Ontario Budget Leaves More than 30,000 Ontarians Waiting for Health Care

“The funding levels for health care services in the provincial budget are worse than expected,” noted Natalie Mehra, director of the Ontario Health Coalition. “Funding levels announced for hospitals and long-term care are far less than what is needed to maintain existing services, let alone address backlogs. The result will be major cuts to needed care services, longer wait lists for long-term care and unsafe conditions in our hospitals.

“The good news is a substantial increase per year in home care funding, up from the pattern of the last decade which has seen home care shrink as a proportion of health care spending,” she said. “With the new investment, it is time to create a public non-profit home care system. Otherwise this budget is a recipe for privatization by stealth: moving care from public and non-profit hospitals to for-profit home care companies and nursing homes.”

“While increases in home care are needed and will help those who are eligible and appropriate for such services, they are not a total “trade-off” with the hospital cuts,” she explained. “To pretend otherwise is simplistic and manipulative, and ignores the real health needs of thousands of Ontarians.”

“Furthermore, red flags should be raised by the budget announcement of “more flexibility” within long-term care homes’ funding for operators to spend money where they choose, since most of these facilities are owned by for-profit companies, including large multinational profit-seeking chains,” she warned.

After years of corporate tax cuts, the provincial budget proposes to pay for the ensuing deficit by, not only the impending hospital cuts and burgeoning long-term care wait lists, but also by freezing the minimum wage and social assistance, worsening income inequality, one of the most significant social determinants of health.

Key issues:

• Prior to the provincial election, the government projected 3.6% annual funding increases for health care. Don Drummond proposed 2.5%. This budget announces 2.1%.

• The budget announces a hospital funding freeze. Hospital global budgets are set at 0%; less than inflation and population growth/aging factors. This will result in hospital deficits and another round of major hospital cuts across Ontario. Ontario has cut more than 18,500 hospital beds since 1990 and now has the fewest hospital beds per capita of any province in Canada and funds hospitals less than all other provinces but one. The evidence is clear that hospital cuts have already gone too far. Already hospital occupancy rates average 98% across Ontario – a level that is so unsafe as to be unheard of in developed countries. Ontario has extraordinarily long wait times for patients waiting in emergency departments to be admitted into hospital because we have such a severe shortage of beds into which to admit patients. This budget puts rural hospitals at serious risk.

• There are more than 30,000 Ontarians on long-term care wait lists. This budget contains nothing new to alleviate these waits which Health Quality Ontario reports have tripled since 2005.

• The budget is almost entirely focused on moving patients into the cheapest mode of care, not on meeting need for care.

• At the same time as the government is severely curtailing hospital funding, they are introducing a new funding formula. British physicians wrote an open letter to Canadian governments warning about the new payment for procedure system that Ontario is adopting, citing its destabilizing and privatizing effects.

• The budget announces new user fees for high-income seniors receiving Ontario Drug Benefits. The OHC is concerned about eroding universality in our health care system – the principle that holds that “judge” and “janitor” should share a hospital ward, ensuring that the judges have an interest in keeping good quality services for everyone. If the government is willing to introduce user fees for wealthy seniors, why not just tax the wealthy?

Ontario Health Coalition
15 Gervais Drive, Suite 305
Toronto, ON M3C 1Y8
www.ontariohealthcoalition.ca
416-441-2502

In a provincial budget that notes Ontario is a “low tax” (and low service) province that spends the least on public services of any province in Canada, the government has unapologetically written a provincial budget that will lead to ballooning health care wait lists, more out-of-pocket costs, and unsafe conditions for Ontario patients.

“The funding levels for health care services in the provincial budget are worse than expected,” noted Natalie Mehra, director of the Ontario Health Coalition. “Funding levels announced for hospitals and long-term care are far less than what is needed to maintain existing services, let alone address backlogs. The result will be major cuts to needed care services, longer wait lists for long-term care and unsafe conditions in our hospitals.

“The good news is a substantial increase per year in home care funding, up from the pattern of the last decade which has seen home care shrink as a proportion of health care spending,” she said. “With the new investment, it is time to create a public non-profit home care system. Otherwise this budget is a recipe for privatization by stealth: moving care from public and non-profit hospitals to for-profit home care companies and nursing homes.”

“While increases in home care are needed and will help those who are eligible and appropriate for such services, they are not a total “trade-off” with the hospital cuts,” she explained. “To pretend otherwise is simplistic and manipulative, and ignores the real health needs of thousands of Ontarians.”

