Ontario’s Fall Economic Statement: Build Ontario

On November 4, Ontario Minister of Finance Peter Bethlenfalvy delivered the Ford Government’s 2021 Fall Economic Statement entitled Build Ontario. This announcement adds details to the government’s high-level policy platform outlined in the Speech from the Throne in October.

Today’s Fall Economic Statement (FES) is developed around three themes:

  1. Protecting our Progress

  2. Building Ontario

  3. Working for Workers

Today’s statement outlines a plan to continue the near record level of spending. The expense outlook for 2021–22 is $189.1 billion, up $3.2 billion from last spring’s budget, reinforcing the Ford Government’s stated commitment to “fuel the economy through growth, rather than cuts”. As spending continues, the Ontario Government remains in a significant deficit. This year’s deficit is projected to exceed $21.5 billion, up $5.1 billion from the end of fiscal 2020-2021.

The headline health care announcements in the 2021 FES include:

  • Investing an additional $1.8 billion in 2021-2022 in hospitals to build capacity, as well as reduce the surgical and diagnostic backlog, bringing total new investment to hospitals to $5.1 billion since the start of the COVID-19 pandemic.
  • Building the health sector workforce by investing $342 million for 5,000 new and upskilled registered nurses and registered practical nurses, as well as 8,000 personal support workers.
  • Investing an additional $72.3 million over three years to increase enforcement capacity in long-term care.

With an election due in June 2022, today’s spending commitments will be the foundation for the Progressive Conservative’s re-election platform. The Fall Economic Statement is the last major economic announcement prior to the 2022 Budget, expected in early spring. The Budget will further outline the government’s long-term plans and priorities, which we expect will be echoed in their platform. We have already seen the government signal an interest in labour and long-term care reform in this legislative session, announcing plans for new employment rights and a minimum wage hike, as well as introducing wide-ranging legislation to improve the quality of care in long-term care homes.

Health Care Commitments

Some of the key health announcements from today’s Fall Economic Statement are outlined below.

Long-Term Care (LTC)

The government released its long-awaited Long-Term Care reform bill last week, and the sector continues to be a key area of focus for the Ford Government in terms of both improving care and updating infrastructure.

Today, the government announced:

  • An additional $3.7 billion in 2024-25 to build an additional 10,000 net new LTC beds and upgrade over 12,000 existing beds.

  • $342 million to hire and upskill over 5,000 registered nurses and registered practical nurses, and 8,000 personal support workers.

  • $22 million over three years to implement technology that will integrate clinical information between hospitals and the LTC sector.

  • Investing $72.3 million over three years which will allow for the hiring of 156 additional inspectors by 2022-23.

Hospital and Capital Projects

The Ford Government has been deliberate about its focus on health and hospital infrastructure, with several projects to build new hospitals or upgrade existing hospitals announced or already underway. Today, they reiterated their commitment to existing spending, including:

  • $30.2 billion over the next 10 years in hospital infrastructure, new health facilities and to renew existing hospitals/community health centres.

  • Ongoing projects with William Osler Health System, expansions of the Trillium Health Partners hospitals in Mississauga and Etobicoke, as well as planning for new facilities in London and Windsor-Essex.

Mental Health and Addictions

The Ford Government announced $175 million in additional funding for mental health and addiction services in this year’s Budget. This is part of the Roadmap to Wellness’ $3.8 billion in funding committed over 10 years.

Today, they expanded on this commitment with investments including:

  • $12.4 million over two years, starting in 2021-22 to continue access to existing and expanded mental health and addictions supports for health and long-term care workers.

  • An additional $8.7 million in 2021-22 to increase mental health supports at public colleges and universities and Indigenous Institutes.

  • $8.1 million in 2021-22 to address increased demand for eating disorder services for children and youth.

  • More than $80 million to support student mental health for the 2021-22 school year to support the hiring of more than 1,000 mental health workers.

Home and Community Care

The government announced $548.5 million over three years for the home and community care sector. The funds will be used to support up to 28,000 post-acute surgical patients and 21,000 patients with complex health conditions every year.

$61 million was also committed to expand home care services to enable the transition of patients recovering from surgeries or living with complex conditions from hospitals back into their homes.

The government is also proposing to extend the Seniors’ Home Safety Tax Credit into 2022, which would provide an estimated $35 million in additional support.

Retirement Homes and Congregate Care

The government will provide an additional $11 million in 2021-22 to help retirement homes through COVID-19. As well as an additional $8.9 million in 2021-22 for COVID-19 supports for the congregate care sector.

Other Highlights

Other highlights from today’s Fall Economic Statement include:

  • Investing more than $1.6 billion in resources to protect students and staff from COVID-19 in the 2021-22 school year. This includes $86 million towards school-focused nurses in public health units and testing.

  • Committing $1.6 million over three years to create a database of volunteers who will receive training to respond to emergencies.

  • Increasing access to dental services for eligible seniors by investing an additional $17 million over the next two years.

  • Enabling $10.1 billion in cost savings and supports for businesses in 2021, including $6.3 billion for small businesses.

  • Committing $500,000 in 2021-22 to the Investing in Women’s Futures program that offers free training opportunities and wrap-around supports for women facing abuse, isolation and mental health challenges.

  • Ontario is investing an additional $5 million in 2021-22 to expand the Second Career program, which provides financial support to offset living costs, including child care, and supports families, including women, to enter and re-enter the workforce.

What’s Next?

What’s next for the health care sector?

Today’s announcements added more detail to the government’s plans across the health care sector, however it is fair to say most of the headline items were extensions of existing policies or repackaging of earlier announcements. There was little in the way of significant new policy or spending programs. The focus of the announcements in the past twenty months have, naturally, been about stabilizing the health care system during the pandemic, however even as the recovery has begun, the focus has remained predominantly on hospitals and long-term care.

The major health care commitment of the new Ford Government in 2018 was their plan to end ‘hallway health care’ in hospitals. Understandably, with the onset of the COVID-19 pandemic, this promise was shelved. With an election on the horizon and one last opportunity for major new policy announcements in the pre-election Budget, it remains unclear if the Ford Government has a larger agenda for the health care sector beyond addressing the urgent need exposed by the pandemic. The question that has not been answered is whether they will return to their earlier headline commitment to end hallway medicine, or advance a new ambitious reform package that seeks to reshape rather than simply rebuild the pre-pandemic system.

Upcoming Dates

Save the date for our upcoming webinar on Wednesday, November 17. We’ll unpack the potential impact of the Fall Economic Statement on the health sector and help your organization leverage the government’s recent commitments as Ontario prepares for an election in just seven months.

Looking forward to the 2022 Budget, the Ministry of Finance will release details shortly for the 2022 pre-budget consultation process. Submissions can be made by emailing submissions@ontario.ca in the interim.