OPSEU/SEFPO

The Ontario Public Service Employees Union represents more than 155,000 frontline public sector workers.

Click here to download a pdf version of the submission.

Our members live, work, and raise their families in almost every community across the province, providing a vast range of public services and community supports that help keep Ontario safe, healthy, affordable, and prosperous.

You will find OPSEU members working on the frontlines in:

• Ontario’s ministries and correctional facilities
• Colleges, universities and boards of education
• Liquor stores and warehouses
• A variety of health care services including:
  • Hospitals
  • Ambulance services
  • Community care and home care agencies
  • Community health centres and public health units
  • Community addiction services
  • Long-term care facilities
  • Community mental health agencies
  • Laboratories and blood services
• A variety of social services including:
  • Children’s Aid Societies
  • Developmental services
  • Child treatment centres
  • Youth correctional facilities
  • Child and family services
  • Child care centres
  • And a host of other municipal, community, and private-sector organizations

From across these diverse sectors and workplaces, OPSEU members report an urgent need for more investment. Ontario currently invests less per person in its public services than any other province.

But despite the scare-mongering tactics being used to paint a dire picture of the province’s finances, the fact is that Ontario is wealthier than it has ever been and the provincial government can afford to make public service investments that will bring significant benefits in both the short and long-term.

Summary of main recommendations

• End the use of privatization in all its forms, and systematically re-examine currently privatized services with a view to bringing them back under public ownership and control.
• Reduce the number of public sector managers, and reinvest any savings in bolstering frontline staff.
• Give frontline public sector workers, through their unions, a meaningful voice in the design and delivery of public services.
• Immediately increase health investment by 5.3 per cent to meet population growth, aging, inflation and increased utilization, and commit to annual increases of at least the rate of health care inflation.
• Restore the minimum wage to $15 an hour for 2019, with provisions for annual cost-of-living increases in following years. Restore also a minimum number of paid sick days, scheduling rules to prevent last-minute shift cancellations, and equal pay for equal work provisions.
• Invest in our colleges and universities to ensure that Ontario is no longer in last place among provinces when it comes to per-student funding.
• Roll back the sale of alcohol in grocery stores, and take a firm stand against the expansion of alcohol sales into convenience and box stores.
• Give municipalities the right to choose the LCBO as the cannabis retailer in their communities.
• Invest in creating and enforcing strong regulations governing the Passport program to ensure that developmental services clients are served by a well- trained stable workforce that earns a living wage.
• Immediately hire 250 new full- time Correctional Officers, 200 Probation and Parole Officers, as well as correctional health care and rehabilitation staff.
• Invest in the creation, inspection and enforcement of strong regulations that keep Ontarians safe and healthy.

Introduction

As frontline workers dealing every day with millions of Ontarians, OPSEU members have unique insight about our public services, and how they can be sustainably and effectively improved. And as an open and democratic union, OPSEU actively encourages its members to share these insights. That is where the proposals in this submission come from—straight from the frontline.

The proposals in this submission are specific, practical, and achievable. And they all reflect two broad themes:

1. Investing in our public services benefits all Ontarians
2. Ontario can afford to invest properly in its public services

Investing in your home makes it more livable and valuable. Investing in your education makes you more attractive to employers and increases your earning power. Likewise, investing in strong public services makes your province safer, healthier, more affordable, and more prosperous.

And the truth is, Ontario can afford to invest in itself. The province is wealthier than it has ever been. Our gross domestic product (GDP) has never been bigger.

Not only is our GDP bigger than ever, our GDP-per-person is at an historic high. We are more productive, more innovative, and wealthier than we have ever been.

Sadly, we are not investing our wealth in ourselves and our future. In fact, Ontario invests less per person in its public services than any other province in the country.

Specifically, this lack of investment means:

• Compared to other provinces, Ontario has among the fewest hospital beds per person
• Ontario invests less per college and university student than any other province
• Ontario invests less per offender under probation and parole than any other province

Underinvestment in a public service obviously has direct consequences on the Ontarians who rely on that service: they must wait longer for lower-quality service.