“Furthermore, red flags should be raised by the budget announcement of “more flexibility” within long-term care homes’ funding for operators to spend money where they choose, since most of these facilities are owned by for-profit companies, including large multinational profit-seeking chains,” she warned.

After years of corporate tax cuts, the provincial budget proposes to pay for the ensuing deficit by, not only the impending hospital cuts and burgeoning long-term care wait lists, but also by freezing the minimum wage and social assistance, worsening income inequality, one of the most significant social determinants of health.

Key issues:

• Prior to the provincial election, the government projected 3.6% annual funding increases for health care. Don Drummond proposed 2.5%. This budget announces 2.1%.
• The budget announces a hospital funding freeze. Hospital global budgets are set at 0%; less than inflation and population growth/aging factors. This will result in hospital deficits and another round of major hospital cuts across Ontario. Ontario has cut more than 18,500 hospital beds since 1990 and now has the fewest hospital beds per capita of any province in Canada and funds hospitals less than all other provinces but one. The evidence is clear that hospital cuts have already gone too far. Already hospital occupancy rates average 98% across Ontario – a level that is so unsafe as to be unheard of in developed countries. Ontario has extraordinarily long wait times for patients waiting in emergency departments to be admitted into hospital because we have such a severe shortage of beds into which to admit patients. This budget puts rural hospitals at serious risk.
• There are more than 30,000 Ontarians on long-term care wait lists. This budget contains nothing new to alleviate these waits which Health Quality Ontario reports have tripled since 2005.
• The budget is almost entirely focused on moving patients into the cheapest mode of care, not on meeting need for care.
• At the same time as the government is severely curtailing hospital funding, they are introducing a new funding formula. British physicians wrote an open letter to Canadian governments warning about the new payment for procedure system that Ontario is adopting, citing its destabilizing and privatizing effects.
• The budget announces new user fees for high-income seniors receiving Ontario Drug Benefits. The OHC is concerned about eroding universality in our health care system – the principle that holds that “judge” and “janitor” should share a hospital ward, ensuring that the judges have an interest in keeping good quality services for everyone. If the government is willing to introduce user fees for wealthy seniors, why not just tax the wealthy?

For more information: Natalie Mehra 416-230-6402 or OHC office 416-441-2502.

-- 
Ontario Health Coalition
15 Gervais Drive, Suite 305
Toronto, ON M3C 1Y8
www.ontariohealthcoalition.ca
416-441-2502

Ontario Budget Leaves More than 30,000 Ontarians Waiting for Health Care

(March 27, 2012) In a provincial budget that notes Ontario is a “low tax” (and low service) province that spends the least on public services of any province in Canada, the government has unapologetically written a provincial budget that will lead to ballooning health care wait lists, more out-of-pocket costs, and unsafe conditions for Ontario patients.

“The funding levels for health care services in the provincial budget are worse than expected,” noted Natalie Mehra, director of the Ontario Health Coalition. “Funding levels announced for hospitals and long-term care are far less than what is needed to maintain existing services, let alone address backlogs. The result will be major cuts to needed care services, longer wait lists for long-term care and unsafe conditions in our hospitals.

“The good news is a substantial increase per year in home care funding, up from the pattern of the last decade which has seen home care shrink as a proportion of health care spending,” she said. “With the new investment, it is time to create a public non-profit home care system. Otherwise this budget is a recipe for privatization by stealth: moving care from public and non-profit hospitals to for-profit home care companies and nursing homes.”

“While increases in home care are needed and will help those who are eligible and appropriate for such services, they are not a total “trade-off” with the hospital cuts,” she explained. “To pretend otherwise is simplistic and manipulative, and ignores the real health needs of thousands of Ontarians.”

“Furthermore, red flags should be raised by the budget announcement of “more flexibility” within long-term care homes’ funding for operators to spend money where they choose, since most of these facilities are owned by for-profit companies, including large multinational profit-seeking chains,” she warned.

After years of corporate tax cuts, the provincial budget proposes to pay for the ensuing deficit by, not only the impending hospital cuts and burgeoning long-term care wait lists, but also by freezing the minimum wage and social assistance, worsening income inequality, one of the most significant social determinants of health.

Key issues:

• Prior to the provincial election, the government projected 3.6% annual funding increases for health care. Don Drummond proposed 2.5%. This budget announces 2.1%.

