Ontario needs to improve working conditions for home care workers

TheStar.com – Opinion/Editorials – Long the poor cousins in Ontario’s health care sector, home care’s personal support workers need improved pay and conditions.
Feb 16 2014.   Editorial

Ontario Health Minister Deb Matthews’ promise to increase wages for personal support workers in the home care industry is a good step forward, but in this increasingly important sector more than a salary bump is needed.

If Matthews wants the struggling home care sector to succeed, front-line health care workers must be treated and trained like professionals. Nothing less will do.

Even with a hike to home-care’s minimum wage of $12.50, the industry’s working conditions, not to mention benefits, are dismal. And despite the fact that personal support workers (PSWs) are being asked to handle more complicated medical procedures, only basic training is required, leaving many scared of the jobs they’re told to perform. And that puts vulnerable patients at risk.

Indeed, as Ontario’s population ages, care for the elderly and infirm will increasingly shift away from hospitals and long-term care, creating a pressing need to attract more PSWs who will dedicate their careers to the home care industry, instead of seeking better wages and benefits in hospitals or nursing homes.

Right now, there are few incentives to enter the field. Most home care agencies even force workers to subsidize their own jobs. They don’t get paid for travel time between appointments, so may end up working a 10-hour day but being paid only for six. Even mileage compensation is low – 35 cents a kilometer compared to about 52 cents for provincial employees.

Lax education requirements are a significant problem in an industry that expects ill-trained workers to perform procedures requiring medical training. There is a registry, but no regulation and no formal training requirements. This must change.

After all, the government is saving money by quickly discharging sick hospital patients to their homes but PSWs are still working with basic education, which means six months or so in privately operated schools, some of which have shady credentials, or community colleges.

Dealing with patients who have dementia, for example, requires specialized training. So does changing wound dressings or operating a “hoyer lift” that moves patients from bed to washroom.

Matthews says she intends to announce wage increases in the coming weeks, inspired (after months of protests) by conversations with struggling workers. “If we are to do better for our patients who need home care, we need to do better for the PSWs caring for them,” she said. Advocates have long made similar warnings but Matthews’ recognition is important.

Properly executed, home care could be a cost-effective way of caring for an aging society, but only if it provides quality care so patients get better, not sicker. Right now, there are few guarantees of that.

Without better training, not to mention wages and benefits, Ontario’s home care sector will languish. It’s up to Matthews to do right by the workers and vulnerable Ontarians.

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