1) Ontario plans to bar international students from medical schools starting in 2026 (Update)

Courtesy Barrie360.com and Canadian Press

By Liam Casey, October 25, 2024

Ontario will not allow international students in medical schools beginning in the fall of 2026, and will also cover tuition for more than 1,000 students who commit to becoming a family doctor in Ontario, Premier Doug Ford said Friday.

Through upcoming legislation, the province aims to reserve at least 95 per cent of medical school spots for Ontario residents and the remainder for students from other parts of Canada.

“There was 18 per cent students from around the world taking our kids’ seats and then not even staying here and going back to their country, and it’s just not right,” Ford said at a news conference. 

“So now it’s going to be 100 per cent Canadian, 95 per cent Ontario.”

Health Minister Sylvia Jones echoed those comments, saying Ontario students “need to come first.”

“We are going to prioritize Ontario residents because those are our taxpayers that are paying those students to go to school,” Jones said.

The province is also expanding a “Learn and Stay” program that covers tuition and other educational costs to include students who commit to becoming family doctors in Ontario.

The grant program, also beginning in 2026, is expected to cost $88 million and be extended to 1,360 eligible undergraduate students. The province says the program should allow 1.36 million more Ontarians to connect to primary care.

The Ontario College of Family Physicians says 2.5 million people do not have a family doctor. 

A study by the Canadian Institute for Health Information released on Thursday said 12 per cent of Ontarians do not have a family doctor. 

It is an issue that has dogged the Ford government over the years, as the numbers of Ontarians without primary care rose during his tenure.

This week, the province appointed former federal Liberal health minister Jane Philpott to a new role with a goal of connecting every Ontarian to primary care within the next five years.

“She’s going to be on the ground fixing that gap,” Ford said.

The province is also expanding its health teams model, which sees patients connect to clinics where they have access to physicians, but also nurse practitioners and other services like physical rehabilitation and mental-health care.

The province said it is also reviewing the visa trainee program that trains international students sponsored by foreign governments in an effort to further protect Ontario students.

Ford pledged to help the current crop of medical students, too, with several of them standing behind him at an Oshawa, Ont., hospital.

“I’m trying to backdate this for a year or two because I’m sure some of you have debt from medical school,” Ford said.

He looked to Finance Minister Peter Bethlenfalvy, and added: “Can you hear that, Mr. Moneybags?”

2) (Updated) 5 million adults without primary care, surgeries returning to normal: CIHI report

Courtesy Barrie360.com and Canadian Press

By Nicole Ireland, October 24, 2024

Eight-three per cent of adults in this country have a regular primary-care provider, but that still leaves 5.4 million adults without one, a new report by the Canadian Institute for Health Information says.  

Seniors 65 years and older are more likely to have access to a family doctor or nurse practitioner than younger adults between 18 and 34, and access to primary care is highest in Ontario and lowest in Nunavut, the CIHI report released Thursday says.  

The report measures the baseline of health priorities agreed upon by the federal government and the provinces and territories, including improving access to primary care, reducing wait times for mental-health and substance-use counselling, recruiting more health-care workers, decreasing surgical wait times and increasing the use of electronic health information. 

Data from Quebec was not available for this report but will be available in future, according to CIHI. 

The institute will also collect data to measure progress on two more health priorities in the near future, including ensuring seniors can age with dignity and improving cultural safety for Indigenous patients in the health-care system.

There will be a report every year to measure progress in these health-care priorities across the country, federal health minister Mark Holland said in an interview on Wednesday.    

Thursday’s report says the surgical backlogs that happened during the COVID-19 pandemic have decreased and the number of surgeries performed has mostly returned to pre-pandemic levels across Canada.  

Holland said each of the health-care funding agreements signed with the provinces and territories includes targets for the number of doctors and nurses that need to be added to the workforce.  

Many rural and Indigenous communities are particularly hard-hit by the primary care shortage, the minister said. 

In addition to recruiting doctors, nurse practitioners and nurses from other jurisdictions, the solution requires a “sustained effort” to encourage more First Nations, Métis and Inuit people — as well as others living in small towns and rural areas — “to be choosing health careers and really seeing far more people serving their own communities,” Holland said. 

The CIHI report noted that even if they have a primary-care provider, a recent survey showed Canadians still “face greater difficulty getting same-day, next-day, evening or weekend appointments” compared with people in nine other high-income countries including the U.S. and the U.K.  

Jenna Kedy, a 20-year-old patient advocate who worked with CIHI on the report, said she’s grateful to have a family doctor after being without one for almost two years, but getting immediate appointments is a challenge. 

Kedy, who lives in Halifax, requires specialist care for several chronic conditions, including juvenile arthritis, fibromyalgia, anxiety and depression. 

Having a family doctor is vital to “connect the dots for you” and keep track of her multiple health issues and medications, she said, but her doctor is too overworked to be available as much as she needs, she said in an interview with The Canadian Press. 

