Ontario Will Be Short 30,000 Nurses and Care Aides in Next 5 Years, With $21.3 Billion Health Care Budget Shortfall: Watchdog Report

Financial Accountability Officer says demand is outpacing funding

Ontario Premier Doug Ford makes an announcement on health care with Health Minister Sylvia Jones in Toronto on Jan. 16, 2023. (Frank Gunn/The Canadian Press)

A new report predicts Ontario will have a shortfall of 33,000 nurses and personal health care aides, and be short $21.3 billion to cover health care costs in the next five years.

The province’s Financial Accountability Office (FAO) released a special health care report on March 8, suggesting the province’s health spending plan “will not meet existing commitments or growing demand.”

The FAO reviewed the province’s five priority areas: hospital capacity, long-term care and home care, surgical waitlists and wait times, emergency departments, and the health care workforce. It concluded the province will have a net cumulative funding shortfall of over $23 billion in the period from 2022–23 to 2027–28.

He said nurse and personal support worker shortages will “jeopardize Ontario’s ability to sustain current programs and meet program expansion commitments.”

Hospital Beds

Ontario hospitals are experiencing capacity strain, according to the FAO. From 2005 to 2019, the number of hospital beds only increased by 3 percent, while the 65 and older population grew by 56 percent.

The province set a targeted goal to add 4,500 new hospital beds from 2019–20 to 2027–28 and free up an existing 2,500 alternate level of care (ALC) beds, for a total capacity increase of 7,000 beds. ALC patients in hospital can be waiting for long-term care and home care.

The FAO said in a news release that it is “unlikely” that target will be met due to “significant risks” with freeing up ALC beds.

The FAO estimates that 7,500 hospital beds will be required to meet the surge in demand from the province’s “growing and aging population,” and even if the province achieves that plan, will still be 500 beds short.

“Relative to projected growth in demand, by 2027–28, Ontario will have less hospital capacity, similar home-care capacity and less long-term care capacity compared to what it had in 2019–20,” said the report.

The FAO cited Ministry of Health statistics for 2017–18 to 2019–20, which show hospitals averaged 96 percent occupancy and roughly 1,000 patients per day received care in hallways or other “unconventional spaces” each day.

Waiting Lists

The FAO’s report noted that fewer surgeries are being performed compared to before COVID.

It also stated that in 2022–23, the average length of stay for patients admitted to an emergency department was 20.9 hours, a 34 percent increase compared to the five-year period before COVID.

Premier Doug Ford said the report was “frustrating” and did not account for the province’s pending health care transfer deal with the federal government, which will add $8.4 billion in additional funds plus a $776 million one-time top-up for “urgent needs.”

While the fiscal watchdog said there were 250,000 patients waiting for surgery as of September 2022, the government disputed that figure, stating the wait list is only about 203,000 people.

A spokesperson from the ministry of health said federal health care money will hire more nurses and link people to family doctors.

Ford said the province was “throwing everything in the kitchen sink at health-care.”

The Canadian Press contributed to this report.