• The budget announces a hospital funding freeze. Hospital global budgets are set at 0%; less than inflation and population growth/aging factors. This will result in hospital deficits and another round of major hospital cuts across Ontario. Ontario has cut more than 18,500 hospital beds since 1990 and now has the fewest hospital beds per capita of any province in Canada and funds hospitals less than all other provinces but one. The evidence is clear that hospital cuts have already gone too far. Already hospital occupancy rates average 98% across Ontario – a level that is so unsafe as to be unheard of in developed countries. Ontario has extraordinarily long wait times for patients waiting in emergency departments to be admitted into hospital because we have such a severe shortage of beds into which to admit patients. This budget puts rural hospitals at serious risk.

• There are more than 30,000 Ontarians on long-term care wait lists. This budget contains nothing new to alleviate these waits which Health Quality Ontario reports have tripled since 2005.

• The budget is almost entirely focused on moving patients into the cheapest mode of care, not on meeting need for care.

• At the same time as the government is severely curtailing hospital funding, they are introducing a new funding formula. British physicians wrote an open letter to Canadian governments warning about the new payment for procedure system that Ontario is adopting, citing its destabilizing and privatizing effects.

• The budget announces new user fees for high-income seniors receiving Ontario Drug Benefits. The OHC is concerned about eroding universality in our health care system – the principle that holds that “judge” and “janitor” should share a hospital ward, ensuring that the judges have an interest in keeping good quality services for everyone. If the government is willing to introduce user fees for wealthy seniors, why not just tax the wealthy?

15 Gervais Drive, Suite 305
Toronto, ON M3C 1Y8
www.ontariohealthcoalition.ca
416-441-2502

Ontario Health Coalition

Health Providers Against Poverty Warns Ontario's Austerity Budget Will Cost by Worsening the Health of Ontario's Most Vulnerable

March 27, 2012: Health Providers Against Poverty today expressed dismay at the Ontario government's continued assault on the health and pocketbooks of the province's poorest residents.

A freeze in welfare rates is effectively a cut to the income of people who are struggling to live on almost 60 per cent less than what they received through social assistance 20 years ago. This is an assault to the health of social assistance recipients, and will continue to shift the burden of care from the income support system to the health system, says Gary Bloch, a family physician in Toronto.

The McGuinty government today confirmed rumours of a freeze to social assistance rates, as well as slowing of the increase in Child Tax Benefit payments. While a short-term savings looks good on the books today, in our offices we expect to see the ongoing health impacts of increased poverty among social assistance recipients now and children currently growing up in poverty over the next decades. Unfortunately, short-term thinking often produces long-term troubles, stated Laura Hanson, a nurse in Toronto.

Anne Egger, a nurse practitioner in downtown Toronto, expressed similar concerns: I continue to see astounding rates of chronic illness, such as diabetes and heart disease, among the low income people in my practice.  I expect this trend to worsen with social safety net-weakening budgets like this one. When the government's books get lighter, my workload gets heavier.

Health Providers Against Poverty is a group of physicians, nurses, nurse practitioners, and other frontline health providers dedicated to reducing poverty as a frontline health intervention. HPAP recognizes poverty as the predominant determinant of health, and advocates for poverty reduction as a means to improving the health of all Ontarians.

Registered Nurses Association of Ontario condemns attack on vulnerable people to rein in spending

TORONTO, March 27, 2012 - The province's so-called plan to keep spending in check will end up hurting vulnerable Ontarians the most, according to the nurses' association. 

Members of the Registered Nurses' Association of Ontario (RNAO) say the "double whammy of freezing the minimum wage and social assistance rates isn't just bad social policy - it's bad health policy," says Chief Executive Officer Doris Grinspun. "Asking those who can least afford it to live with less is unconscionable," adding "nurses want to know what happened to Premier McGuinty's bold strategy to reduce poverty?"

RNAO says these moves and delaying the planned increases to the Ontario Child Benefit program will only hurt those who need help most. "The Premier seems to have forgotten his promise not to leave anyone behind," says Grinspun, adding that these cuts will result in higher health-care costs, as there is overwhelming evidence linking poverty with increased illness and premature death.

Nurses say expecting people to live on less than $20,000 per year stands in stark contrast to the salaries of hospital executives which the province says it will cap. "Rather than freezing salaries - ranging from $400,000 to $800,000 - the government should create a new normal where exorbitant compensation is prohibited," adds Grinspun.   