“If I ever had a big thing come up, it’s not like I could call my family doctor and go see him that week,” Kedy said. 

“As someone with such unpredictable illnesses, it still does cause unnecessary trips into the ER,” she said. 

“The doctors are overwhelmed and they can’t provide the same level of care they could have if they had less on their plate.”

According to the CIHI report, there were 48,199 family physicians in Canada in 2022. In P.E.I, New Brunswick, Ontario, Saskatchewan, Alberta, B.C. and Yukon, more family doctors were entering the workforce than leaving it. 

In Newfoundland and Labrador, Nova Scotia, and Manitoba, more were leaving the workforce than entering it. Data was not available for Quebec, N.W.T. or Nunavut. 

But almost all provinces and territories saw more nurse practitioners entering the workforce in 2022 than leaving it. 

The exceptions were Yukon, where more nurse practitioners were leaving than entering the workforce. Quebec data was not available. 

Cheryl Chui, director of health system analytics at CIHI, said one of the other health-care priorities — using connected electronic health information systems — is an important part of solving the primary care shortage. 

That’s because it will “enable better sharing of information and to reduce some of the administrative burden that health-care professionals face,” she said. 

Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.

3) Supply shortage for Ontario home care, palliative patients ‘unacceptable’: minister

Courtesy Barrie360.com and Canadian Press

By Allison Jones, October 21, 2024

Ontario is wrestling with delays and shortages of supplies needed for home and palliative care, with dying people unable to get sedatives and patients going to hospital because their supplies have run out, the province’s doctors say.

Health Minister Sylvia Jones said Monday that she and her ministry are working hard to rectify the “frustrating” situation.

“(It) is absolutely unacceptable,” she said in question period. 

“We have been working with Ontario Health atHome to ensure that no patients, no patients’ families, no clinicians are impacted by a logistics issue. I want to assure the people of Ontario that we have been on this issue since we first learned that there were shortages. … We know this is unacceptable and we are not going to allow this to continue.”

Jones said she has directed the agency to reimburse any patient, family or clinician who has paid out of pocket for necessary equipment.

Ontario Health atHome said in a statement that it has new supply contracts as of Sept. 24 and it is doing everything possible to stabilize the delivery of critical medical items.

“Ontario Health atHome takes any impact to our patients very seriously, and we understand the distress this is causing,” the agency wrote in a statement. 

“We want to assure patients, their families and health system partners that we are doing everything we can to address this situation and are continuing to look for opportunities to stabilize the delivery of these critical medical items.”

Dr. Joyce Cheung, the Ontario Medical Association’s chair of palliative medicine, said palliative care doctors across the province have been raising concerns about medication and supply delays that have sent patients to emergency rooms, and a lack of medication and needles leaving people in pain.

One of her palliative patients went 30 hours without a pain pump, she said, and another patient with metastatic cancer nearly ran out of ostomy bags for collecting stool.

“I don’t know what to do,” she said. “Are people buying supplies off Amazon where we cannot validate the quality of these supplies? We’re hearing these stories. They are ongoing in every corner of the province.”

The province passed legislation late last year to create Ontario Health atHome, in order to better co-ordinate home care across the province. Cheung said physicians were not part of any transition planning when the agency switched to new suppliers this fall.

“We were all taken aback,” she said. “We’re just like, ‘What is going on?’ We’re just seeing what’s happening on the ground, and we don’t even know how to pivot, because we didn’t realize this was going to be such a disaster.”

There were probably good intentions behind standardizing supply contracts, but the implementation has gone awry and it seems as though the vendors did not anticipate the amount of supplies they would need, she said.

“I think there’s going to be some forensics to be done afterwards of what actually happened,” Cheung said. “How can we prevent this from happening again?”

Bayshore Specialty Rx, one of the companies responsible for distribution of the supplies, said a confluence of factors, including unexpected stock issues, impacted their fulfillment system. 

“We sincerely apologize to those impacted and we are fully committed to restoring the level of service that Ontario home health care patients deserve,” the company, which operates in the southwest region of Ontario, wrote in a statement. 

“Our entire team is focused on mitigating these challenges and ensuring continuity of care for every patient under our services.”

Bayshore said it is restoring and improving tracking systems, dedicating additional staff to manage the distribution of urgent supplies, improving communications and sourcing alternative supplies.  

Liberal health critic and emergency room doctor Adil Shamji said the situation is dire, and should have been anticipated.

“When I had a chance to speak with ministry bureaucrats and to debate the legislation that brought forward Ontario Health atHome, it was clear that, apart from knowing what the branding was — specifically that it would be called Ontario Health atHome — they had no other clue about how this centralized, mega agency would actually perform, would actually be able to deliver care for patients who require it from home,” he said.

“They’re scrambling and flying by the seat of their pants.”

NDP Leader Marit Stiles said she wants clear answers as to why this happened in the first place.

“Not only is it unacceptable what’s happening in home care right now, but it’s unethical, deeply unethical,” she said.