Joint Op-Ed: Ford could break Ontario’s fractured home-care system

This opinion editorial was originally published in the Hamilton Spectator on April 24, 2024.

We all know someone who has received home-care services.

Patients discharged from hospital to continue recovery at home, people with disabilities who require supports and services, seniors receiving care so they can continue living independently, people who require community support like clinic care or day away programs, among others — home and community care is an invaluable health-care service.

Our need for a robust and accessible home-care sector has never been greater as Ontarians age. We will soon need at least 6,800 more personal support workers just to maintain the current level of services and similar numbers of nurses, occupational therapists, physiotherapists and home-care sector health professionals.

This is a looming staffing crisis that we must avoid.

Yet, just as the province sees an explosion in demand for home care and those who are responsible for providing and co-ordinating it, our provincial government is plunging this much-restructured service into chaos — again.

With the whirlwind of sector reorganizations, from Community Care Access Centres, to Local Health Integration Networks, Home and Community Care Support Services, and now the new Ontario Health atHome, it is admirable that some home-care workers continue to weather so much change.

Earlier this year, the Ford government passed Bill 135 — the creatively named Convenient Care at Home Act — scheduled to take effect June 28. This was done with little consultation with those it impacts. Look no further than the disaster of the Greenbelt and Bill 124 to see how the Ford government ignores constituents and stakeholders, preferring to plow through legislation that benefits private interests.

Among other things, Bill 135 amalgamates services (merging 14 regions into one), lacks public governance and oversight, and introduces a path to more privatization. It opens the door to subcontracting and privatizing more of our home-care services and the co-ordination of those care services.

These changes are rife with serious pitfalls for the accessibility of care in underserved communities and potential abuse by private agencies already endemic in the sector. Amalgamation will hurt access to care and the lack of oversight puts far too many opportunities for conflicts of interest into the hands of private, for-profit corporations.

As we are seeing with private nursing agencies, unscrupulous for-profit companies have shown they will take every opportunity to increase their profit.

Bill 135 does not address one of the most pressing issues in the sector: retaining and recruiting the health-care workers who co-ordinate, provide and make home care possible.

These workers ensure those suffering with chronic health conditions receive the care they need, saving our broader system desperately needed resources. They work with children and young adults with complex health issues or disabilities, ensuring they succeed in their studies at school and at home.

They work in a fractured system, with widespread privatization and precarious working conditions. For years, workers’ wages have fallen far behind. This situation has left many questioning whether they should stay, and Bill 135 may prove to be their breaking point.

Health-care unions representing front-line workers are calling on the province to ensure home care jobs and services are maintained and expanded in all local communities. Now is the time to increase sector funding and negotiate fair wages to support recruitment and retention of workers and the services communities rely on. Bill 135 must be amended to prioritize the public delivery of home-care services.

Publicly delivered health-care services have repeatedly been found to be less costly, to adhere to proper care standards and provide the most reliable and equitable system possible.

It is abundantly clear that allowing private companies to profit from home care will do nothing positive for workers or those in their care. It is just another opportunity for Premier Doug Ford to sell off essential public services to the highest bidder.

This government is again destroying a sector of health care unilaterally — enacting changes that will damage Ontarians’ access to care and allowing private companies to make off with public money.

The province must pause these dangerous plans for home care, properly consult with health-care workers, negotiate fair wages, expand services and abandon privatization plans.

Failure to do so will harm us all.

Erin Ariss is a registered nurse and president of the Ontario Nurses’ Association.

Fred Hahn is president of CUPE-Ontario.

J.P. Hornick is president of OPSEU-SEFPO.