Huge waiting lists, unequal access to care and high administrative costs continue to plague Ontario’s home care system, the Ontario Health Coalition claims.
Those are some of the findings in a report, Still Waiting: an assessment of Ontario’s Home Care System after two decades of restructuring, released by
the coalition on Monday.
Though home care has been repeatedly reformed since the mid-1990s, the coalition states that changes made by policy-makers have not addressed the problems that are central to the very purpose of the home care system.
The auditor general’s findings in 2010 — that home care is inequitable, insufficient and ineffectively measured and managed — reveal a failure by successive governments to make accessible public home care their priority, the report said.
It adds that the priorities reflected in home care reform are the result of misguided priorities and an imbalanced decision-making process that has eschewed democractic input, transparency and public accountability.
The report, covering the last decade of home care restructuring, is the coalition’s fourth since 2001.
“As with the findings of the provincial auditor, virtually all of the problems identified in our four previous reports remain true today,” the coalition
“Today, the patients find their ability to access publicly funded care in community settings to be severely rationed, poorly organized and subject to user
“While these changes have not worked for post-acute patients, they are not working for the aging and those with chronic illnesses and disabilities either.
“Though the provincial government introduced an aging at home strategy in 2007, most of this funding is directed towards reducing hospital costs and the
services funded through this program are ad hoc,” the report states.
“The vision of a comprehensive strategy for long-term care, enabling Ontarians to stay at home as we age or experience illness and disability, has been
largely abandoned,” the coalition claims.
Sara Williamson, co-chairwoman of the Thunder Bay Health Coalition, said Monday that locally, the home care system is under “constant pressure” due to a lack of government funding.
Community Care Access Centres deliver the program under a variety of government funding programs, “a patchwork of resources from different programs,” said Williamson.
She said the government hasn’t developed a funding allocation that adequately covers the cost of assessing clients needs in the community.
That’s a problem, said Williamson, when there’s a growing waiting list for home care services in the area.
As for how the report might help improve the situation, she said she felt “it’s good in that it reminds the public and the provincial government that the
home-care delivery system needs to be pushed up on the priority list . . . making it more efficient and meeting the needs in the communities.”
Problems cited by the Ontario Health Coalition in the report include no assessment of community need for care, nor standards for access to care; under-funded programs and poor access to care; high administrative costs mean the system suffers; poor oversight and lack of assessment of quality of care; staffing shortages and poor working conditions across the system; too much for-profit privatization of service; no democractic governance and a lack of public accountability; and a failure by governments to address long-standing problems.
Home care will continue to grow in importance for Ontarians, the coalition says.
“We hope that the report will contribute toward the establishment of clear standards for improved access to care,” says the report.
The coalition suggested an integrated, locally controlled, non-profit home care service.
The coalition encompasses more than 400 organizations, thousands of individuals and more than 50 local health coalitions dedicated to safeguarding and improving the public health system under the principles of the Canada Health Act.