But underinvestment in a service often has other consequences, too. It creates a ripple effect that spreads out, straining and weakening other public services in a vicious cycle.

Underinvestment in mental health, for example, means that more people end up in jail. Underinvestment in education means that more people are forced to rely on social services. Underinvestment in social services means more hospital visits, and fewer Ontarians able to contribute to their communities and our economy.

Fortunately, the reverse also holds true. Proper investment in mental health will reduce the strain on our jails. Investment in education will reduce the strain on social services. And investment in social services will mean more people living healthier, more productive lives.

By properly investing in our public services, the vicious cycle can be turned into a virtuous circle.

Privatization

If Ontario is richer than it has ever been, why is our government struggling to find the revenue to invest properly in our public services?

One of the main causes can be summed up in a single word answer: privatization.

From one end of the province to the other, OPSEU members are reporting that privatization is creeping ever deeper into our public services. It is happening in the Ontario Public Service (OPS), corrections, health care, education, liquor and cannabis sales, social services, and every other public service in between.

Unfortunately, privatization rarely – if ever – delivers on its grandiose promises to lower costs and improve quality.

The opposite is almost always true: privatization leads to increased costs and lower quality while sending Ontario’s public wealth into the hands of an already wealthy few.

Examples abound:

• Since Hydro privatization began in the late 1990s, rates have tripled and the province has lost billions in revenue.
• The Auditor General examined a decade of privately financed infrastructure projects and found that the people of Ontario were overcharged for them by more than $8 billion. Even worse, these “P3” schemes have left us saddled with facilities such as Waypoint Mental Health Centre or the Toronto South Detention Centre that are dangerous because of shoddy design and construction.
• Privatized medical lab testing takes longer than traditional hospital-based testing and costs up to 50 per cent more.

Meanwhile, reversing privatization often yields significant benefits.

• When Hamilton made its water system public again, quality improved and the city saved millions.
• It was the same story when Timmins brought snow-plowing back in-house: quality rose and costs dropped.
• And when the government brought a Toronto cancer clinic back under public ownership and management, the costs per treatment dropped significantly.

Government can take a significant step towards reducing costs while increasing quality and accountability by taking a firm stand against privatization.

Health care

Ontario’s health care system is a point of pride for all the people of this province regardless of their political, social or economic stripe.

But years of underinvestment have strained health care towards the breaking point, opening the door to strong forces working against the people; forces that stand to profit from the privatization of our health care system.

As more services are privatized, out-of- pocket costs rise for patients, health care jobs become more precarious with fewer benefits and security, and wealth inequality continues to rise, making life less affordable for the vast majority of the people.

If government is really for the people, it must not let this happen.

Ontario ranks near the very bottom of all provinces when it comes to per capita health care funding. According to a number of experts, including Ontario’s Financial Accountability Officer, provincial health care investment is not keeping pace with the annual health care inflation rate, leaving us unable to meet the demands of population growth, aging, and increased utilization.

Health care is the single largest program expenditure in the Ontario budget, yet there has been no provincial capacity planning since 2000. This has resulted in a significant disconnect between population need and the levels of service and staff that are actually funded.

It is time for a budget that is truly for the people; one that recognizes that Ontario’s health care system functions like an ecosystem – when funding for services and staffing gets slashed in one area, there are consequences across the entire system.

When mental health care is underfunded, hospitals are impacted. When hospitals are underfunded, more pressure is placed on already-overstretched home and community care, long-term care and ambulance services.

When services are underfunded today, it does not save money; it costs more in the long run and hurts many people in the process. It is time for long-term planning and investment, not more cuts and privatization.

