Ontario parties promise family doctors for everyone. How can they make that happen?
All the main parties in the Ontario election campaign are promising to ensure everyone in the province has access to a family doctor.
For the voters who care deeply about this issue, the question of which party can turn the promise into reality will likely be top of mind when election day comes on Feb. 27.
So what are the parties promising?
First some conext:
Some 2.5 million Ontarians don’t have a family doctor or regular access to any other primary care provider, such as a nurse practitioner. That leaves them waiting in walk-in clinics when they get sick, or turning to hospital emergency rooms if they have no other options.
Projections suggest another three million Ontarians will lose their family doctor to retirement in the next few years.
That’s the precise situation that Louise Lee and her family have faced for two years, since their longtime family doctor announced plans to retire.
“We had people looking online for us. We were continually searching online to find places to add our name to wait lists,” said Lee, who is in her 50s and lives in Navan, Ont., a half-hour’s drive from downtown Ottawa.
“Anyone who mentioned going to a doctor, we would say, “Are they taking patients? Could you ask on our behalf?'” she said, describing the hunt as stressful.
Lee and her husband and their two adult sons finally got attached to a family doctor’s office in December.
Health care ‘big factor’ in casting her vote
The two-year-long struggle and the general state of the health care system in Ontario “is a big factor in how I’m going to choose to vote,” said Lee.
“It’s very frustrating that health care isn’t a more important issue in this campaign,” she said.
Her frustration is shared by Dr. Dominic Nowak, president of the Ontario Medical Association. He argues that it would be a mistake for any party to downplay the shortage of family doctors.
“If you want to form government in this province, you have to tackle health care,” Nowak said in an interview.
Liberal Leader Bonnie Crombie calls fixing family medicine her most important priority in the election.
At nearly every campaign stop across the province, Crombie cites an estimate of how many local residents are without a family doctor.
Liberals: 3,100 doctors, $3.1B
“You shouldn’t have to go to a walk in-clinic, you shouldn’t have to go to the emergency ward,” Crombie told a recent campaign event in Thunder Bay. “You should have access to primary care in your community, and we will make sure that that is the case.”
In December, the Liberals became the first party to release a detailed plan for universal access to primary care.
The pledge is to spend $3.1 billion to recruit an additional 3,100 family doctors by 2029, along with what Crombie calls a “guarantee” of a family doctor for everyone in Ontario.
The PC government waited until the day before Doug Ford triggered the election campaign to announce its commitment on family doctors.
In his 12 days of campaigning since then, Ford has not focused any of his public events on the family doctors issue. He has only addressed it when questioned by reporters.
PCs: 305 primary care teams, $1.8B
The plan would involve creating 305 new primary care teams — with an unspecified number of physicians — at a cost of $1.8 billion, providing two million more Ontarians access to primary care.
While that number falls short of the estimated number who currently don’t have a family doctor, Ford has repeatedly spoken of it as connecting every single person in the province to a family physician.
When asked about this on Friday, the PC leader responded by saying Ontario has a higher percentage of the population attached to a family doctor than any other province.
“Is it good enough? It’s not good enough,” Ford said. “I believe in continuous improvement.” He pointed to his government’s appointment last fall of Dr. Jane Philpott, the former federal Liberal health minister, to chair the province’s primary care access team, tasked with overseeing the push on family doctors.
Details of the plan are found in a government news release, although not on the Ontario PC party website. The promise is mentioned in party news releases as a bullet point.
Marit Stiles of the NDP unveiled her party’s plan for family health care on Friday in Sault Ste. Marie, where some 10,000 people lost access to their family doctor last year when a large clinic cut patients from their roster because of physician retirements and departures.
“We’re going to work tirelessly until everyone in this town has a doctor,” Stiles told the campaign event in Sault Ste. Marie. “We can’t trust Doug Ford or the Liberals to fix what they broke.”
NDP: 3,500 doctors, $4B
The NDP promises to spend $4.05 billion to recruit 3,500 new doctors over the next four years – more money and more physicians than either the PCs or Liberals.
Just like Crombie, Stiles pitches the promise as a “guarantee” of access to a family doctor.
The NDP plan to increase access to family medicine also includes provisions shared by the other parties, such as reducing the paperwork burden on family physicians, and clearing hurdles so doctors who trained and practised overseas can be approved to practise in Ontario.
Green Party Leader Mike Schreiner has said his party is “committed to ensuring that everyone in this province has access to a family doctor, nurse practitioner, or primary healthcare provider,” but hasn’t released details yet.
More than 1,000 people lined up in the snow in Walkerton, Ont., on Wednesday to try to get a family doctor — but only the first 500 would be successful.
Just two weeks before Ford called the election, Ontario saw striking images of how desperate some people are to find a family doctor. More than 1,000 people lined up outdoors on a snowy January morning in the small town of Walkerton to try to get one of 500 spots with a physician launching a new practice.
Nowak, the OMA president, likened that event to the dystopian novel and movie franchise The Hunger Games, and says it points to the political importance of the issue in the election.
“What we’re encouraging voters to do is vote based on who they trust to deliver on getting our health-care system back on track,” he said.
While the statistics certainly suggest millions of Ontario voters are affected by the shortage of family doctors, it’s far from clear how the issue will influence the election.
Federal money key to campaign pledges
Consider this notable demographic trend in data published by the Canadian Institute for Health Information: the age group least likely to have a family doctor in Ontario is young people aged 18 to 34.
That’s also the age group that is least likely to turn out to vote.
You might wonder, given that Ontario has struggled with a family doctor shortage for years, why all the political parties are now able to make these promises to fix it
In part, they can thank Justin Trudeau’s federal government.
Ottawa agreed to a major boost in overall health care funding to the provinces in late 2022, and signed its bilateral deal with Ontario in early 2023.
The agreement is crucial to the parties’ pledges on family doctors, as it commits Ottawa to give Ontario an additional $11.4 billion over 10 years in targeted health funding and in turn requires the province to boost the proportion of Ontarians with access to primary care.
It means these provincial political parties are making campaign pledges backstopped by federal government money.
The federal-provincial deal puts an emphasis on allowing more family physicians to work in teams alongside other health providers, such as nurse practitioners, nurses, social workers and mental health providers.
The team model aims to have the other health workers take some of the workload off the family doctor, allowing the physician to increase the number of patients on their roster.
Less than 30 per cent of people in Ontario are covered by any form of team-based primary care, according to Ministry of Health data from 2023.
The impact of Canada’s primary-care crisis is being felt acutely in Sault Ste. Marie Ont., where 10,000 people will be cut off from their family doctor at the end of May. CBC’s Nick Purdon breaks down the Group Health Centre’s de-rostering and what it means for patients.
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