Not all is grim in the budget, nurses say. David McNeil, RNAO's president, says "measures to improve same-day and next-day appointments as well as after-hours care with primary care providers, including nurse practitioners and physicians, are sound investments to prevent health complications and misuse of hospital ERs."

RNAO is also pleased that the McGuinty government ignored advice from economist Don Drummond to experiment with for-profit delivery, and instead is opting to expand the use of not-for-profit community-based clinics to perform routine procedures. McNeil says "the evidence clearly shows that not-for-profit clinics have better health outcomes and cost less."

Nurses understand the province wants to reduce the deficit. RNAO says the decision to delay a planned cut on corporate income taxes is welcome news, and the government should start a serious conversation on fair taxation to pay for public services.  

Meanwhile, the best way to bring the deficit under control is not with deep cuts to social programs, but by improving integration between social programs and health services, as well as and within health itself. For example, RNAO points to existing duplication between Community Care Access Centres, hospital discharge co-ordinators and home care agencies. "This is unnecessary duplication that costs taxpayers money and could be better spent on direct care for patients at home. We have 4,300 primary care nurses who are eager and ready to take on the care co-ordination role," says Grinspun.

The Registered Nurses' Association of Ontario is the professional association representing registered nurses in Ontario. Since 1925, RNAO has advocated for healthy public policy, promoted excellence in nursing practice, increased nurses' contribution to shaping the health-care system, and influenced decisions that affect nurses and the public they serve.

For more information about RNAO, visit their website at www.rnao.org . You can also check out their Facebook page at www.rnao.org/facebook and follow them on Twitter at www.twitter.com/rnao. 

Le Collège des médecins du Québec confirme qu’il y avait un problème et recommande des améliorations à l’assurance qualité

Les résultats de l’enquête commandée par le comité exécutif du Collège des médecins du Québec afin de réviser la lecture de plus de 22 000 mammographies effectuées dans trois cliniques de Montréal et de Laval, entre 2008 et 2010, ont révélé qu’au total 109 cancers du sein ont été détectés et pris en charge, au fur et à mesure qu’ils étaient diagnostiqués.

« En novembre 2010, dès que nous avons appris qu’il ait pu y avoir possiblement des erreurs de diagnostics lors de lectures de mammographies, nous avons immédiatement mis sur pied cette enquête de révision afin de nous assurer que toutes les femmes ayant subi ces examens puissent avoir accès le plus rapidement possible aux traitements requis par leur condition », a rappelé le Dr Charles Bernard, président-directeur général du Collège. « Nous sommes conscients que cette enquête a suscité beaucoup d’inquiétude chez les femmes mais le rapport d’aujourd’hui nous confirme que nous devions faire cette enquête, et nous remercions les femmes de leur compréhension ». Par ailleurs, le médecin radiologiste à l’origine de l’enquête n’exerce plus depuis octobre 2010, soit avant que l’enquête n’ait été amorcée.

« Notre premier souci a toujours été de nous assurer que les femmes ayant passé ces mammographies soient informées, soutenues et accompagnées jusqu’à ce qu’elles aient obtenu tous les services et soins de santé dont elles avaient besoin », a affirmé le Dr Louise Charbonneau, enquêtrice pour le Collège des médecins.

« L’enquête nous a permis de constater que des améliorations pouvaient encore être apportées pour éviter qu’une telle situation ne se reproduise », a ajouté le Dr Huguette Bélanger, enquêtrice. « En plus d’intensifier ce qui se fait déjà, nous avons formulé 10 recommandations additionnelles. Celles-ci visent essentiellement à permettre aux radiologistes en clinique privée d’être en lien formel, systématique et plus étroit avec des centres de référence dans le domaine afin d’obtenir une rétroaction et un soutien appropriés ».

Le rapport recommande principalement :

• l’établissement d’un lien formel entre les centres de dépistage, les centres de référence et les cliniques privées de mammographies pour favoriser la rétroaction et le suivi de performance des centres de dépistage et des radiologistes y exerçant;
• la nomination de quatre radiologistes experts pour couvrir l’ensemble du territoire québécois et assurer le suivi continu de l’assurance qualité de l’interprétation des mammographies;
• la numérisation systématique et obligatoire de toutes les mammographies pour permettre une consultation immédiate des films si nécessaire.

