There’s a disturbing trend happening across Ontario’s hospitals right now. Hundreds of nurses, nurse practitioners (NPs), and other health professionals have been laid off across the province. Every one of these layoffs is a double loss: a skilled professional pushed out of the system, and a hospital with one less person able to see patients.
I previously served as a Nurse Practitioner working in a hospital. These layoffs hit close to home. So, hear me when I say – this is a crisis.
The Numbers Behind the Trend
The Ontario Nurses Association (ONA) reports that over 1,300 nurse positions, including nurse practitioner roles, have been cut since January 2025. At the same time, new NPs are struggling to find work in the province at all. The result is predictable: hospitals pushed over capacity, wait times climbing, and health outcomes suffering.
These cuts have continued straight through the April 1st Canada Health Act deadline, which required provinces to implement a public funding model ensuring medically necessary NP services are covered under provincial health insurance. Ontario missed that deadline. NPs are still waiting for the stability that a real funding model would provide.
My Experience as a Hospital NP
I spent thirty years working at Lakeridge Health in Whitby and Oshawa. I saw up close what happens when NPs are properly integrated into a hospital team, and what’s put at riskwhen they’re not. I started in the emergency department, working alongside physicians, nurses, and fellow NPs. Each of us brought a unique and varied skill set that helped us achieve our shared goal: getting patients the right care, fast. In lower-acuity cases, I took ownership of a patient’s care plan, recovery, and discharge, freeing up capacity and cutting wait times for everyone else in the department. In more complex, urgent cases, I drew on the advanced clinical training that becoming an NP requires, and I had the confidence to act on it.
That’s the value an NP brings to a hospital floor: not a substitute, but a distinct, highly trained role that makes the whole team more effective. When a hospital lays off its NPs, it isn’t just cutting a line item; it’s cutting a form of care the rest of the team can’t fully replace. This has a ripple effect across the healthcare system. When rural and remotecommunities lose their only NP, as Southeast Public Health did this February, the impact is immediate and severe. But the same principle holds true in every hospital across the province: each layoff makes the system a little less able to do its job.
The Bottom Line
A key issue is that budgets too often fail to distinguish between nurses and nurse practitioners, which means NPs’ distinct contributions get overlooked in funding decisions. Insufficient compensation further compounds the problem. The lack of a structured framework that recognizes and incentivizes NP care specifically means we are missing a critical opportunity to connect patients with care.
The good news is this isn’t a problem that Ontario has to solve this from scratch. Other provinces have already responded with models worth studying:
• British Columbia runs two complementary funding pathways: a Primary Care Network that lets NPs work with a high degree of autonomy in community settings, and Health Authority employment that offers stable, salaried positions with benefits integrated into the wider health system, including hospitals.
• Saskatchewan removed limits on the number of contracts available to NPs this spring and expanded their scope of practice, building on the success of its Primary Care Nurse Practitioner Contracts model launched last summer.
What these provinces have done to create jobs for NPs — and jobs that are adequately and reliably compensated — provides useful starting points to innovate funding models in Ontario. Both approaches share something Ontario is missing: a funding structure that treats NP roles as distinct, valued, and worth retaining. The province should look at how these models can change to provide NPs with autonomy and security so that they can provide the care that Ontarians need, and to emphasize the work of NPs as a critical part of the wider primary care system.
Layoffs mean more than a loss in the number of available jobs. They leave NPs vulnerable, undermine the value of NP-led care, and reduce access to care for patients. Ontario must recognize the importance of NPs, the importance of our work, and the importance of funding models that ensure we can continue to provide high-quality care for Ontarians, when and where they need it. The precedent is being set; it’s time for Ontario to catch up.
