Since 2018, Ontario has been governed by an administration that pursues a “populist” agenda, focusing on privatization, deregulation and profit-driven models. Unfortunately, these policies have led to a marked departure from public health priorities, raising significant concerns among citizens and experts alike.
The government’s actions have had detrimental effects on health care and public safety. These concerns are not abstract; they directly impact my day-to-day medical practice and the patients I serve. Below are several examples illustrating the widening gaps in governance:
- Increased access to alcohol, marijuana and vaping
The Ontario government has significantly relaxed regulations around alcohol and marijuana sales while maintaining minimal restrictions on vaping. These changes have exacerbated public health concerns, particularly for youth and vulnerable populations. Increased access to these substances has resulted in rising addiction rates, especially among younger demographics. Vaping has introduced a new public health challenge, with growing concerns over lung disease.
In my practice, I’ve seen a troubling increase in patients – many of them adolescents and even children – struggling with mental health issues and addiction. The number of cases has doubled or even tripled as a direct consequence of these policies. This is not just a policy misstep; it is a public health failure.
- Privatization and virtual health care
Ontario is witnessing a growing investment in private health-care services, including virtual care. While virtual care is promoted as a solution to reduce pressure on the public health-care system, its benefits are disproportionately available to wealthier patients, leaving marginalized communities behind. This shift risks deepening inequalities and moves us closer to a two-tier healthcare system.
Many of my patients who have used virtual care clinics end up in emergency departments or back in my office, frustrated and confused because their issues were not properly addressed. Rather than alleviating strain, virtual care often exacerbates it, particularly when it lacks the personal touch and follow-up required for effective treatment.
- Reduction in safe injection sites and addiction services
The government also has scaled back support for safe injection sites and addiction services. Rather than addressing the root causes of addiction, it prioritizes short-term solutions such as increased policing and emergency responses. This has left a glaring gap in long-term harm reduction strategies, further fueling the opioid crisis.
Scaled back support for safe injection sites have left a glaring gap in long-term harm reduction strategies.
Many experts have spoken out in protest, and even in smaller communities like Manotick, the lack of addiction services is taking a toll on my patients every day. The government’s failure to provide comprehensive addiction recovery programs only worsens the situation.
- Strain on pharmacists and medication mismanagement
Expanding pharmacists’ prescribing authority without adequate support has placed additional burdens on them, especially with programs like MedsCheck. Pharmacists are increasingly pressured by employers to meet quotas, compromising the quality of care provided to patients. While pharmacists may be able to treat minor ailments, this approach is overly transactional and fails to address the comprehensive health care needs of patients.
My pharmacist colleagues have expressed concerns about being asked to prescribe for a limited number of minor conditions. While this may seem helpful in isolated cases, it does not replace the comprehensive, relationship-based care that patients need. Primary care requires longitudinal attention to ensure that underlying issues are addressed holistically. Treating symptoms in isolation is poor judgment and diminishes the quality of care.
- The family doctor shortage and orphan patients
Ontario’s ongoing shortage of family doctors has left millions of patients without adequate care. The increasing reliance on virtual care and lower-scope providers only exacerbates these inequities. The growing crisis of “orphan patients” – those without a family doctor – is worsening as more family physicians leave the field, driven out by poor health-care policies and underfunding.
This crisis will continue to deteriorate unless we invest in team-based care, with family doctors serving as the most responsible practitioners. Without comprehensive reform, the situation will only get worse.
As Ontario’s policymakers focus on short-term gains and privatization, they neglect the long-term mental and physical health needs of our population. In the past six years, we have regressed in many areas of health care, and it is time to act. Democratic Presidential Candidate Kamala Harris insists, “We will not go back!” and the same sentiment should apply here.
We must prioritize health care, committing to ensure every Ontarian has access to a family physician working in a collaborative team with nurse practitioners, pharmacists and other health-care providers. A healthier Ontario will lead to a wealthier, more prosperous Ontario.
