Our previous New Normal Election Analysis pieces examined seniors’ care and income inequality. Below, we look at provincial party commitments towards creating good jobs, improving mental health, and addressing anti-racism and health system equity.
Good Jobs
A good job is crucial for health, and for equity. It consumes so much of our time, and is a huge and indispensable factor in whether we have what we need to Thrive.
The Ontario New Democratic Party (ONDP) platform includes commitments to creating good jobs and addressing workers’ pay, benefits, and security. Beyond raising the minimum wage to $16/hour in 2022 – with $1/hour increases until it hits $20 in 2026 – they also commit to legislating 10 permanent “personal emergency” leave days and creating Ontario Benefits (including at least dental and vision) to help cover those in casual, contract, app-based, and part-time jobs.
For gig and contract workers, they promise to prevent misclassification and ensure workers receive the same wage, benefits, and protections as other employees. Those hired through temp agencies will also be considered an employee of the client company after a standard probation period.
The ONDP plan to establish a four-day work week commission that would develop recommendations on how to design and implement a year-long pilot project.
The Ontario Liberal Party (OLP) plan includes a commitment to giving all workers 10 paid sick days and benefits. They would create develop and implement a Portable Benefits package geared towards self-employed, gig, contract, and creative workers.
To help gig workers, the OLP promises to bring back equal pay for equal work, ensure production quotas are safe and fair, and make it easier to join a union.
The OLP platform also includes a plan to launch a four-day work week “demonstration.”
The Progressive Conservative budget proposed on April 28 largely focussed on investing in workforce development, including skilled trades strategies and training. They plan to develop a long-term Ontario Workers’ plan to address labour shortages and training for future opportunities.
On April 5 the government announced a general minimum wage increase to $15.50 commencing October 1. They also introduced legislation shortly before the election on issues including requiring large workplaces to have “disconnect” policies.
The Green Party platform includes commitments to strengthening workers’ rights and protections. As mentioned in our income inequality analysis, they commit to raising minimum wage and introducing a “top-up” to address higher cost of living in cities. They would also legislate 10 paid sick days, repeal Bill 124 to restore rights to collective bargaining, and provide part-time, temporary, and casual workers with full and equal access to employment benefits programs including Employment Works, the Canadian Pension Plan, and the Workplace Safety Insurance Board.
To address the needs of gig and temp workers, the Greens promise to implement a “Gig Workers’ Bill of Rights,” which would end misclassification of employees as independent contractors, ensure payment for all hours worked, make gig work count towards Permanent Residency applications, and develop a program of portable extended health benefits.
In conclusion, the opposition parties all propose to meaningfully improve conditions for workers. Their proposals to create provincial portable benefits packages, end misclassification of gig workers, and legislate 10 permanent sick days are all critical to reducing health inequities.
However, although gig workers are, rightly, receiving new attention, these proposals do not lay out goals for a workplace in which every Ontarian can thrive.
All parties must commit to actively addressing all barriers to employment for equity-seeking groups and ensuring fair access to stable and permanent jobs that have safe and inclusive working conditions, reasonable working hours, living wages, and promote good health overall.
They must reject the current paradigm in which low paid gig and part time work without proper benefits and worker protections is considered an acceptable outcome, through legislating and enforcing minimum standards that are ethical and mean every worker can live a healthy life, and in which employers that fail to provide good jobs are not subsidized through funding and the tax code.
Mental Health
The lead commitment from the Ontario New Democrats in this area is “universal mental health care.” The plan is estimated to cost $500 million, eventually rising to $1.15 billion per annum, and would cover 6-12 sessions of psychotherapy under OHIP plus funding towards training primary care doctors, nurses, community health workers, and social workers in Cognitive Behavioural Therapy (CBT).
The ONDP also promises to create Mental Health Ontario, a new co-ordinating organization.
To address children and youth mental health care, the ONDP commits to reduce the wait-list for children’s mental health to 30 days by expanding access to treatment and support services. This is estimated to cost $15 million in 2022/23, rising to $58 million per annum in 2023/24.
The ONDP also propose to increase in-school support by hiring more mental health workers and creating a new position at the school board level to assess and improve delivery of mental health care.
The Ontario Liberal Party plan to invest an additional $3 billion into expanding mental health and addictions services; they commit to training 3000 new mental health and addictions workers, reducing children’s mental health care wait times, requiring private employer benefits include mental health services, providing free ‘mental health first aid’ and guided online supports, and investing in Indigenous-led mental health supports.
In schools, the OLP plan to increase mental health supports by adding 1000 mental health workers and offer new optional credits including on mental health and resilience.
The Progressive Conservatives proposed budget promised to invest an additional $204 million – on top of the $3.8 billion over 10 years that had previously been allocated (some spent as early as 2018) for the 2020 Roadmap to Wellness strategy – towards building mental health capacity and expanding existing services.
The Green Party platform commits to increasing mental health spending to 10% of Ontario’s healthcare budget and expanding access to publicly funded mental health and addiction services under OHIP, including services offered by psychotherapists, psychologists, and social workers. This would increase provincial funding by $765 million in 2022/23 and rise to $1.53 billion per annum in 2023/24.