« Le Collège suivra l’application des recommandations et a obtenu la confirmation de la collaboration de l’Association des radiologistes du Québec et du ministère de la Santé et des Services sociaux », a annoncé le Dr Yves Robert, secrétaire du Collège des médecins.

Enfin, l’enquête comportait un autre volet touchant un peu plus de 500 scanographies (C-T scan). Dans ce cas-ci, plutôt qu’une relecture, une démarche a été effectuée auprès de tous les médecins traitants afin d’évaluer la pertinence de revoir le résultat de cet examen diagnostic. Cela a amené à refaire l’examen chez 158 patients. Des recommandations sur les obligations de mise à niveau des appareils ont été formulées à l’intention des responsables de cliniques d’imagerie médicale et du ministère de la Santé et des Services sociaux.

Les représentants du Collège remercient tous les collaborateurs qui ont été mobilisés dans le cadre de cette enquête, notamment les deux médecins enquêtrices, l’Association des radiologistes du Québec et les 41 radiologistes relecteurs, le ministère de la Santé et des Services sociaux du Québec qui a rapidement autorisé les ressources pour mener à bien l’enquête, l’Agence de santé et des services sociaux de Laval qui a mis en place et administré le centre de coordination de l’enquête, les centres de référence qui ont fait preuve d’une disponibilité accrue auprès des femmes nécessitant des examens complémentaires ainsi que le personnel et la direction médicale des cliniques Radiologie Fabreville (Laval), Radiologie Jean-Talon Bélanger et Radiologie Domus Médica (Montréal).

Le rapport complet est disponsible à : http://www.cmq.org/fr/public/profil/commun/Nouvelles/2012/2012-03-27/~/media/Files/PesseEvenements/Rapport-mammographies-mars2012-DEF.ashx?31227

Le Collège des médecins du Québec est l'ordre professionnel des médecins québécois. Sa mission : une médecine de qualité au service du public.

Quebec mammogram review finds 109 possible errors

The Collège des médecins du Québec confirms that there was a problem and recommends improvements in quality control

The Collège des médecins du Québec confirms that there was a problem and recommends improvements in quality control

The findings of the investigation ordered by the executive committee of the Collège des médecins du Québec to review the results of over 22 000 mammograms done in three clinics in Montreal and Laval, between 2008 and 2010, revealed that a total of 109 cases of breast cancer were detected and managed, as they were diagnosed.

According to the CBC, the potential problems are linked to one radiologist who worked in three clinics — Radiologie Jean-Talon Bélanger and Radiologie Domus Médica in Montreal and Radiologie Fabreville in Laval.

“In November 2010, as soon as we heard that errors may have been made in mammogram interpretations, we immediately launched the investigation to ensure that all the women who underwent these tests could receive the treatment their condition required as quickly as possible,” pointed out Dr. Charles Bernard, president and chief executive officer of the Collège. “We are well aware that this inquiry was a cause of anxiety for many women. But today’s report confirms that we had to do it, and we thank the patients for their understanding and collaboration.” The radiologist whose work led to the investigation stopped practicing in October 2010, before the investigation began.

“Our primary concern has always been to ensure that the women who had these mammograms are informed, supported and accompanied until they receive all the services and health care they need,” stated Dr. Louise Charbonneau, investigator for the Collège des médecins.

“The investigation revealed that improvements could still be made to prevent this type of situation from happening again,” added Dr. Huguette Bélanger, investigator. “As well as stepping up what is already being done, we formulated 10 additional recommendations. The main objective of the recommendations is to establish a formal, systematic and closer connection between radiologists in private clinics and referral centres in the field in order to provide radiologists with appropriate feedback and support.”

The report’s key recommendations are:

·         that a formal connection be established between screening centres, referral centres and private mammography clinics to promote monitoring and feedback with respect to the performance of screening centres and their radiologists;

·         that four expert radiologists be appointed to cover the entire territory of Québec and ensure continuous monitoring of the quality control of mammogram interpretations;

·         that all mammograms must be systematically digitalized to allow immediate consultation of films if necessary.

“The Collège will monitor the application of the recommendations and has obtained confirmation of the collaboration of the Association des radiologistes du Québec and the Ministère de la Santé et des Services sociaux,” announced Dr. Yves Robert, secretary of the Collège des médecins.

