Health care worker shortage data should not be released to the public, Ontario information watchdog rules

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A team leader nurse gets updates from another nurse while they treat patients inside the intensive care unit of Humber River Hospital in Toronto, on April 20, 2021.CARLOS OSORIO/Reuters

Health care stakeholders and an expert on privacy are criticizing a recent ruling that allows the government of Ontario to keep details of the province’s shortages of nurses, personal support workers and doctors confidential.

Alec Fadel, an adjudicator at the Office of the Information and Privacy Commissioner of Ontario, was ruling on a bid by journalists at Global News to obtain human-resources data from the Ministry of Health through a freedom of information request.

Mr. Fadel acknowledged in his decision, released April 16, that there is “compelling public interest” in disclosing the figures. But he said this did not outweigh the Ministry of Health’s concerns that releasing detailed data could have a negative impact on the province’s ability to negotiate with doctors, nurses or private staffing agencies.

The Global News journalists will not seek a judicial review of the decision, they said.

Critics decried Mr. Fadel’s decision, saying he had relied too heavily on the government’s claim that making those figures public would be harmful to its relations with health professionals or private staffing agencies.

“This ruling is wrong-headed. The rationale for it really just doesn’t hold water. And I think it’s a dangerous ruling for Ontario,” Natalie Mehra, executive director of the non-profit Ontario Health Coalition, said in an interview.

She alluded to recent closings of emergency rooms, birthing units and outpatient labs in the province. “There couldn’t be a more pressing public interest then to know the data about the extent of the staffing shortages and whether or not the staffing plans of the government are adequate.”

Ms. Mehra also noted that the Financial Accountability Office of Ontario said last year that, despite Premier Doug Ford’s investment in health, the province is projected to be short 33,000 nurses and personal support workers by 2028.

The ministry’s arguments were “really about preventing the media from being able to quote the Ford government’s own internal documents and projections,” she said.

An expert in privacy issues also said Mr. Fadel is mistaken in concurring with the government’s claim that disclosing those statistics would make a difference when negotiating with organizations representing health care professionals.

Those groups already know that the health care system is short-handed, James Turk, director of the Centre for Free Expression at Toronto Metropolitan University, said in an interview.

“Whether that desperate shortage is a shortage of 10,000 or 6,000 or 11,000 is not going to impact how they bargain.”

In his ruling, Mr. Fadel wrote that the information being withheld “points to specific shortages in 2022, 2023 and 2024 and also estimates gaps in these areas at five and 10 years in the future.”

Those numbers “would contribute additional and different information that is relevant to the ongoing public debate concerning health care work-force shortages,” he added.

The union representing nurses said the decision to withhold the information is a sign that the province’s health care system is severely depleted.

“What is the Ford government trying to hide by refusing to share with Ontarians the nurses’ and health care professionals’ shortage projections?” Erin Ariss, president of the Ontario Nurses’ Association, said in a statement sent to The Globe and Mail.

Mr. Fadel’s ruling is part of a broader issue about the public’s ability to access government records.

In 2023, The Globe launched Secret Canada, an investigation that revealed how public institutions across the country routinely break freedom of information laws by overusing redactions, violating statutory time limits and claiming “no records” exist when they do.

Mr. Fadel wrote in his decision that “the ministry … submits that disclosure of the information could be injurious to the government’s ability to manage the economy.”

He said the government had argued before him that, “based on the economic principles of supply and demand,” revealing the shortage numbers would lead nurses to demand wage increases, physicians to seek higher billing fees and private staffing agencies to charge more to supply temporary workers.

Like other provinces, Ontario has been relying increasingly on more costly personnel from private agencies to deal with the shortage of health care workers.

Documents obtained by The Canadian Press this spring through a freedom of information request show that the province’s hospitals and nursing homes will spend 63 per cent more on agency nurses in the past year, from $368.64-million in 2021-22 to a projected cost in 2022-23 of $600.18-million.

Mr. Fadel wrote that the Ministry of Health told him Ontario hospitals are concerned by the rising costs of agency nursing.

“The ministry submits that if these private sector agencies have access to the withheld information, which shows current and future human resource gaps, such information would likely be used by them to negotiate even higher rates,” he said.

Prof. Turk noted that other jurisdictions have published work-force projections, allowing interested organizations to advocate with accurate information.

“The default position in any democracy,” he said, “is that the public has a right to know what their government does and what information their government has.”

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