Work Alert #8

May 29, 2020 – Message from Dr. Anthea Lafreniere, PARO President 

When I received the call late yesterday afternoon telling me that the government had decided not to include residents and other essential frontline health workers in their pandemic pay plan, I was at the hospital serving patients. Like many of you, I had been at the hospital in the night dealing with an emergency case that, in the pre-COVID era, would have been handled during the day. I had patient cases in my queue and I was the only resident on service with work that needed to get done. Patients, their families, allied health professionals, our staff doctors, and the Hospitals that we work in, count on us to show up for work.

Many of us have been covering double wards since the pandemic took hold. Many of you have not been with your families since the beginning of March, in order to reduce the risk of carrying the virus home. Too many of us have had our vacation cancelled or have been encouraged not to take vacation in order to be available to provide care. Countless residents have been pulled off of our rotations and redeployed to ICUs, CCUs, ERs, COVID wards and COVID Screening Clinics. Collectively, we are working even harder than normal to care for our patients. Everyone who I have spoken to has been proud of the way that residents have stepped up, demonstrating how much we care about our patients while working to ensure that our health care system is ready and able to care for Ontarians.

Every day, the Government has run full page advertisements in the major newspapers thanking the ‘heroes that go to work each day’, including the “doctors, nurses, paramedics, personal support workers and pharmacists who are caring and providing for our sick”. Despite these overtures, the governments’ pandemic pay plan has recognized some and not others and their ‘thanks’ rings hollow when you are one of the groups that they are publicly thanking, but, through their policy initiatives, are choosing to ignore. They have forgotten many frontline health care providers, including residents, laboratory workers, radiology technologists, pharmacists and more. In contrast, the two other provinces that have introduced pandemic pay plans, Quebec and British Columbia, have included residents, as well as other front-line health care providers, that Ontario has chosen to forget.

The Ontario government earned praise from many when they announced their pandemic pay plan, long before the federal government indicated that they would be footing up to 75% of the bill. We were shocked when we saw the eligibility list and realized that residents hadn’t been included, so we immediately went to work to ensure that your commitment to patients and the work that you are doing was recognized.

PARO has a long and proud history of successfully challenging decisions that adversely affect our members. We knew from past experience that we had to ensure that the Minister of Health, her political staff, and the Ministry officials understood the essential role that residents play in keeping our health care system operational. We also knew that we had to mobilize support from key influencers, both inside and outside of government. For the past few weeks, we have drawn on the experience of our senior staff, legal team, and government relations specialists to mobilize support and make our case. I wrote to the Minister of Health and the Premier on multiple occasions providing the necessary information to systematically debunk the reasons that we were hearing for why we had been excluded. We garnered support and letters and phone calls from a wide range of key influencers, including the Deans of all six medical schools, as well as representatives from the Association of Faculties of Medicine of Canada, the Canadian Medical Association, the College of Family Physicians of Canada, the Medical Council of Canada, Resident Doctors of Canada, the Royal College of Physicians and Surgeons of Canada, the Society of Rural Physicians of Canada, HealthCareCan and the Canadian Medical Protective Association. We used our networks to have trusted individuals make personal phone calls to advocate on our behalf.

We had multiple conversations with our Employer, the Council of Academic Hospitals of Ontario and dealt directly with the Vice President of Labour Relations and Chief Negotiations Officer for the Ontario Hospitals Association. The President of the Ontario Hospital Association wrote a strong letter to the government outlining the importance of including all frontline health care workers in the pandemic pay plan. The OHA advocated directly on our behalf to the Minister, her staff, and senior Ministry officials. We joined forces with and supported the efforts of a coalition of health care employers who wrote a compelling letter to the Premier and the Minister this past Monday.

At the beginning of this week, we were realizing the benefits of all of our hard work. Every indication provided reassurance that we had successfully made our case that residents were essential to the smooth operations of our health care system and that we should expect an announcement about pandemic pay before the end of the week. Many of the organizations representing overlooked frontline health workers were under the impression that the Ministry of Health was recommending an expansion of the program to include those that had been forgotten.

