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Home care is a core fundamental piece of sustainable health care. A properly functioning home care system is an essential part of a continuum of care – keeping people out of expensive hospital beds and allowing people to be discharged from hospitals faster without compromising their well-being. It also reduces the demand on hospital emergency facilities, saving precious health care dollars and decreasing wait times in ERs across Ontario. Perhaps what’s most important is that home care reduces the burden on families and allows Ontarians – primarily seniors – to live at home longer, independently and with dignity.
For some time, families and health care professionals have warned that Ontario’s home care system is broken. The number of people receiving home care is dwindling while demand grows. This is the result of limited resources being spread too thinly. For example, in 2007-2008, 114,000 people received in-home physiotherapy. In 2009-2010, the number decreased to 87,242.
Our home care system may actually be worse than the available data indicates because the current data is unreliable. For example, to contain costs many Community Care Access Centres (CCACs) have imposed very strict criteria for who gets home care. If someone is deemed to be ambulatory – able to get to a hospital outpatient or other community-based facility – they are considered ineligible for home care services by many CCACs.
Hospitals have also been working to contain costs and many have opted to downsize or even close their outpatient facilities, pushing patients on to long waiting lists or into expensive private care. Even for those who do receive home care they are given only a limited number of visits. Wait time data is then artificially shortened because those who are deemed ineligible or those who have exhausted their visit limits are simply not included.
One cause is the legacy of managed competition left over from the Harris/Eves era, a policy that the McGuinty government has continued. Under managed competition, the CCACs are forced to pay private agencies to provide the health care services they require, rather than employing the health care professionals themselves. The procurement process is flawed, prioritizing price over value with a bias towards large multi-disciplinary agencies. Some smaller agencies won contracts from CCACs, but didn’t receive any actual business!
Ultimately, due to our current approach, Ontarians – especially seniors – are being left behind. Forcing seniors to beg for care is not acceptable. It’s time for a sustainable health care plan that recognizes the benefits of an accessible and quality home care system as an essential part of a continuum of care that respects our seniors.