When the NDP led by Bob Rae unexpectedly won the provincial election in 1990, the recession was just taking hold. His government received the final report of the Task Force on the Use and Provision of Medical Services, which contributed to the development of community care access centres that could provide a continuum of care for patients who did not need expensive hospital services. After failing to prime the economy through government spending, the Rae government turned to spending constraints that took the form of unpaid work days for provincial employees. Nurses and other health care providers were affected by this action, and doctors found their billing options capped as part of the effort to control costs.
In 1993, the Ontario Nurses’ Association circulated a report on health care in Ontario called Rethinking Health Care: Making Changes Now So Our Health Care System Can Survive. This document presented citizens with a variety of options designed to change the focus of the health care system to wellness and community-based services. It attracted great attention from concerned Ontarians and enabled the Ontario Nurses’ Association to become a key voice for new approaches advocating for nurse practitioners and a different division of labour in hospitals and family medicine.