Now that we’ve passed the one-year mark of the work of Jane Philpott and Ontario’s Primary Care Action Team, we can see the encouraging signs about the changes underway across Ontario.
The focus on primary care is a welcome development in the overall discussions about health-care system sustainability. It enables many voices to be heard, including those of the Alliance for Healthier Communities, to ensure transformation in primary care serves the needs of communities across the province. This real focus on primary care allows us to address gaps in access and attachment and equity, and to truly build a strong, sustainable foundation for Ontario’s entire health system.
However, if the government is to fully realize its vision, it must boost funding to help support the retention and recruitment of vital staff.
Alliance members serve people and communities facing the greatest barriers to primary health care. Every day, staff in Alliance member organizations see first-hand how team-based primary care strengthens population health, reduces emergency department pressures and helps people stay well, close to home.
Ideas for new ways of working in primary care are giving Alliance member organizations and others across the province the roadmap for transformation that will truly make a difference to the present and future of team-based primary care. The Neighbourhood Health Home and the Link Worker models help increase attachment and access to primary care; help providers work more efficiently and joyfully; and provide the health system with a strong, upstream foundation of preventative care to help stem the tide of demand on acute, emergency and tertiary care.
These new ways of working in primary care do not require changing or disrupting existing payment or governance models. They are ways of enabling collaboration using the structures we already have in place.
The Neighbourhood Health Home builds capacity by pooling and sharing resources among local primary care partners. It uses a “hub and spoke” approach in which an established team-based organization acts as the hub that provides ongoing primary care, social supports and health promotion, while connecting patients from all primary care providers to community programs and services. This neighbourhood-level collaboration helps maximize existing investments, coordinates intake, increases access to interprofessional care, fosters collaboration and allows more people to be attached to a primary care team.
Link Workers are a critical component of the Neighbourhood Health Home approach. Having a Link Worker on the team allows physicians, nurse practitioners and other clinical team members to focus on medical care while ensuring patients get support for the social and practical issues affecting their health. When clinicians identify a patient who would benefit from non-clinical supports, the Link Worker guides them to the appropriate resources – whether that involves accessing benefits, joining seniors’ exercise programs, finding housing supports or connecting with local peer groups. Link Workers are already working in many parts of Ontario, and the role shows strong promise for expansion.
Ontario’s primary care workforce continues to face significant pressures. Recruitment and retention challenges, rising operational costs and long delays in capital modernization make it difficult for teams to maintain services and expand attachment. We believe that with targeted investments, Ontario can build on recent progress and strengthen the system in a way that benefits patients, communities, and the broader health system.
The Alliance for Healthier Communities and its members are asking the Government of Ontario, in Budget 2026, to affirm support for the growth of the Neighbourhood Health Home approach through the Interprofessional Primary Care Team (IPCT) expansion and to expand Link Worker roles across primary care teams, embedding Link Workers as a mandatory part of IPCT expansion across Ontario to increase capacity and attachment. To address the barriers that many people face to attachment and access to primary care, we need the tailored and nimble approaches that the Neighbourhood Health Home and Link Workers make possible locally.
We are grateful for initial funding, but the gap identified more than two years ago by the 2023 Ontario Community Health Compensation Market Salary Review, between primary care and other parts of the system, continues to widen. We are losing staff to the acute system, private health care and education or out of health care completely. We need the Government of Ontario to expedite recruitment and retention funding by unlocking existing future year funding commitments for 2026-27 and 2027-28 and to develop a plan for ongoing investments that address the wage gaps and consider inflationary increases. We need to catch up.
This is also an opportunity to strengthen Ontario’s employment base in ways that sustainably support the health of communities via jobs that are tariff-proof. The 2023 Eckler Report outlined 79 vital, benchmark positions in community health, many with salaries that have been stalled for nearly a decade compared to other sectors in Ontario for work in the exact same role. Closing this gap is an opportunity for the government, both to strengthen Ontario communities, but also to ensure the primary health-care organizations are staffed to meet the goal of 100 per cent attachment.
The Primary Care Act and the vision that positions primary care as the foundation of Ontario’s health system is the bold thinking our system has needed for many years. We’ve seen the evidence of what’s possible if Ontario can do what other jurisdictions have done and build a coordinated, sustainable team-based primary health-care system: reduced costs, greater equity, improved health experiences and outcomes.
