Ontario's Health-Care Job Cuts

Ontario entered the Ford government era already facing a nursing shortage. The province had fewer nurses per capita than the national average and a growing gap between supply and demand. When the Ford government passed Bill 124 in 2019 — capping wages for nurses and PSWs at 1% per year for three years — nurses began leaving public hospitals for private staffing agencies that could pay market rates. The result was predictable and documented: hospital vacancy rates surged. At William Osler Health System in Brampton, the nursing vacancy rate climbed from 6% in 2019-20 to 26% in 2022-23, according to the Ontario Auditor General. Hospitals scrambled to fill gaps with agency staff who cost two to three times more than employed nurses — deepening deficits that then triggered further cuts to employed positions. The cycle was self-reinforcing and entirely foreseeable.

The consequences for patients have been severe. In 2024 — the worst year on record — Ontario recorded 1,117 emergency department closures, according to a CBC analysis of provincial data. More than 200 unplanned temporary ER closures occurred between July 2022 and June 2023 alone, the Auditor General found. By early 2024, CUPE reported that approximately 2,000 patients per day were receiving care in hospital hallways, storage rooms, and other non-clinical spaces. Surgical wait lists nearly doubled: from roughly 36,360 patients waiting beyond the clinically recommended time in 2019, to 73,000 patients in March 2024.

The Financial Accountability Office's October 2025 review of the Ford government's health spending plan found a structural funding gap that grows each year. The government planned to increase health spending by just 0.7% per year — against the 4% annually needed to maintain current service levels and a historical average of 6.6%. The resulting shortfall reaches $9.6 billion by 2027-28. Ontario's independent budget watchdog projected this trajectory would eliminate 7,263 nurse positions and 1,784 PSW positions, and close 2,457 funded hospital beds — all while the province's population grows and ages.

By March 2026, the Ontario Nurses' Association had tracked more than 700 front-line nurse and PSW positions cut since January 2025 at hospitals across North Bay, Hamilton, Ottawa, Niagara, and the GTA. CUPE projected a total of more than 1,000 confirmed eliminations across multiple facilities. Each eliminated position in a shortage environment doesn't just mean one less worker — it means one more department running understaffed, one more ER at risk of unplanned closure, one more nurse or PSW considering whether to stay in the public system at all.

The most immediate consequence of cutting health-care positions during a nursing shortage is that the cuts don't stay contained. When a nurse is laid off and replaced — or not replaced — a gap opens that is disproportionately expensive to fill. Ontario hospitals spent $9.2 billion on for-profit staffing agencies over ten years (2013-14 to 2022-23), according to a 2025 Canadian Centre for Policy Alternatives study. Agency nurses consumed 6% of hospital labour costs while providing just 0.4% of frontline hours. Ottawa-area hospitals — already running at 87-99% occupancy — face projected cuts of 725 frontline staff and nearly 200 beds by 2027-28. The financial logic compounds: deficits trigger cuts, cuts trigger vacancies, vacancies trigger agency reliance, agency spending deepens deficits.

Rural and northern communities have been hit hardest. North Bay Regional Health Centre cut up to 40 positions — including nurses and an occupational therapist — while already admitting only 40% of emergency patients within the provincially recommended 8-hour window. A hospital operating near its staffing floor has no buffer; a single wave of illness or resignation can force unplanned ER closure. Northern Ontario saw agency staffing costs surge by 216-480% over the decade studied by the CCPA, as local hospitals struggled to compete for staff without the capacity to pay market wages.

Running alongside the cuts to public hospitals, the Ford government directed $280 million in public funds to private surgical clinics in December 2025 — two tranches of $155 million and $125 million — despite evidence from Ontario's own Auditor General that the same procedures cost 20-200% more at private facilities than in public hospitals. Former Health Minister Christine Elliott, who announced the 2019 agency layoffs, subsequently registered as a lobbyist for Clearpoint Health Network, Canada's largest private surgical clinic chain. The pattern — underfund public hospitals, allow wait lists to grow, then direct public money to private alternatives — is one the Ontario Health Coalition and health economists have described as a deliberate restructuring of the provincial health system.

The long-term trajectory documented by the FAO points toward a health system that cannot meet demand. Ontario already has fewer hospital beds per capita than comparable provinces, and the planned reduction from 35,540 to 33,083 funded beds by 2027-28 will widen that gap as the province's population grows. The cuts are not occurring in a moment of fiscal crisis — Ontario posted a $2.1 billion surplus in 2021-22 while nurses were still capped at 1% wage increases. They are a sustained policy choice, made in the presence of abundant evidence about the consequences, during a staffing shortage the government's own ministry had privately documented.