Hospitals

Ontario’s community hospitals are functioning at crisis levels, and severe overcrowding has become the new “norm.” After a quarter century of austerity and years of hospital budget freezes, hospitals have reached the breaking point. This is neither safe nor acceptable. In order to address this crisis, government must:

• Increase hospital investment by 5.3 per cent to match the rate of health care inflation and maintain existing service levels. To effectively combat hallway health care and bring bed occupancy rates below 85 per cent (broadly considered the safe level), government must focus on health system planning and long-term investments to ensure that population need is met. This includes immediately boosting hospital investment by 5.3 per cent, and increasing that investment annually by at least the rate of health care inflation. The government’s recent short-term funding commitment of $90 million is nowhere near enough to combat hallway health care.
• Stop and roll back costly privatization schemes. From using public-private partnerships to build hospitals to privatizing medical lab testing and services like housekeeping, privatization has done serious damage to our health care system. Eliminating privatization is an important step towards controlling costs and ensuring the highest possible quality of care. For example, bringing lab testing back into public hospitals would reduce costs by 50 per cent, cut wait times, and improve quality inspection control.
• Improve hospital capacity and ensure safe levels of hospital services, beds and appropriate staffing levels. Ontario’s hospitals are hubs of care in our communities. Hiving-off services like cataract procedures, hip and knee replacements, colonoscopies/endoscopies and diagnostic imaging to private, for-profit clinics costs more, and compromises the quality of care. Instead, the government must improve hospital capacity to meet population need in all communities. That includes ensuring safe levels of hospital services, beds, and appropriate staffing levels to coincide with bed increases. When it comes to tackling wait times, hospital professionals who provide diagnostic and rehabilitative services play a crucial role.
• Expand inpatient and outpatient physiotherapy services across all hospitals to improve access. The demand for inpatient and outpatient physiotherapy services is exceeding service levels. It is important to expand these services across all hospitals in Ontario because improved access to physiotherapy reduces the time patients spend in hospital, thereby reducing costs and improving health outcomes.
• Impose a moratorium on hospital closures and costly mergers. The persistent rhetoric around “finding efficiencies through consolidation” has proven false. By consolidating services into fewer sites (most often in larger urban centres), hospital corporations have cut spending by cutting services from the smaller, often rural hospital sites. Community hospitals are already overstretched financially, yet they are forced to pay for restructuring out of their own operating budgets, with dire implications for the delivery of health care services.

Home and community care

The hospital overcrowding crisis has led to more and more patients being pushed too quickly into the home care system, stretching home care beyond its limits. It is simply unable to adequately care for more patients who are more sick.

• Immediately increase investment to cover the true cost of home care. Home and community care workers need the resources to keep people at home safely and to ensure positive patient outcomes.
• Eliminate redundancies by improving the democratic accountability of Local Health Integration Networks (LHINs) and contracting-in the management and delivery of home and community care. By ensuring that Ontario’s LHIN boards are democratically elected and accountable to the public, government can effectively contract- in the management and delivery of home and community care. Currently, there are more than 160 separate third- party agencies providing home and community care services – the majority of which are private, for-profit entities. Each agency has its own infrastructure, layers of bureaucracy, and demand for profit. By contracting-in, we could eliminate the immense redundancies that plague Ontario’s home care system.
• The Ontario government should end contracting-out by exploring all options for termination or non-renewal of existing contracts with provider agencies and focus on investing in a fully public, non-profit home care system instead; one where quality patient care is the focus.
• Promote fairness and stability in Ontario’s home and community care sector by reviewing the work being done by registered nursing staff to improve the recognition of their skills and abilities. Quality patient care also depends on respect for frontline workers. Personal Support Workers (PSWs) have harmonized per-visit rates and an established minimum wage rate. This is not the case for registered health care staff such as Registered Practical Nurses. These staff face stagnant wages, precarious contracts, few benefits, and they bear the responsibility for high employment costs such as having access to a car. As a result, the sector has been plagued by high rates of staff turnover, and an ongoing shortage of nursing staff.

Long-term care

Ontario’s long-term care sector is the wild west of health care.

