Opinion: Treat nurses and doctors with fairness especially during pandemic

Recently, ministers Seamus O’Regan, Jr and David Lametti introduced Bill C-3, which would provide ten days of paid sick leave per year to workers in the federally regulated private sector.

Now that Omicron variant cases have been reported in Canada, this legislation is even more important. But it is only a start.

For over a year, NDP leader Jagmeet Singh and many other MPs and journalists have called for this. However, federal and provincial health ministers should ensure that physicians, nurses, and all health professionals are fully covered. It is not enough for politicians to simply call us “heroes.” Health professionals are exhausted and burned out and some are quitting. By 2022, according to the Canadian Nurses Association, Canada will be short 60,000 nurses. Sadly, although applications from foreign-trained nurses rose by 11 per cent last year, the assessment process is backlogged, and it can take $16,000 for a foreign-trained nurse to become licensed here.

Therefore, to reduce the rate of attrition among existing nurses, governments need to provide them financial security, especially from the potential impacts of COVID-19. MDs need this as well.

Private disability insurance is generally unavailable to cover MDs against COVID-19 related loss of income. For example, the Ontario Medical Association plan has an elimination period of at least 30 days and is unavailable to those over age 65; many with pre-existing illnesses would also be excluded. Yet in 2018, 16 per cent of specialists and 15 per cent of family physicians practicing in Canada were over age 65.

All physicians – not just those in hospitals – need income-replacement from day one if they are forced to self-isolate or become ill with COVID-19. This might be similar to the SARS Income Stabilization Program in 2003 in Ontario.

According to the Canadian Institute for Health Information, as of June 15, nearly 95,000 Canadian health workers had become infected with COVID-19. As of November 10, according to the Canadian Federation of Nurses Unions, 55 had died, including at least four physicians. One of these was a 48-year old emergency physician from Regina.

Rather disturbing is the prevalence of “breakthrough” infections. For example, fully vaccinated persons accounted for 35-40 per cent of new cases. In Manitoba, 43 per cent of those in the hospital and 18 per cent in the ICU were fully vaccinated.

These numbers should improve as children are vaccinated and high-risk groups receive booster shots. However, it seems that although vaccines are crucial, we must continue to use all the tools in the toolbox. These include border controls (which might reduce the influx of additional cases of the Omicron variant), adequate paid sick benefits, social distancing, and mask mandates. Inasmuch as experts now admit that the virus may be airborne, there should possibly be greater use of N95 masks.

When despite these measures, certain regions are overwhelmed, we need the ability to transfer ill patients to other provinces. In June, Ontario accepted 51 patients from Manitoba, and two were also sent to Alberta and Saskatchewan. When a surge occurred in Saskatchewan in October, that province sent 27 patients to Ontario.

Quebec must be part of this. It is now reporting over 1,100 new cases per day – the highest since late April. If the situation worsens, it may attempt to transfer its own patients elsewhere. However, treating physicians must be given assurance that they will be properly paid.

As I elaborated in one of my previous columns, Quebec does provide portable hospital benefits, but despite Section 11 of the Canada Health Act, it is the only province not to sign the Reciprocal Medical Billing Agreement (RMBA). If Ontario intensivists were to treat such a patient they could bill Quebec directly, and likely receive a much lesser amount than their own province would pay. If they billed the patient, they would almost certainly receive nothing.

In fairness to physicians, Alberta, Ontario and other provinces should make it clear that the CEO of a hospital may well be reluctant to accept a Quebec patient unless the Quebec Health and Social Services Minister Christian Dube signs the RMBA.

New Federal Health Minister Jean-Yves Duclos reacted with speed and decisiveness to the new Omicron variant. He and Conservative Health Critic Luc Berthold are both from Quebec. They should collaborate and urge Dube to sign well before the pandemic becomes a crisis in that province.

Ottawa physician Dr. Charles S. Shaver was born in Montreal. He is past-chair of the Section on General Internal Medicine of the Ontario Medical Association.