To address backlogs and waitlists, the Greens plan to implement a wait time reduction strategy specifically for mental health services that sets targets and tracks wait times. They would also invest $120 million per annum starting in 2022/23 to increase core funding to the community health sector to reduce waitlists for children’s mental health care to 30 days or less.
For students, they promise to make the “appropriate” investments so that they can connect to community mental health professionals at or near their primary and secondary schools.
The Greens also propose developing a wider mental health and addictions strategy that would increase investments into mental health supports such as establishing a 3-digit, 24/7 province-wide mental health crisis response line and creating mental health-focused crisis response teams.
In review, only the Green Party has committed to increasing funding for mental health and addictions care to 10 per cent of Ontario’s health care budget, 1 per cent higher than what was recommended by the Mental Health Strategy of Canada (and which is still lower than many other OECD countries). The ONDP and Green Party proposals to bring some psychotherapy coverage under OHIP will help reduce barriers to these services and help to improve mental health outcomes, presuming they are rolled out equitably and effectively. All three opposition parties placed an emphasis on reducing wait times for children’s mental health care to 30 days or less. We are concerned that the proposed investments are not sufficient to meet these goals.
On mental illness, all platforms needed to lay out an acceptable future where mental health treatment is culturally appropriate and available to all who need it when they need it. We would not accept a reality in which treatment cancer, or a broken arm, was left up to the individual to pay for privately or to simply suffer, and that cannot be the reality for mental illness.
Our current system is, at best, drastically underfunded and disjointed. We focus on mental health treatment when social policy that decreases stress and allows people to thrive will decrease the need for mental health services and improve the recovery rates for people who develop illnesses. We would need to build the capacity to absorb significantly increased funding, such as the Green Party proposes. This gives all parties an opportunity to lay out what the system they want to build would look like and what the balance of new services and supports they would need. How many new specialists would they train, and when? What resources would go into primary care and community clinics, which are often the first point of access for mental health services? What would be the roles of the education sector, community agencies, municipalities, and businesses? What social policy such as benefits and supportive housing would support the transformation? How would government lead and learn from all of these partners?
To improve every Ontarians’ everyday life, prevent or mitigate the impact of many mental illnesses, and make the above more affordable, all parties and the next government should commit far more energy than they have to mental well-being, through creatively developing and funding efforts in areas including education, exercise, and enhancing social connection. They should partner with municipalities to fund local coordination and programmatic efforts, as well as putting in place modern, forward-looking, universal programs of their own.
Anti-Racism and Health System Equity
The Ontario New Democratic Party platform commits to implementing a provincial anti-racism strategy that would be informed by race-based data collection across all provincial ministries. To ensure accountability, they would appoint a minister responsible for anti-racism and fund the existing Anti-Racism Directorate into a full secretariat.
Other promises include: introducing mandatory anti-oppression and anti-bias training for public employees and legislators; establishing an Ontario Anti-Racism Advisory and Advocacy Council; addressing white supremacist and extremist groups; and providing funding to places of worship to help with security costs.
To address health care equity, the ONDP commits to ensuring race-based data is collected in all areas of health care to identify and fix systemic inequalities and establishing a systematic review of Black Canadians being disproportionately impacted by HIV/AIDS, mental health issues, heart disease, and other factors.
To help combat racism, the Ontario Liberals would reverse funding cuts to anti-racism programs, appoint a stand-alone Minister responsible for anti-racism, and better investigate hate crimes and human rights complaints.
They also propose to develop and mandate health equity standards, including having hospitals and long-term care homes collect race-based data and report on incidents of racism.
The Progressive Conservatives proposed budget did not include any new measures to address anti-racism or to make our health system more equitable.
The Green Party proposes to fully fund the Anti-Racism Directorate and require anti-racism and anti-oppression training for all public employees and legislators.
To address racial inequities in healthcare, they would mandate and fund the collection and use of socio-demographic and race-based data in the healthcare system.
On anti-racism and health system equity, the opposition parties all have language indicating their support for taking these crucial issues more seriously. However, none of them commit to the vision, or significant efforts, needed to ensure health inequities due to racism and our inequitable health system are eliminated. Ontarians are sick more and longer, and die younger, because of racism and a health system that does not adequately address their needs, and future governments must not perpetuate this reality.
For anti-racism, this means an all-of-government commitment to fighting against racism’s impacts across our society and building resilience, including through addressing other social determinants of health. Although all three opposition parties indicate they will act, they must provide specific, detailed targets and processes – committing to collect race-based data, while a start, is not enough. For our health system, this means establishing a morally acceptable metric for how much of the damage done by the social determinants of health to the health of Ontarians the health system is expected to ameliorate, and then providing funding that is appropriate to the scale of that challenge, alongside innovative metrics, oversight, and leadership to do so. Significant current examples include the disproportionate damage COVID-19 has done to racialized and low-income communities, and that Long COVID will continue to do – how much of the health system must be moved to eliminate those disparities?
Conclusion
Overall, the opposition parties are all more ambitious than the current PC government, though all commit to mental health investments. But they all must commit to more, and better.
All three of these areas represent significant challenges to building a New Normal that Ontario can be proud of, and that provides Ontarians with the systems and supports they need to live healthy lives. It is time to reimagine the possible, and build a better, more resilient, future for all.