Navigating the tangled web of home care

By MPP Bobbi Ann Brady

Home care is a great idea, and one that most Ontario residents support, but the problem is government can’t get it right.

Let’s start with the agency overseeing home care. It used to be there was a local Community Care Access Centre (CCAC) to oversee home care. This was a program of the PC government in 1996, and it replaced the system put in place by prior governments. Then the Liberals tweaked that system, and eventually replaced it with Local Health Integration Networks (LHIN). Another change of government and we now see the present government roll out Ontario Health atHome to replace the LHIN.

As a former staffer working for MPP Toby Barrett, I must say that with a local connection under the CCAC, the system was more responsive to residents and lobbying for the people of the riding was more effective. With each subsequent change, there is always talk of efficiencies and reducing bureaucracy. I am all for efficiency and spending more of our valuable health care dollars on service delivery, not administration, but the improvements in care are still to be seen.

The auditor general’s special report in 2014 recommended streamlining the relationship between the CCAC and LHIN.

One common thread through all these changes has been service delivery through private-sector providers. It increased under the LHINs from the former government, which will be critical of privatizing under the current government – that’s politics for you.

Now, under the government’s Bill 135, more changes are in store. Also called The Convenient Care at Home Act, the legislation will create a new agency called Ontario Health at Home, which will be a subsidiary of Ontario Health. The new agency will be an amalgamation of the LHINs, which will eventually cease to exist. Bill 135 will allow Family Health Teams to run care coordination.

Dealing with people on the front line, there has been one constant through all these changes: people aren’t getting the care they need. This problem is getting worse, not better. The current challenge seems to be a shortage of PSWs to deliver these services. To their credit, the government is trying to address this, but haven’t committed to extending a competitive wage to those in homecare, which seems to be the number one issue cited by those in the industry.

Bill 135 has been assigned to the Standing Committee on Social Policy, and this past week I spent nearly two days listening to public hearings on the bill. The majority of those who presented believe the bill will make matters worse and should be scrapped. Some believed it might have a good foundation but were wary given the legislation does not articulate the outcomes for patients. Further privatization is what most people are concerned about and with most legislation, the devil will likely be in the details (regulations).

I asked many presenters if they had been consulted prior to Bill 135 being introduced – the majority had not. Perhaps government needs to conduct public hearings prior to floating trial balloons, instead of after the fact.

At the time of writing, I am working on my amendments to the bill which will include, but likely ruled out of order, that the government repeal Bill 124.

We all like home. We all like our own bed; therefore, home care is the way to go, so it’s my hope one day government can get it right. If Bill 135 is the solution will remain to be seen, but I don’t have high expectations if history is any indication.

Bobbi Ann Brady is MPP for Haldimand-Norfolk.