The wait list for long-term care beds has exceeded 20,000 since the 1990s, and as of April 2018, had reached 32,835.

And when an Ontarian does get a long-term care spot, they face the lowest standards in all of Canada, and among the lowest care levels among comparable jurisdictions even though patient acuity and the complexity of care is growing.

Since 2010, only those with high or very high care needs have been deemed eligible for long-term care, and many of them have cognitive or behavioural problems. Staff are increasingly overworked and expected to do more with less.

• Invest in reducing the large and growing wait list for long-term care by creating more publicly owned and managed long-term care facilities. With the proliferation of privately operated homes, residents are increasingly forced to pay massive out- of-pocket costs or face an impenetrable wait list for publicly funded long-term care. As a result, residents are suffering. It is why the government must take immediate action to address the large and long-standing wait list for long- term care and invest in publicly funded, non-profit long-term care beds. Last fall’s commitment by the provincial government to open 6,000 new beds doesn’t go far enough to address the waitlist of 32,835.
• Increase long-term care staffing levels to ensure a minimum care standard of four worked hours of personal care, per resident, per day, is achieved. Long-term care residents deserve the highest quality of care possible. New investment is required to increase staffing levels and to ensure a minimum care standard of four worked hours of hands-on personal care, per resident, per day.
• Provide appropriate staff training to minimize exposure to workplace violence, including training on responsive behaviours. Today, 46 per cent of long-term care residents exhibit some level of aggressive behaviour related to their cognitive impairment or mental health condition. As patient acuity continues to grow, the government must commit to developing a provincial strategy to improve access to specialized seniors’ mental health services and increase access to specialized long-term care homes.
• Strengthen and enforce minimum standards of care. People living in long-term care must be able to count on safe, professional, and high-quality care. Minimum standards must be strengthened for all long-term care facilities, particularly those that are privately owned and managed. And those standards must be enforced by an appropriate number of professional frontline OPS inspectors.

Ambulance

Ontario’s Ambulance Communications Officers (ACOs) and paramedics are often the first line of defense in a medical emergency. Ontario’s EMS/911 system works well and saves lives every day.

But demands on the system are growing by six per cent a year.

Additionally, the ongoing hallway medicine crisis in the province’s hospitals is putting unsustainable pressure on paramedics – they are often stuck waiting for hours to offload patients at the Emergency Department because the hospital has no available beds.

To improve patient care, the government must:

• Reduce ambulance offload delays by investing in more hospital beds. The hospital bed crisis has had a system-wide domino effect, and its ripples are being felt on the frontlines of emergency medicine. In order to reduce major hospital offload delays, the government must improve hospital funding, hospital occupancy standards, and hospital bed capacity.
• Invest in the entire ambulance system in order to meet the annual growth in demand:
  • Provide our 911 dispatch system with better tools to prioritize calls;
  • Invest in single paramedic response units, backed up by ambulances, in order to reduce the response time in emergencies;
  • Build a registry of life-saving defibrillators and invest in more public defibrillators and CPR training;
  • Expand community paramedic programs that deliver non- emergency, in-home services and reduce the number of 911 calls.
• Invest in appropriate tools, resources and staffing at Ontario’s Central Ambulance Communications Centres (CACCs) and hire more permanent, full-time Ambulance Communications Officers (ACOs). Recent media reports have highlighted the pitfalls of severe staffing shortages in Ontario’s CACCs. Just recently, all ACOs working out of the Cambridge CACC were “temporarily” relocated to Hamilton because of a crisis-level staff shortage. Too often, staff are working on a contract basis, with little job protection and high exposure to trauma and PTSD. This has undoubtedly resulted in high staff turnover and pervasive short-staffing has become the new “norm.” This is not acceptable.
• The provincial government must provide the appropriate tools, resources and staffing at all of Ontario’s CACCs.
• This includes hiring more permanent, full-time ACOs immediately. Saving lives means focusing on permanent solutions, not makeshift mitigation tactics.

