The Registered Nurses' Association of Ontario (RNAO) shared public policy reforms it plans to lobby for in the upcoming Ontario provincial election in Owen Sound Tuesday.
RNAO Chief Executive Officer Doris Grinspun spoke to a gathering of registered nurses (RN), nurse practitioners (NP) and other health care professionals at the Grey Bruce Health Unit.
She outlined a platform that largely calls for continued and increased investment in the public system, including social and environmental determinants of health.
"We need to influence and we do influence where the health system is going," Grinspun says. "Investing in social and environmental determinants saves money. It may cost investment, but it saves money in the long run."
Social reforms the RNAO is pushing for include: Increasing the minimum wage to $15 an hour -- which the Wynne Liberals have already committed to do; Invest $1.4-billion to build more affordable housing units and address the backlog of existing units in need of repair; Amend the building code to require all new multi-unit to incorporate accessibility principles; Develop at least 30,000 units of supportive housing for people with mental health and addiction issues.
Another key issue Grinspun highlighted is ensuring there are sufficient RNs and NPs in key sectors such as primary care, home care, hospital care and long-term care.
She says Ontario has the lowest RN-to-population ratio in Canada in 2016, with 703 RNs per 100,000 people. That number fell from 711 RNs per 100,000 in 2015.
The 2016 national average was nearly 20% higher at 839 RNs per 100,000 people.
RNAO is lobbying a new staffing formula in nursing homes that would cap unregulated care providers -- or personal support workers (PSW) -- at 55%, and require at least 20% RNs and 25% RPNs.
"It's far less regulated care providers and that's not good for residents in nursing homes," Grinspun explains. "They deserve and need the best possible care and we believe the staffing ratio of 20% RN and 25% RPN and no more more than 55% PSWs will begin to do justice to residents in nursing homes."
Susan Shular, a program manager at Grey Bruce Health Unit, says changing the staffing formula for long-term care providers is one issue that will help improve delivery of services on a local level.
"I've worked in that sector in the past and have family that have lived in long-term care facilities, and I think that's a really important one," Shular says. "It doesn't mean the unregulated staff aren't important, because they are ... it just means we need the regulated staff there to support them in their work so that the resident gets a well-rounded group of care."
Grinspun also spoke to the need for more collaboration and action to improve health outcomes for Indigenous communities. Specifically, RNAO wants governments to partner with Indigenous communities to address urgent health needs and identified such as the ongoing crisis of children and youth suicide.
Grinspun says that requires a transformation of the system from a colonial approach to an Indigenous-led self governance model.
It's a lobbying point she says, sadly, will probably be the hardest to affect timely change on.
"Give them the ability to decide for themselves what type of health system they want," Grinspun says. "Let them lead. And be with them, not doing for them, which has produced not outcomes in our country, not just in Ontario."
That's another issue, if acted on, Shular thinks can help improve health outcomes in Grey Bruce.
"We do have two First Nations communities in our area and both of them really need to be heard," Shular notes. "When we work with them they say 'don't do anything for us, do it with us'"
"They want to be heard and they want changes to be made that are going to be suitable, helpful and healthy for them."
RNAO also seeks a universal pharmacare system in Ontario covering all medically necessary drugs and associated products, with no means testing, co-payments or deductibles.
The lobbying group also wants increased investment in oral health --$10-million -- to support a public program to provide oral health care to low-income adults and seniors in the province.
RNAO is a professional association that represents registered nurses, nurse practitioners and nursing students in Ontario.