This is why we were shocked to learn yesterday, that, under the cover of darkness late on Wednesday night, the Deputy Minister of Health released a Memorandum on Pandemic Pay Eligibility. In this memorandum she explained that there was a limit to the amount of funding provided by the federal government and that, after careful consideration, ‘the government will not be expanding the pandemic pay beyond those already eligible’. The rationale seems unsatisfactory given that weeks after Ontario first announced their plan the Federal Government announced that they would pay 75% of the bill.

For many of us, not being included on the list was a clear signal that the work we do isn’t valued. Some residents have shared with me their discomfort asking for additional pay for the work they are committed to performing – and, to those residents, I hear you. Seeking inclusion is about being recognized and valued. This is about not being forgotten.

This pandemic has brought out the very best in so many healthcare workers on the frontline. Healthcare workers, who, like residents, are dedicated in their duty to others, people who put their own health at risk to use their skills and training to care for others.

But the pandemic has also shone a light on how often residents are overlooked and forgotten. I’m appalled by the stories I’ve heard about residents being forgotten when Hospitals have arranged in-service training for all their other employees on donning and doffing PPE, or the multiple stories I’ve heard of residents who have had to queue to be fit-tested and re-tested and re-tested a third time for N95 masks as certain sizes have become unavailable, or the stories where every employee working on a ward, where there was a COVID outbreak, was notified, except for the residents. I am angered and frustrated that, though we have support from the 23 Hospital CEOs that form the governing council of CAHO for our proposal on how cancelled vacation should be handled, we are still waiting for the Ministry of Health to sign off on the plan. And I am angry that the government doesn’t understand how disruptive it is to morale on the frontline by recognizing some and not others.

One of the critical skills required to make it through medical school and to thrive in residency, and one of the hallmarks of PARO, is tenacity. I know we were successful in changing the mindset of the Ministry of Health on the critical role that we play. So now we need to turn our focus on the President of the Treasury Board and Premier Doug Ford – the person who is ultimately responsible for the decisions of government. We also plan to ensure that the Federal Government fully appreciates that their plan to recognize the efforts of frontline workers is being implemented differently between the provinces.

We successfully demonstrated to the Minister of Health that we enjoy a high level of support by key players in health care and medical education and we know it made an impact.

Now is the time to galvanize public support for residents and the other frontline health care providers we work with every day, who the government has chosen to forget.

The PARO Board and senior staff met late last night to discuss and refine the next steps of our plan to make sure that you aren’t forgotten. We need your help. In the past few weeks, we witnessed the power of the anecdotal stories we told about the impact of the pandemic on residents’ lives.

We intend to put a face on what it means to be a resident during this pandemic.

Everyday, you make a difference in the lives of others and by sharing your story you can make a difference in your own. We will use the personal stories we receive to convince decision makers that they need to reverse their decision. Stories have a way of resonating and our human impact messages are our most persuasive tool at this time. Other healthcare workers have also been forgotten and our joint effort will make us visible to those in power who have chosen to look away. If you aren’t sure what to say, tell us how COVID has changed the way you work, or share a sacrifice you’ve made in the name of COVID, or tell us what it would mean to the hospital if residents weren’t there. Images are also powerful – so share a photo of you at work with your PPE or with other colleagues who have been forgotten – or grab a photo of you and others with handwritten “Forgotten on the Frontline” signs.

We are reaching out to the other health care groups who have been ignored and will be inviting them to join us in our Forgotten on the Frontline initiative.

As we finalize the details of the next steps of our plan, we will share them with you, including more opportunities on how you can help. For now, please get involved and help get this decision reversed by telling us your story via your personalized link that has been emailed to you. If you have not received this link, please contact PARO.

COVID-19 Work Alert #1

COVID-19 Work Alert #2

COVID-19 Work Alert #3

COVID-19 Work Alert #4

COVID-19 Work Alert #5

COVID-19 Work Alert #6

COVID-19 Work Alert #7

COFM Residents and Public Health Emergency Preparedness Guidelines