The Ford government has defeated an Ontario Liberal-led effort to stop nurse practitioners from being able to charge for health-care services, insisting it wants to end the practice but that Ottawa must address it before Ontario can act.
During a vote on Monday morning, the government defeated Ontario Liberal MPP Adil Shamji’s plan to ban charges levied by health-care professionals.
More than a dozen private health clinics led by nurse practitioners started offering services in Ontario this year — from urgent appointments to treat minor ailments to more in-depth mental assessments — for fees that averaged hundreds of dollars.
A database of clinics, compiled by the Nurse Practitioners Association of Ontario, shows more than 30 locations in the province as of late 2023.
While the Canada Health Act lays the groundwork for how medically necessary services are paid for under the country’s single-payer model, nurse practitioners are treated as employees within the health-care system rather than independent operators.
In April, Health Minister Sylvia Jones initiated a push asking the federal government to make changes to the Canada Health Act that would address the public-private grey area in the province’s health-care system.
Shamji claims the government can fix the loophole immediately.
“Sylvia Jones and Doug Ford have said that there is nothing they can do about private paid nurse practitioner clinics,” Shamji said.
“My bill will change all of that and if this government is serious about you, about Ontarians getting health care, about having access to the primary care that you deserve, they will pass this legislation.”
Shamji emphasized on Thursday that Ford was trying to shift responsibility for a problem he believes can be handled at Queen’s Park.
“For all that he says about pointing figures at different levels of government, various kinds of investments, promises that he never follows through on, he actually has an opportunity to do something concrete and substantial today,” he told reporters.
The Liberal MPP said he hadn’t calculated the full cost of the legislation if implemented, but that it would make nurse practitioners “available to every single Ontarian, regardless of their ability to pay.”
The law Shamji drafted would declare that nurse practitioners “shall not accept payment or benefit” if they provide someone covered by OHIP with, among other things, publicly funded primary care, bringing them into the public system.
That would eliminate the loophole currently being used, the Liberal MPP argues, but the government has raised concerns that banning the practice in Ontario but not across the country could lead health-care workers to leave.
Six months after Jones’ April push to make the federal government step in and address the issue, the province does not appear to have tangible progress to show.
The Ministry of Health told Global News its “statement still stands” from the spring and summer on the issue, suggesting little has changed.
“This lack of a prohibition has created a loophole that certain healthcare providers and their clinics are taking advantage of, knowing there is no legal consequence or risk of getting shut down,” a spokesperson for Jones said in a statement resent in response to questions.
“We hope the Federal government takes action to ensure Ontarians, and Canadians, can access publicly funded primary care.”
Earlier in the year, the government said it was worried about creating a patchwork system of standards across the country.
“We need the federal government to come down and say all provinces and territories need to fix this, and then let each province and territory figure out how that will fit into their health care system,” a government source said in April.
