Ontario’s Home Care System Needs Major Surgery – Citizens’ Health Coalition

A Foreword by Niagara At Large publisher Doug Draper

In the wake of a new report by the not-for-profit ‘Ontario Health Coalition’, charging that more than 10,000 people across the province are desperately waiting for home care services, Ontario’s NDP is calling on the Liberal government to scrap competitive bidding for home care services.

Ontario NDP health critic slams government on home care

Competitive bidding for the province’s home care system was introduced more than eight years ago by the former Ontario Conservative government of Mike Harris, despite naysaying from then Liberal opposition leader Dalton McGuinty. But when the McGuinty formed a government in 1983, it allowed the bidding to move forward and one of the first victims was the Niagara chapter of the Victoria Order of Nurses, which had been providing home care servces across the region for the better part of a century.

The VON lost the bidding in a highly secretive process (where not even the cost of the bids was made public) to a private sector firm that hired many of the VON nurses back for lower wages and benefits.
The bidding system has remained controversial to this day and this April 4, Ontario NDP health critic France Gelinas called on the McGuinty government to put an end to it while the Toronto-based Ontario Health Coalition released a report, charging that the system has taken a toll on numerous individuals and families in need of home care across the province.

Niagara At Large is posting both the NDP media release and a release on the Ontario Health Coalition report below for our many readers’ information, and we encourage you to share your comments at the bottom of this post.

April 4, 2011

Fix home care by ending competitive bidding: NDP

Queen’s Park – NDP Health and Long-Term Care Critic France Gélinas welcomes the Ontario Health Coalition’s new report “Still Waiting: An assessment of Ontario’s home care system after two decades of restructuring”.

“Health care providers, patients, and activists across Ontario have long told the McGuinty government that their for-profit system of home care is undermining the strength of our entire health care system. Today, the Ontario Health Coalition has gathered this evidence and delivered a damning report.”

The Ontario NDP has long opposed the system of competitive bidding, pointing to the fact that it funnels money to large, private, for-profit firms rather than investing in the front-line care Ontarians require.

“Under competitive bidding, compensation and working conditions of home care workers have deteriorated considerably—creating instability and chaos for patients. Moreover, research has shown that 30% of spending on home care is being funneled into administration, with even more lost to profit, resulting in increased health care costs and lowered quality of care,” said Gélinas.

“Quality home care is not just good for seniors. It benefits both our health care system and the public purse. You only need to look at the province-wide hospital bed crises, surgical cancellations and emergency room delays to appreciate the devastating blow that a broken home care system delivers to our hospitals,” said Gélinas.

Ontarians “Still Waiting” for Access to Home Care: New Report

Ontario Health Coalition, April 4, 2011 – A new report on the state of Ontario’s home care system has found more than 10,000 people on wait lists for services.  “Still Waiting: An Assessment of Ontario’s Home Care System After Two Decades of Restructuring”, released by the  Ontario Health Coalition today, reveals that major problems reported by Ontario’s Auditor Generals since 1998 are still not resolved. As a result, Ontario’s home care system is plagued by inadequate services, inequitable access to care and poor oversight.

The report also reveals that 18,500 hospital beds have been closed since 1990 and other hospital services such as outpatient rehabilitation are being cut across Ontario. While patients are being downloaded from hospitals, too often there are inadequate services in the community.

“Access to home care in Ontario is not improving. Huge wait lists, totalling more than 10,000, have persisted for more than a decade,” said Natalie Mehra, coalition director. “We found that home care funding is actually shrinking as a percentage of health spending even though hospital beds continue to be cut and closed. Patients face long waits, inequitable and inadequate access to care, and user fees. Access to information and democratic accountability are worse than ever.”

“Seniors want to age at home,” noted Derek Chadwick from the Canadian Pensioners Concerned. “Often home care is not available unless seniors have the money to pay for it out-of-pocket.”

“This report is meant to be a wake up call for all Ontario political parties as we lead into the provincial election,” said Derrell Dular, managing director of the Older Canadians Network. “Improving access to home care must be a priority. Provincial Auditors have repeatedly recommended a full review of the competitive bidding system that has siphoned resources and focus away from front line care. We are repeating this call.”

Key Findings:

•For more than 12 years, Provincial Auditors have reported that access to home care across Ontario is inequitable with some CCACs receiving up to double the funding    that others receive.

•There are no standards for access to care. Huge wait lists have persisted for more than a decade, totalling more than 10,000 people since 1999.

•Home care funding is decreasing as a proportion of health spending — from 5.5% to less than 4.5% between 1999 and 2010. Funding per home care client has decreased from $3,846 in 2003 to $3,003 in 2009.

•Inadequate standards and poor quality control have continued for more than 12 years, according to Provincial Auditors. Inconsistent and inadequate tracking of complaints has not been resolved after 12 years.

•Public accountability and democratic control over home care have decreased.

•Administrative costs are very high. Administration and case management take up 30% of CCAC budgets totalling more than $500 million. There are four tiers of administration before funding reaches front line care, yet oversight is consistently poor. Competitive bidding has siphoned vast resources away from care.

•Staffing shortages threaten access to care.

•Repeated calls by the Ontario Auditor General for a full review of the competitive bidding system in home care have been ignored.

Review the full Ontario Health Coalition report on home care by clicking on – http://www.web.net/~ohc/homecare2011finalreport.pdf

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