Mandatory Staffing Ratios in Hospitals and Long-Term Care

Summary#

• This bill would set clear limits on how many patients each nurse, licensed practical nurse, and orderly (préposé aux bénéficiaires) can care for at one time.
• It applies to key hospital units (surgery, general medicine, specialized medicine, emergency) and to long‑term care homes (CHSLDs).
• The government must create these staffing ratios by a formal rule (a regulation) within one year after the law is passed.
• A new advisory committee of health groups and managers would recommend the ratios and report on results every five years.

Key changes

• Requires the government to set maximum patient‑to‑staff ratios in listed hospital departments and CHSLDs.
• Creates a seven‑member advisory committee with representatives from nurses, licensed practical nurses, orderlies’ union, doctors, and two health‑care managers.
• The committee must deliver a first report on how the ratios are working and their impact on care quality, then report every five years.
• The health minister must table the report in the National Assembly, and a legislative committee will study it.

What it means for you#

• Patients and families

  • You should see clearer minimum staffing levels on hospital units named in the law and in CHSLDs once the government sets the ratios.
  • This aims to give staff more time per patient, which may help with attention, comfort, and safety.
  • Changes will start after the government issues the regulation. The law gives up to one year to do this.

• Nurses

  • Your workload would be capped by a set number of patients per nurse in the covered units.
  • Employers may adjust schedules, move staff, or hire to meet the ratios.

• Licensed practical nurses (infirmières et infirmiers auxiliaires)

  • A maximum number of patients per LPN will also apply where you work in the covered settings.
  • Duties and team mix may be adjusted to meet the ratios.

• Orderlies (préposés aux bénéficiaires)

  • A maximum number of residents or patients per orderly will be set in CHSLDs and affected hospital units.
  • Work assignments may change to align with the new limits.

• Hospitals and CHSLDs

  • Must comply with the ratios once the regulation is in force.
  • May need to recruit more staff, change unit layouts, or limit admissions if staffing is short.
  • Will be part of ongoing reviews as the advisory committee reports on impacts.

• Rural and small facilities

  • Meeting fixed ratios could be harder where hiring is difficult, which may affect how many beds or services can be open at a time.

Expenses#

Estimated impact: likely higher staffing costs for hospitals and long‑term care homes.

• Costs would mainly come from hiring more staff or adding shifts to meet the ratios.
• Some units could face overtime or agency costs if recruitment is difficult.
• No publicly available information on exact costs.

Proponents' View#

• Clear ratios improve patient safety and quality by making sure each worker has a manageable number of patients.
• Lower workloads can reduce burnout and help keep nurses, LPNs, and orderlies in the public system.
• Standard rules across facilities bring consistency and fairness in staffing.
• Regular reports create transparency and help adjust ratios based on real‑world results.
• Including professional orders, unions, doctors, and managers in the advisory committee balances perspectives.

Opponents' View#

• Fixed ratios can be rigid and may not fit sudden surges, like in emergency rooms or during outbreaks.
• If staff are scarce, meeting ratios could force hospitals or CHSLDs to close beds or reduce services.
• Higher staffing needs may raise costs for the health system without guaranteed savings elsewhere.
• Rural and remote facilities may struggle more to comply, widening access gaps.
• The advisory committee’s makeup may not include all voices (for example, patient groups), and reporting adds administrative work.