Home-care system in free fall after more cuts

Posted on November 20, 2014 in Health Delivery System

TheStar.com – Opinion/Commentary – Ontario Health Minister Eric Hoskins insists no patient is suffering despite cutback.
Nov 19 2014.   By: Bob Hepburn, Politics

In an upbeat speech to more than 1,000 Ontario nurses, Health Minister Eric Hoskins boasted Wednesday about how home and community care are “the cornerstones” of a major health-system transformation underway in the province.

Cheerfully, Hoskins told delegates at the Ontario Nurses’ Association annual convention that one of his top priorities is to redesign home and community care, with better co-ordination of services through local Community Care Access Centres.

His remarks, though, were greeted with more than a few groans from delegates at the back of the room.

That’s because the nurses are furious with a fresh wave of cuts in home- and community-care services by CCACs, which govern such services across Ontario, that are affecting thousands of sick and elderly patients.

It’s a disturbing trend Hoskins avoided mentioning in his speech.

Indeed, Hoskins refuses even to concede that anyone has been affected by the cuts, despite such papers as the Windsor Star and Ottawa Sun publishing detailed articles about how patients suffering from strokes, multiple sclerosis and cancer have seen their services cut off.

Show me the examples of where patient care is suffering, Hoskins said in an interview after his speech.

Well, one person who could show Hoskins some examples is the woman who — ironically — formally introduced the minister at Wednesday’s speech.

“Appalled. Disgusted. Horrified.”

Those strong words are used by Linda Haslam-Stroud, president of the nurses’ association, to describe how Windsor-area health-care professionals feel about a controversial decision to slash daily nursing home-care services by 33 per cent.

“Care co-ordinators — registered nurses and allied health professionals tasked with assessing patients and developing care plans — know that cutting this much home care will result in a great deal of patient suffering,” she wrote in a letter to the editor of the Windsor Star that appeared on Tuesday, just one day before she introduced Hoskins to convention delegates.

Haslam-Stroud wrote the letter in response to a decision by the Erie-St. Clair CCAC to cut off services for “mild-needs” patients in the face of a $5-million deficit.

Windsor is not the only area to see CCAC cuts.

In the Ottawa region, the local CCAC is slashing services for many seniors even while the demand for service is increasing. The moves are resulting in some health-care workers losing their jobs.

In the Greater Toronto Area, some private service providers contracted by CCACs to actually deliver care to patients have reduced working hours for some employees because of a drop in patient referrals from CCAC care co-ordinators.

In Windsor, CCAC bosses are telling patients they can find alternative services, such as help getting dressed, washed or getting their wounds treated, through agencies like the Alzheimer Society or the Victorian Order of Nurses. These agencies have all said they are already at capacity and would need more money to add extra patients.

Patients are also told they need to start paying their own money for private care.

Interestingly, at the same time that patient services are being cut, wages for the top employees at Erie-St. Clair CCAC are rising. Over the past five years, the number of employees earning over $100,000 a year more than doubled, to 21 from just nine. At the same time, the salary for the chief executive officer position jumped 37 per cent, to $220,000 from $160,000 a year.

Hoskins is either unaware of these trends or has decided to keep quiet about possible steps in the coming months to radically restructure the CCACs and the entire home-care system. An expert panel appointed by the government earlier this year to make recommendations for home-care reform is to present its report in January or February.

Admittedly, Hoskins was confronted with a health-care system already in crisis when he was appointed health minister in June. Tens of thousands of patients, most notably those needing rehab therapy, were already deeply affected.

That’s because the Liberal government had been pressuring hospitals to discharge patients quickly in order to save money. But the government failed to provide enough money for the home-care sector, leaving patients with empty promises of at-home or community services that ultimately amounted to only a few home visits or none at all.

Regrettably, under Hoskins’ watch, that trend is continuing — and indeed may be escalating.

As Haslam-Stroud said in her letter to the editor, care co-ordinators “are being forced to cut home care that provides the vital care, with dignity and safety, that patients deserve.”

Is this the legacy Hoskins wants to leave as health minister?

Is this the legacy Ontarians deserve?

< http://www.thestar.com/opinion/2014/11/19/homecare_system_in_free_fall_after_more_cuts_hepburn.html >

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