The Ford government has no immediate plans to shut down for-profit nurse practitioner clinics in Ontario despite receiving clear direction from the federal government on the gradual elimination of the fee-for-service facilities.
The province has been under pressure from health-care advocates and political opponents to tackle the rise of private nurse practitioner clinics that charge patients for everything from initial intake visits, urgent appointments, follow-up appointments and prescription refill requests.
While Canada’s health-care system prevents out-of-pocket fees, private nurse practitioner clinics began popping up in 2024 after they didn’t receive provincial funding as part of the Ford government’s nurse practitioner-led clinic program.
Last spring, more than a dozen such clinics popped up across the province.
The Canada Health Act also allowed nurse practitioners to operate in a grey area since the law governing the country’s health-care system only included language around physicians and hospital workers but didn’t specifically outlaw private clinics from opening.
Ontario Health Minister Sylvia Jones called that a “loophole“ that prevented the province from cracking down and repeatedly asked the federal government for clarification on the Canada Health Act.
In early January federal Health Minister Mark Holland updated the Canada Health Act to specifically allow provinces to treat nurse practitioners and pharmacists like physicians, letting them create billing codes for additional health-care providers and creating a path for independent nurse practitioner-led practices to operate under the public system.
At the time, Holland also told provinces his expectation was that they would enact the changes, which come into force in 2026. Provincial governments that fail to implement billing codes would see health-care funding withheld, Holland said.
In Ontario, as the Ford government prepares for a snap election, Jones didn’t appear to be in a hurry to act now that the loophole she asked Ottawa to fix has been addressed.
“What we are doing, and what I want to see, is opportunities for nurse practitioners who are training, who are in the province already, to be able to work in multi-disciplinary teams,” Jones said at a news conference on Monday.
Asked repeatedly if she had no immediate plans to close the for-profit nurse practitioner clinics operating across Ontario, Jones pivoted to talk about a separate announcement.
“I will respectfully say that $1.8 billion expanding primary care practitioners in the province of Ontario is huge action,” she said.
The Registered Nurses Association of Ontario (RNAO) is calling on the province to speed up a new funding model for nurse practitioners in which they are “compensated fairly and competitively.”
“We don’t support the for-profit clinics, yet, closing them without creating a parallel stream of funding for nurses, for NPs that cannot find work and that waiting to serve the public, will do more harm than good,” said RNAO CEO Doris Grinspun.
While the province has until 2026 to clamp down, Grinspun said the timeline “doesn’t prevent them from moving faster.”
Liberal health critic Adil Shamji believes there’s more to the province’s delay.
“Sylvia Jones was entirely evasive on the issue of what she’s going to do with existing private paid nurse practitioner clinics and that’s entirely consistent with her approach to privatization in her health care system,” Shamji told Global News.
“She’s been happy to turn a blind eye to refer the problem to other people and to pretend as though there’s nothing that she can do,” Shamji added.
