Bureaucracy snarls Ontario home-care, groups say

By Pauline Tam, Ottawa CitizenOntario's home-care system is too bureaucratic, with too much taxpayer money being wasted on administration and not enough going to frontline services, two health-care watchdog groups charge.
The inefficiencies create long delays for the frail, sick and elderly who depend on inhome care to stay out of overcrowded hospitals and nursing homes, the groups say.
Ahead of a provincial election in October, the Canadian Union of Public Employees, which represents 50,000 health-care workers across the province, and the Ontario Health Coalition, a pro-medicare group, launched a campaign Wednesday to make home-care reform a priority.
The groups called on the McGuinty government to change the way it rewards contracts to agencies that provide homecare services, which "has diverted huge sums of money from patient care into profits," said Fred Hahn, president of CUPE Ontario.
The issue could prove to be politically delicate for the governing Liberals, who are attempting to shore up support among labour unions and left-leaning voters in anticipation of a tight two-way race against the Progressive Conservatives.
The watchdog groups cited the most recent annual report by provincial Auditor General Jim McCarter, which highlighted the home-care sector's inability to keep up with de-mand for personal support, homemaking and therapy services.
Ontario's 14 community care access centres (CCACs) are responsible for providing home-care services to more than half a million people who might otherwise be in hospitals or nursing homes.
The McCarter report indicated that an additional 10,000 Ontarians are on waiting lists every year for home care, with average delays ranging from eight to 262 days.
McCarter's report also showed that of the $1.8 billion Ontario spends annually on home care, 30 per cent, or $527 million, is allocated to administration and case management through the CCACs.
The groups blamed the home-care sector's woes on the controversial practice of "competitive bidding," in which home-care providers compete for contracts.
In an interview Wednesday, Ontario Health Minister Deb Matthews said "a decision has not yet been made" about the future of competitive bidding because she is focused on improving the quality of home care, which includes reducing waiting lists.
"We're not going forward with competitive bidding until we know how to measure and how to factor in quality," said Matthews.
Marlene Rivier of the Ontario Health Coalition said because of pressure to keep costs down in order to win contracts, home-care providers are continuously plagued by staffing shortages resulting from low pay, piecework instead of full-time jobs and few opportunities for front-line workers to advance in their careers.