Ontario’s Largest Hospital Union Opens Talks with Ontario Hospital Association, Prioritizing Staffing Ratios, Job Security, and Pay Equity
Ontario’s largest hospital sector union has launched a new round of contract negotiations with the Ontario Hospital Association (OHA), representing more than 45,000 hospital workers across the province. The bargaining, led by the Ontario Council of Hospital Unions (OCHU-CUPE), the hospital division of the Canadian Union of Public Employees, officially began today and is expected to set the tone for how hospitals address long-standing concerns around staffing, compensation, and workplace conditions.
Union leaders say their top priorities in this round of bargaining are the introduction of minimum nurse-to-patient ratios, greater job security, and improved compensation for hospital staff. These issues, they argue, are critical not only for workers’ well-being but also for the overall stability and quality of Ontario’s hospital system, which continues to face severe pressures in the aftermath of the COVID-19 pandemic and ongoing staffing shortages.
Safe Staffing at the Forefront
OCHU-CUPE President Michael Hurley emphasized that the union’s call for legislated nurse-to-patient ratios is supported by robust evidence.
“There are over 100 studies that found that safe staffing in the form of nurse-to-patient ratios saves lives – what could be more important than that?” Hurley said. “Implementing ratios would create a transformative change in Ontario’s hospitals, vastly improving quality of care, reducing workloads, and achieving significant cost-savings. These are all well-documented findings from other jurisdictions, and we hope that the hospital association will seriously consider this proposal.”
The push for mandatory staffing ratios is not without precedent. In British Columbia and Nova Scotia, governments have already introduced minimum nurse-to-patient standards, and Manitoba is currently studying the policy. Internationally, California became the first jurisdiction to adopt legally mandated nurse-to-patient ratios in 2004, followed by several states in Australia, where the policy has been credited with improving health outcomes, retaining staff, and boosting workforce morale.
Hurley pointed to the experience of Victoria, Australia, where ratios were strengthened in 2015. The province witnessed a 24 percent increase in nursing staff as more than 7,000 inactive nurses returned to the profession. “That’s the kind of turnaround Ontario desperately needs right now,” he said.
Addressing a Worsening Staffing Crisis
Ontario hospitals have been grappling with an escalating staffing crisis for more than a decade. Chronic exhaustion, high stress, and burnout have become defining features of the workplace for many frontline staff. According to OCHU-CUPE, job vacancies in hospitals have surged by 331 percent since 2015, leaving gaps that directly impact patient care.
Union leaders argue that embedding staffing ratios into the collective agreement would go a long way toward improving working conditions and alleviating the pressures driving workers out of the system. By stabilizing the workforce, they say, hospitals could reduce turnover, shorten patient wait times, and avoid service disruptions caused by staff shortages.
Wage Stagnation and Pay Equity
Alongside staffing, compensation is a major sticking point in negotiations. Sharon Richer, secretary-treasurer of OCHU-CUPE, said hospital wages have failed to keep pace with inflation, eroding the real income of hospital workers.
“Compensation for this predominantly female and disproportionately racialized workforce hasn’t kept up with inflation,” Richer explained. “In fact, the average wage for vacant hospital positions is now 13 percent lower in 2024 compared to 2015, after adjusting for inflation.”
She added that this wage stagnation is directly linked to worker attrition. “Workers are expected to take on heavier workloads and much more responsibility, while seeing their real incomes decline. That’s the reason why so many people continue to quit the workforce. The consequences of this policy are borne by the public, as staffing shortages lead to longer wait times, delayed treatments, and alarming levels of service closures.”
The union says fair wages are not just about worker well-being—they are central to attracting and retaining qualified staff in an increasingly competitive health care labor market.
Concerns About Technology and AI in Hospitals
Another issue emerging in this round of bargaining is the role of artificial intelligence and automation in hospitals. OCHU-CUPE has raised alarms about the rapid adoption of AI-driven technologies without adequate consultation with staff or unions.
“Hospitals have not been honest about the impact of technology,” Hurley said. “The increasing use of AI is premised on wiping out jobs and reducing costs, even if there are undisclosed negative implications for patients and staff. Robots developed to interact with acutely ill patients is an example of the misguided, cost-driven use of technology.”
The union is not opposed to innovation but insists that any technological upgrades must prioritize patient safety and transparency. Furthermore, OCHU-CUPE is calling for retraining opportunities for any workers displaced by automation.
“If technological upgrades are essential to improving quality, then we expect the hospitals to train displaced staff,” Hurley said. “If we don’t need as many clerical staff, we can retrain them to become nurses, where there is an acute shortage.”
A Sector at a Crossroads
The outcome of these contract talks could have sweeping implications for Ontario’s hospital system, which employs tens of thousands of nurses, personal support workers, clerical staff, cleaners, and other frontline professionals. For years, hospitals have struggled with limited budgets, aging infrastructure, and soaring demand for services, particularly as Ontario’s population ages.
Union leaders argue that continuing on the current path—characterized by staff shortages, wage suppression, and overreliance on temporary fixes like agency nurses—is unsustainable. They say that real structural change is needed, and the upcoming contract is an opportunity to reset priorities.
“Our members are exhausted, and patients are suffering because of it,” Richer said. “We’re not asking for luxuries. We’re asking for a system that values the people who hold it together.”
Learning from Other Jurisdictions
Research from other provinces and countries suggests that the union’s demands are not only realistic but also achievable. In California, mandated staffing ratios were credited with improving nurse retention and reducing mortality rates in hospitals. In Victoria, Australia, the implementation of ratios was followed by an influx of trained professionals back into the workforce.
Experts say that while introducing ratios and raising wages would require upfront investment, the long-term benefits—better patient outcomes, fewer staff shortages, and lower turnover—could actually reduce costs over time.
The Road Ahead
The bargaining process is expected to be challenging. The Ontario Hospital Association has historically raised concerns about the cost implications of mandated staffing levels and wage increases, arguing that hospitals operate under tight fiscal constraints. At the same time, public sentiment has shifted strongly in favor of supporting health care workers since the pandemic, which exposed vulnerabilities in Ontario’s hospital system.
Union leaders say they are prepared for difficult negotiations but remain optimistic that solutions can be found. “We’re coming to the table with proposals that are evidence-based and proven to work elsewhere,” Hurley said. “We’re confident that if the hospitals and the government take this seriously, we can build a stronger, safer, and more sustainable system for everyone.”
As negotiations continue, hospital staff, patients, and the broader public will be watching closely. The stakes are high: with Ontario’s health care system already under significant strain, the decisions made at the bargaining table could shape the future of hospital care in the province for years to come.