Another aspect of the investigation dealt with more than 500 CT scans. In this case, instead of rereading the exam, the approach was different. The investigators got in touch with all treating physicians to reassess the need for redoing the test, this was done for 158 patients. Recommandations are made to regulate updating of all imaging equipments to medical directors of imaging clinics and the Ministère de la Santé et des Services sociaux.

The Collège’s representatives would like to thank all those who collaborated in the investigation, in particular the two investigator physicians, the Association des radiologistes du Québec and the 41 radiologists who re-examined the mammogram results, the Ministère de la Santé et des Services sociaux du Québec which quickly authorized the resources to conduct the investigation, the Agence de santé et des services sociaux de Laval which established and managed the coordination centre for the investigation, the referral centres which increased their availability for women who required further tests as well as the staff and medical department of the three clinics concerned: Radiologie Fabreville (Laval), Radiologie Jean-Talon Bélanger and Radiologie Domus Médica (Montreal).

The full report is available at http://www.cmq.org/en/public/profil/commun/Nouvelles/2012/2012-03-27/~/media/Files/PesseEvenements/Rapport-mammographies-mars2012-DEF.ashx?31227 .

The Collège des médecins du Québec is the province’s professional order of physicians. Its mission is to promote quality medicine in order to protect the public and help improve the health of Quebecers.

More Misery for the Poorest Ontarians

In its March 27, 2012 budget, the Ontario government is freezing welfare rates and cutting in half the expected increase in the Ontario Child Benefit, further adding to the marginalization of poor people in Ontario.

But according to the Public Health Agency Canada, there is strong and growing evidence that higher social and economic status is associated with better health. In fact, these two factors seem to be the most important determinants of health (http://www.phac-aspc.gc.ca/ph-sp/determinants/index-eng.php#key_determinants).

In fact,

• Only 47% of Canadians in the lowest income bracket rate their health as very good or excellent, compared with 73% of Canadians in the highest income group.
• Low-income Canadians are more likely to die earlier and to suffer more illnesses than Canadians with higher incomes, regardless of age, sex, race and place of residence.
• At each rung up the income ladder, Canadians have less sickness, longer life expectancies and improved health.
• Studies suggest that the distribution of income in a given society may be a more important determinant of health than the total amount of income earned by society members. Large gaps in income distribution lead to increases in social problems and poorer health among the population as a whole. 

Many groups are responding to these cutbacks:

In a media release on the front page of their website, the Wellesley Institute stated "Yesterday Premier McGuinty announced that social assistance rates will be frozen for a year and that the scheduled $200 increase in the Ontario Child Benefit will be reduced to $100, with the remaining $100 being delayed until July 2014.

"These choices, which the Premier claims are not aimed to reducing the provincial deficit “on the backs of families who may find themselves in difficult circumstances for the time being or on the backs of our children,” will have negative and inequitable health outcomes for the most vulnerable in our society, and particularly for women and children. Already in Ontario:

• Over three times as many people in the lowest income group report their health to be only poor or fair than in the highest (self-reported health is regarded as a reliable indicator of clinical health status);
• People in the lowest income neighbourhoods had significantly higher rates of probable depression and hospitalization for depression than those from the highest income neighbourhoods; and
• The percentage of people with diabetes or heart disease was three to five times higher in the lowest income group than the highest.

"There is considerable evidence that early childhood development is a crucial determinant of health throughout life. Poverty, inadequate living conditions, restricted opportunities and other lines of inequality and exclusion for children lay the foundations for a lifetime of health and other problems. The Premier’s announcement sets the stage for a life of poor health for children growing up in poverty.

"People on social assistance or who rely on the Ontario Child Benefit are already struggling to survive. Single people on OW receive $599 per month and single people on ODSP, who usually have higher living costs, receive only $1,064 per month. A freeze in increases to these already meagre rates is effectively a cut, and this cut will be felt by those who are already amongst the most vulnerable in Ontario.

"What is also concerning about yesterday’s announcement was that it preempted the work of the Commission for the Review of Social Assistance in Ontario, which is due to report to the government in June. The Commission’s most recent discussion paper, to which the Wellesley Institute responded, set out adequacy, fairness, and work incentives as three competing priorities that must be balanced against one another. The Premier has sent a message to the Commission that adequacy is no longer on the table, and his decision will increase unfairness and inequality.

The Wellesley Institute has prepared two responses to the Commission and has blogged extensively about how to build more health-enabling social policy."

I will bring you more reaction to the welfare freeze and cut in the Ontario Child Benefit as they come in.