimately put patients at risk.

Gélinas said that today, physicians can delegate tasks to nurses — inserting catheters and dispensing narcotics, for example — but she’s concerned that the government will allow those tasks to be delegated to anyone, including her hypothetical hairdresser.

Adil Shamji, the Liberal health critic, shared some of those concerns.

“The devil is always in the details,” he said. “There is a theoretical alternate universe in which a hairdresser could become defined as a physician or a registered nurse … I don’t think it’s going to go that way. However, I do worry immensely about where those definitions will actually land and whether it will protect the scope of practice of those health-care workers and ensure that there’s adequate patient safety in that protection.”

Both Shamji and Gélinas said it’s a problem that the important details are to be written in regulations approved by Ford’s cabinet, rather than legislation debated by MPPs, and neither have any faith in the government.

Another reason the NDP and the health coalition are concerned is the changes are part of the legislation that will allow private companies, either for-profit or non-profit, to open independent surgical centres in the province. Gélinas warned the for-profit clinics will do everything they can to hire less skilled workers in order to keep their staffing costs down and their profits up.

“I have nothing against hairdressers. I have nothing against mothers-in-law,” she said. “My point is that they should be nurses working in those surgical suites.”

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