ERs are at capacity and hospital deficits are growing, putting pressure on candidates to address health care.
On a freezing February morning, members of the union that represents thousands of Ontario health-care workers lined up gurneys near Queensway Carleton Hospital in an effort to shine a spotlight on Ontario’s strained health system during the province’s brief winter election campaign.
The action came in the midst of tariff threats from the U.S., a potential blow to Canada’s economy that have become a major focus of the campaign.
Progressive Conservative Leader Doug Ford called the snap election 15 months ahead of schedule in response to those tariff threats from U.S. President Donald Trump, saying he needed a new mandate to fight the threat.
“Health care is in the shadow of the tariffs at the moment,” said Michael Hurley, president of CUPE’s Ontario Council of Hospital Unions outside of Queensway Carleton Hospital. “But for all the families that are waiting for long-term care, for all the people waiting for surgeries and all the people who love them, for people who are experiencing all the waits, or for many people who have no access at all to primary care, this remains a burning issue and it certainly is for all the people who work in institutions like this.”
A day before the election call, the hospital in Ottawa’s west end had issued a wait-time alert due to the high number of patients being admitted and waiting in the emergency department. At the time, hospital occupancy was over 100 per cent, 21 additional patients were admitted without beds, and more than 100 people were waiting to be seen in emergency.
Queensway Carleton is far from alone. Similar scenes have become the norm at hospitals across the province, especially during the busy respiratory season. Ottawa hospitals have had some of the longest emergency wait times in the province in recent years, but waits across the province are well above target times. And, despite a 2018 promise from the Progressive Conservative government to end hallway health care, it is becoming more common. Those are among the signs of a health system under chronic and growing strain.
Tariffs were top of mind in the early days of the campaign. But after a month-long reprieve from Trump — who said he would delay imposing 25 per cent tariffs on Canadian goods until March — many are hoping for a shift of gears and a sharper focus on key issues, especially health, for the remainder of the brief campaign.
To some 2.5 million Ontario residents without family doctors, including hundreds who lined up in a snowstorm in Walkerton, Ont. last month seeking primary care, it might come as a surprise that anyone has to be reminded that the province’s health system needs attention as MPPs seek election.
Evening Update
But election campaigns can be like that.
Health organizations, including the Ontario Medical Association (OMA), are encouraging people to ask candidates about what their party will do to ease the crisis in health care and to demand more concerted efforts to fix problems in health care, rather than band-aid approaches.
Health issues are getting more traction as the focus shifts away from tariffs. Liberal Leader Bonnie Crombie launched her bid to become the next premier with a campaign bus that read: 2.5 million people have no family doctor in Doug Ford’s Ontario. Her platform includes a pledge to hire 100,000 new nurses, doctors and other health-care workers and ensure access to a doctor or nurse practitioner within 24 hours. She also announced a $3.1 billion health-care platform to attract 3,100 family doctors by 2029.
Just days before the election call, Ford and Health Minister Sylvia Jones announced a $1.8 billion plan to connect every person in Ontario to a primary care provider by 2029, if re-elected. The plan would be led by former federal Liberal health minister Dr. Jane Philpott, who had earlier been appointed to head a provincial primary care action team. Philpott’s work has been widely supported, although the government was criticized for waiting until the eve of an election to make the announcement. Critics also note that, despite commitments and promises, many key health concerns have not improved and some have worsened in recent years.
PC campaign spokesperson Ivana Yelich said in an email that health-care spending has increased 31 per cent since 2018 and the government has laid the groundwork for more than 50 hospital developments. Yelich also cited investments in health-care training programs and medical schools, as well as breaking down barriers for internationally trained doctors.
NDP Leader Marit Stiles also promised to connect every Ontarian to a family doctor or nurse practitioner with a focus on community-based primary care teams, to create a centralized referral system to reduce wait times and to open underused operating rooms on evenings and weekends to clear surgical backlogs, among other things. As of publication, there were no dollar figures attached to that platform.
Despite provincial investments and promises, the OMA, which represents physicians and medical students across the province, said Ontario residents have waited too long for real improvements to health care. In the past year, it says, there has been no improvement in the shortage of doctors. There are still 2,600 vacant physician positions across the province, nearly identical to one year ago. In Ottawa alone, there are 196 vacant physician positions, according to the OMA.
“Health care is something we pride ourselves on as Canadians, yet our system is struggling to deliver even the most fundamental services,” said Dr. Dominik Nowak, the president of the OMA. “We have stagnated too long. We need action to keep our system improving to ensure a healthy future for Ontario.”
Key to that action is ensuring every Ontario resident has access to a family doctor, he said. Nowak calls that a foundation of Ontario’s health system.
“If you have a family doctor, you end up getting cancer screening and preventative care, you end up living longer at a lower cost to the health system. If we have a system built on the idea that everyone has a family doctor, it makes it more sustainable,” said Nowak. “On the flip side, if we continue on like this, it makes our system unsustainable.”
The worsening primary care shortage sends more people to emergency departments, often for acute issues that could have been treated earlier. It overwhelms hospitals and drives up the costs of health care.
The OMA has said it supports the work of Philpott to ensure every Ontarian has a family doctor and would like to help co-design the system. Kimberly Moran, CEO of the Ontario Medical Association said more needs to be done to retain and attract family physicians in order to close gaps in primary care access.
The lack of access to primary care may be shaking the foundation of the health care system, but it is not the only area in need of attention, according to CUPE and others.
Here are some other key areas of concern about Ontario’s health system:
Funding gaps
Ontario provides less funding to hospitals (per capita) than any other province. In recent years, that has left many hospitals carrying crushing debt. During the first half of the 2024-2025 fiscal year, Ontario hospitals racked up $800 million in deficits, according to CUPE. Ottawa hospitals had deficits of $50 million during the same period.
Staff and bed shortages
Hospital staffing and hospital beds have not kept up with population growth. The rest of Canada has 16.1 per cent more beds per capita than Ontario, according to CUPE researcher Doug Allan. He estimates that, in Ottawa alone, 250 additional hospital beds are needed.
Hallway health care
Hallway health care, something Ford promised to end in 2018, has significantly worsened at Ontario hospitals since then. Recently, during a viral illness surge, a CHEO official described having patients in “every single nook and cranny of the hospital”.
The creation of more long-term care beds has not kept up with population growth and demand and the number beds per 1,000 people aged 75 and over has declined by 17.6 per cent, as has the long-term care wait list. The Ontario government promised to add 30,000 extra beds by 2028 but is behind schedule.
Meanwhile, Dr. Anthony Sanfilippo, a Queen’s University professor of medicine and author of The Doctors We Need: Imagining a New Path for Physician Recruitment, Training and Support, argues that work to restore the health care system must come from the bottom up – starting with the way doctors area selected and trained. That would include doing a better job of matching physician education to the needs of society, he said.