Mental health

No worker should fear for their life when they go to work. But this is a reality for thousands of mental health care workers who face increasing exposure to violent assaults. If staff are not safe, neither are patients.

The government simply isn’t investing enough to prevent this violence.

• Immediately invest in preventing violence against mental health workers. To address the high risks faced by workers in mental health facilities, government must invest in increasing staffing levels and implementing better risk assessment procedures, including the system-wide use of the Violence, Aggression and Response Behaviours Tools (VARB) for assessing security, conducting organizational risk assessments and assessing individual client behaviour.
• Extend PTSD presumptive legislation so that health care workers are entitled to WSIB. For frontline mental health workers who have experienced trauma, it is crucial that the PTSD presumptive legislation be extended so that health care workers are entitled to WSIB. By extending the legislation, mental health care workers would have faster access to the resources and treatment they require. This would improve health outcomes and reduce longer-term health care costs.
• Invest in more supportive housing for mental health and addictions patients that is appropriately staffed. Supportive housing is an integral resource for mental health and addictions patients, but improved investment is required. These homes must also be staffed at appropriate levels by professionals including Social Workers, Occupational Therapists, Recreational Therapists, Registered Nurses and Registered Practical Nurses. Investing in the right care means focusing on long-term solutions, not band aid fixes.
• Provide all mental health and addictions services on a fully public, non-profit basis with full public accountability. Like many other health sectors, the mental health and addictions sector has been plagued by costly privatization schemes. Privately owned and operated methadone clinics are one troubling example. Methadone is frequently prescribed for people who are seeking treatment for opiate dependency. The goal is to prevent death, reduce harm, and support rehabilitation. But the current system is not well-integrated, and people are not being treated holistically. That’s because addictions services have become a lucrative industry. There is profit to be made from the distribution of methadone, giving clinic owners very little incentive to reduce users’ dosages. This is an unsettling example of the corrosiveness of privatization when it comes to public health care and improving health outcomes. All mental health and addictions services should be provided on a fully public, non-profit basis with full public accountability.
• The government must increase the resources provided, and ensure these resources are made available in all communities.

Blood services and diagnostics

Ontario’s public blood system works because Ontarians believe in giving. In fact, Canada is completely self-sufficient when it comes to blood collection and supply.

Unfortunately, the same cannot be said for our supply of fractionated plasma products, which are used to produce medications.

Ontario depends on world markets for plasma products used to produce medications, much of which is collected through paying donors.

• Maintain the ban on private blood and plasma-product collection to ensure the ongoing safety of Ontario’s blood supply, and invest in public plasma collection facilities. The government must invest in public plasma collection facilities to reduce dependency on world markets for the fractionated plasma products used to produce medications, much of which is collected by paying donors. To achieve the highest quality and standards of safety, the government must stem the growth of private clinics.
• Promote fairness for laboratory technicians, regardless of their workplace. The diagnostic testing done by laboratory staff at Public Health Ontario is vital work that prevents public health crises like Walkerton, SARS and other outbreaks. This work keeps our communities safe, and it is vital to the health of all Ontarians. But public services are stronger when workers are treated fairly. OPSEU is calling on the government to harmonize the pay and working conditions for all laboratory technicians, regardless of whether they work in community hospitals or community-based laboratories.

Ontario Public Service

OPSEU members are at the heart of the Ontario Public Service (OPS). We represent more than 35,000 Ontarians working directly for the province’s 23 government ministries.

Our members are constantly flagging issues and improvements that can be made to the services provided by their particular ministry.

After consulting with OPSEU’s democratically elected leaders representing our members in the OPS, we have identified the following five overarching proposals to improve the efficiency and effectiveness of all the services provided by the OPS.

