Home care reforms don’t address poor working conditions

Posted on December 16, 2023 in Child & Family Delivery System

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TheStar.com – Opinion/Contributors
December 16, 2023.   By Connie Ndlovu, Contributor

The almost entirely female – and, in Toronto, mostly racialized – home care personal support workers expect more of the same: low wages, irregular work, few benefits, and almost no pensions.

Recent reforms to home care will not resolve chronic problems of poor working conditions, fragmentation of services, and an inefficient delivery model, writes contributor Connie Ndlovu, a home care personal support worker and president of CUPE Local 7797

We home care workers love our jobs, but it keeps getting harder. Ever since the last PC government established a system of compulsory contracting out of home care in the mid-1990s, the home-care system has been in trouble. Over and over, the government keeps “reforming” the system.

None of these reforms resolved the big problems in the sector: privatization, poor working conditions, fragmentation of services, and an inefficient delivery model. The government’s latest proposed reforms, Bill 135, Convenient Care at Home Act, also fails to address these problems. Compulsory contracting out and privatization of home care will continue.

As a result, the almost entirely female — and, in Toronto, mostly racialized — home care personal support workers expect more of the same: low wages, irregular work, few benefits, and almost no pensions. This will continue the widespread staff shortages in home care. The government has introduced a reform that totally ignores the main problem of home care.

Staffing is a big problem. Indeed, even the for-profit providers that did so much to reduce wages and ruin working conditions in this sector complain that they cannot attract enough people to the workforce to deliver the care needed.

Home care workers want to end privatization and develop a system with working conditions at the same level as the other parts of the public health care system. Until such reforms are implemented, the ability of home care to provide the service needed by the public will simply not be possible. Home care workers love providing care in the home and would choose to stay if they could afford it. But the inferior conditions of work mean that many are forced to move on, breaking the continuity of care, eroding the quality of care, and making the staffing crisis worse.

Home and Community Care Support Service (HCCSS) employees will also face uncertainty as their employer restructures — for the fifth time. This time, the reform creates one province-wide organization, raising important, unanswered questions:

Similarly, the reform raises questions about the conditions of work. The HCCSSs have used their fourteen regional organizations to impose inferior working conditions on some workers. Under this reform, that excuse makes even less sense — the new organization, “Ontario Health atHome,” (sic) will be a province-wide organization. CUPE home and community service workers are calling on the government to address wage inequality. But so far there is no commitment that the government will work with HCCSS employees to remove inferior wages and working conditions and treat all workers the same. Indeed, the government appears to be deepening its policy of wage inequality. But continuing down the path of division will destroy morale — one more case of a government treating women workers unfairly.

Unfortunately, there are no provisions in this bill for public meetings of the new Ontario Health atHome Board, no public notice, no public access to minutes and documents.

There are no provisions for democratic responsiveness to local communities. This is important as with the creation of a single, province-wide organization the potential for the organization to overlook local community interests is significantly greater. Communities, especially small, rural and northern communities, need to know that their services will be respected and maintained.

The legislation provides for the assignment of employees of Ontario Health atHome to work under the direction of the contracted home-care corporation to deliver care co-ordination services. This, of course, raises questions about the location of work for many HCCSS workers, raising significant uncertainty that needs to be dealt with. Government should guarantee reasonable limits to distances that must be travelled to new work locations. So far, we have nothing.

This aspect of the reform also raises the issue of Ontario Health atHome employees working under the direction of corporate home-care organizations. At least until now, HCCSS employees have worked to ensure that home-care businesses provide appropriate care to patients. This is necessary given the compulsory contracting out for such services. But making Ontario Health atHome employees work under the direction of provider organizations sounds like putting the Colonel in charge of the chickens.

For-profit corporations cannot be left to direct public servants, who, above all, must focus on the public good and not on the profits that corporations must focus on.

Home-care workers are past fed up. We want to build a better home-care system — but we cannot do this if the government continues to try to put privatization and poor working conditions at the centre of their reforms.

Connie Ndlovu is a home care personal support worker and president of CUPE Local 7797.

https://www.thestar.com/opinion/contributors/home-care-reforms-dont-address-poor-working-conditions/article_09d6d3ac-9925-11ee-83fd-d70ee32df58d.html?source=newsletter&utm_content=a12&utm_source=ts_nl&utm_medium=email&utm_email=0C810E7AE4E7C3CEB3816076F6F9881B&utm_campaign=top_205623

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