Canadian Insurance News

A critical part of our health care system is grossly underfunded and inefficient, with underpaid, overworked employees scrambling to keep up with growing demand for services.

OurWindsor.Ca

A bitter strike by 3,000 nurses and other health professionals now dragging into its third week is providing a rare and disturbing glimpse into Ontario’s home- and community-health sector.

What the strike by workers at 10 Community Care Access Centres across the province has exposed is clear evidence that this increasingly critical part of our health care system is grossly underfunded and inefficient, with underpaid and overworked employees scrambling — and too often failing — to keep up with growing demand for services.

The result of this worsening mess is that tens of thousands of patients across the province, ranging from seniors to young schoolchildren, often receive too little or no care at home, in nursing homes and schools.

It’s especially true for patients pushed quickly out of hospitals in an effort to save money and turned over to CCACs, which oversee home- and community-care, to provide such services as rehab therapy, speech training for stroke victims and help getting dressed in the morning.

At the same time, the stresses and demands being placed on community health-care professionals have created a group of dedicated workers who rightly feel frustrated, disillusioned and underappreciated.

For years, successive governments have talked boldly about the need to focus more resources on community care. However, barely 5 per cent of the province’s health care budget goes to home- and community-health care.

Instead of injecting serious money into the sector, the government has provided only token extra help, while at the same time forcing hospitals to kick patients out of costly hospital beds as fast as possible.

Today, the proof that our community-care sector is short of money and treated like a second-class part of our health system is everywhere.

In the CCACs, managers desperate to save money are forcing care co-ordinators to reduce home-care services for needy patients. “Our managers sit down with us on a regular basis to discuss ‘high users’ and ways in which we may be able to decrease home support services,” one Peterborough area care co-ordinator wrote in an email, adding she is “sickened by this penny pinching.”

In private companies contracted by CCACs to provide the front-line workers who actually treat patients face-to-face, managers are squeezing their own employees. They do so by setting strict limits on the time therapists and nurses can spend with a patient, refusing to pay for mandatory professional training and cutting workers’ hours. Most of these employees haven’t seen any pay raise in a decade.

In community health centres and nurse practitioner-led clinics, workers have seen their pay frozen by Queen’s Park for the last nine years. “We are just going to be collateral damage,” with the province likely arguing yet again that they cannot afford raises if and when doctors and nurses get more money, suggests Adrianna Tetley, CEO of the Association of Ontario Health Centres.

Clearly, fundamental reform of home and community care in Ontario is desperately needed.

Health Minister Eric Hoskins has stated repeatedly that such reform is one of his top priorities.

In the coming weeks, Hoskins will have a tremendous opportunity to make good on his comments by acting on two major reports to land on his desk.

First, a provincial panel created last year to review home and community care, chaired by Gail Donner, the former dean of the faculty of nursing at the University of Toronto, was to have submitted its report to Hoskins at the end of January. Hoskins should release the panel’s findings and recommendations immediately.

Second, the provincial auditor was ordered last spring by the Ontario legislature to review the financial operations of the CCACs. That report is due this spring.

With these reports in hand, and a provincial budget coming later this spring, the Liberal government has a real chance to revamp the entire system.

For too long foot-dragging and finger-pointing by the Liberals, Conservatives and New Democrats at Queen’s Park and by timid health ministry bureaucrats have derailed any meaningful reform efforts.

If Queen’s Park politicians fail again, they will have only themselves to blame.

Sadly, such failure will be another blow to community health professionals who have seen their incomes eroded over the years and their skills rarely acknowledged by bosses and politicians who are more interested in bottom lines than insuring decent and fair levels of care.

Ultimately, though, the real losers will be our sick, our elderly and our dying who will be forced to struggle even harder to get the care they need and deserve.