• Drastically reduce the use of all forms of privatization, including asset sales, “public-private partnerships,” private consultants, and the unnecessary rental of private workspace, equipment, and fleet vehicles. As outlined in the introduction to this submission, privatization is a failed policy experiment that rarely delivers on its promises, and almost always leaves governments poorer and citizens with lower-quality services. The private sector is good at making profits but has a long track record of failure and price-gouging when it comes to delivering public services. Stopping and rolling back privatization would save significant amounts of money and improve the services Ontarians depend on. Privatization in its many forms is rampant across the OPS:
  • Privatized services. Services such as highway maintenance and snow- plowing, driver testing and licensing, ServiceOntario Centres, and email and IT systems have been privatized. Quality has suffered, and costs have increased.
  • Privatized public assets. The sell-off of publicly owned assets and entities have cost Ontario billions upon billions of dollars in lost revenue and increased prices. The sale of Hydro One, Highway 407, and OLG casinos across the province are just three of a number of examples of public asset sales that result in generations of financial loss.
  • Privatized construction financing. Infrastructure and facility construction projects financed through public-private partnerships and “alternative financing and procurement” contracts have ended up costing much more than if government had simply financed the projects with the low interest rates it can command. In 2015, the Auditor General found that Ontarians had been overcharged by more than $8 billion for privatized infrastructure projects over the previous 10 years.
  • Private consultants. The overuse of private consultants has reached epidemic levels in the OPS. The Auditor General found in 2016 that the Treasury Board Secretariat was using consultants 90 per cent of the time when filling staffing requests for IT workers, adding that each consultant costs $40,000 more per year than a permanent employee would. Revisiting the issue in 2018, the Auditor General stated that “there is still an over-reliance on IT consultants” and “that ministries at times used consultants for ongoing or operational work that could have been undertaken more cost-effectively by full-time permanent or term employees.” It’s not just money that we lose to consultants, it’s also vital experience. Once the job is done, so is the consultant. But if the work had been done by a permanent employee, their experience and expertise would remain in the OPS to the benefit of the people of Ontario.
  • Private workspace and equipment rentals. Similar to the overuse of private consultants, the OPS has come to rely far too heavily on the rental of private workspace, private equipment, and private fleet vehicles. For example, the Ministry of Economic Development, Job Creation and Trade has its Toronto office space scattered between seven locations, six of them privately owned. This work could easily be housed within one of government’s publicly owned office buildings, saving significant rental costs
• Drastically reduce the number of managers and reinvest those savings in strengthening the frontlines. Over the past 30 years, the number of OPS managers has grown, while the number of frontline workers has shrunk. Senior management says the ratio of staff to managers across the OPS now stands at 1:7. In some ministries, the ratio is even more unsustainable. In the Ministry of Economic Development, Job Creation and Trade, OPSEU members report the ratio is 1:4. Members at other ministries report it’s as high as 1:3. Having too many managers is a waste of resources and reduces the quality of service that everyday Ontarians depend upon. The money spent on management salaries and perks is much more wisely invested in strong and effective frontline staff.
• Even simply filling vacancies and hiring an appropriate number of staff would yield significant efficiencies and improvements, cutting the unnecessary costs of overtime, training temporary contract workers, and reducing the burn-out that inevitably results from unsustainable workloads.
• Invest in the inspection and enforcement of strong regulations that keep Ontarians safe and healthy. Regulations are often derided as meaningless “red tape.” But the truth is that strongly enforced regulations save lives and, ultimately, money. Cutting regulations, and the frontline OPS workers who enforce them, will end up costing Ontarians dearly. Private-sector “self-regulation” simply cannot be trusted. Time and again, we have seen examples of private corporations maximizing profits by cutting corners and turning a blind eye to problems. The results can be disastrous. The Aylmer Meat Scandal. The Sunrise Propane explosion. Walkerton. All could have been avoided with strong regulations strongly enforced.
• Invest in improving OPS management’s human resources practices. A chronic and wasteful problem across the OPS is management’s inability to quickly and effectively resolve disputes over its collective agreement. Although many grievances can and should be solved by the direct manager, OPSEU stew