This week, nurses await the outcome of contract talks between the Ontario Association of Nurses, which represents 68,000 RNs across the province, and the Ontario Hospital Association. They also await the result of the Ford government’s appeal of the Ontario Court decision that struck down Bill 124 as unconstitutional.
In both cases, wages are at stake, but the issues are larger than that. When nurses talk about it, they refer to declines in quality of care, to their senior colleagues leaving the profession, and to a lack of respect. For nurses, wages are only part of a much larger picture. We’ve heard about the doctor shortage, wait times, and rotating emergency room closures. I talked to some senior RNs at the Belleville hospital this week. They tell me about Emergency Department and Floor nurses so rushed off their feet they cannot take care of people properly, and overlook things. That every day they worry they will forget something critical. They are angry at the deteriorating standards of care, which they say came on so gradually they cannot quite pinpoint the start. Certainly, before the pandemic, but it was then that the gaps became craters.
Wages, as usual, tell much of the story. Passed in 2019, Bill 124 restricted wage increases for almost all public sector employees to 1 per cent for three years, but it was particularly hard on nurses. Registered nurses were already paid less than the expertise the profession requires suggests is altogether fair. And far less than those in comparable service professions – police, firefighters, and teachers.
Bill 124 excluded police and firefighters, a workforce that is mostly male, from the wage suppression. Nurses and teachers on the other hand, workforces that are both highly educated and mostly female — in the case of nurses, about 90 per cent female — were in for it. Or at least, that is how it felt.
It is not clear how we justify higher wages for jobs that demand far less training than nursing or teaching, both of which require, at the minimum, a four-year university degree. Over the course of a career, a police officer will earn 30-60 per cent more than a Registered Nurse. After 25 years, an RN earns just over $100k. A police officer $130k-$160k. Those are the provincial averages. The wage gap starts early. After four years on the job, and a four-year university degree, a Registered Nurse earns about $78k, according to the ONA 2022 pay scale. After four years on the job, which includes a fully paid training period in Cadet school, a Constable First Class earns $107k.
One of the traditional rationales is that a police officer puts their life on the line in the name of duty and service. On average, six or seven officers die on the job every year in Canada. And have done every year since 1962, when figures first started to be kept.
But this is a false distinction. Nurses put their lives on the line during epidemics and still do. The Canadian Institute of Health Information reports that 46 health care workers died in the first two years of the Covid-19 pandemic. The international council of nurses called it “one of the most dangerous jobs in the world.”
But anyway. Since when did you have to volunteer to die to merit a raise? What really matters is that Ontario, like the rest of Canada, has nurses, teachers, police, and firefighters so dedicated, they put everything on the line, every day. They give the best part of their lives over a lifetime of service.
In the case of nurses, adjudication processes set in motion since the fall of Bill 124 have made a start toward rectifying what is now being frankly acknowledged as years of pay discrimination. The fate of Bill 124, in other words, tells the story of a spectacular backfire.
Almost immediately after it was passed in 2019, the pandemic hit. Nurses were suddenly more visible than they’ve ever been outside a hospital, and even more necessary. Nonetheless, Ford held his line, and restricted nurses who had been subject to the sustained endurance test that was and is the pandemic to 1 per cent increases over the full three years, “increases” that substantially lagged the pace of inflation and so, in real terms, were decreases. He also nixed constitutionally guaranteed negotiating rights — in the case of nurses, for workers already not legally allowed to strike.
Nurses are now fighting back. Hard. The ONA is demanding wage increases of 12 per cent this year and 6 per cent next, not only to rectify years of gender biased pay inequity, but to address the crucial issues of recruitment and retention. There are simply not enough nurses anymore; job vacancies have tripled, from about 5 per cent of positions in 2018 to 15 per cent in 2023, and over the same period, resignations have more than doubled, from a norm of about 5 per cent to 11 per cent this year. Unable to either recruit or retain, hospitals cannot sustain a standard quality of care.
It’s not only that their jobs have become impossible to perform well, but nurses, turned off by years of mistreatment, have left the profession in such large numbers, hospitals can no longer function effectively, never mind efficiently. They now spend hundreds of millions of dollars, five times what they spent three years ago, hiring agency nurses to fill the gaps. In 2020-22, hospitals spent $26,947,021 on agency nurses. In 2021- 22 it was $52,910,106. In 2022-23, they spent $131,741,841.
Guess where that money could have gone. What a waste.