Competition for home care contracts blocks information sharing and coordination — OHC

The Executive Director of the Ontario Home Care Association recently wrote to the Toronto Star making claims about home care agencies being more accountable and transparent. Sue VanderBent also says home care agencies have better client service indicators than ever before. Of course, those who are having difficulty accessing home care in Ontario may beg to differ on the question of access and quality. Natalie Mehra, Executive Director of the Ontario Health Coalition replies to VanderBent below:

We heartily support the call for an end to competitive bidding and a full review of Ontario’s home care system.

Home care competitive bidding — the system of contracting out home care services — has spawned massive protests and is so unpopular that it has been placed on moratorium not once, but twice. If the newly elected provincial government continues to extend the current moratorium, it will simply entrench for-profit privatization of vital health care services.

With a very few exceptions, the only proponents of competitive bidding are the companies that want to use the bidding system to win greater market share or increase their profits. Their interests are often contrary to the public interest.

Competition for contracts among provider companies is a potent force that blocks information sharing and service coordination. In fact, competitive bidding necessitates extra tiers of administration and fragments rather than integrates service.

Studies show that the for-profit companies in Ontario’s home care system have a higher mark-up than the non-profits in order to make room for profit-taking from their taxpayer-funded contracts. The for-profits overtly support two-tier home care. They want more user fees for patients on top of government funding as these give them more revenue streams from which to take profits. They have lobbied against extending basic employment standards to some of the most marginalized workers in Ontario’s health care system.

In contrast, the public interest is in enhanced stability and continuity of care, better coordination, and vastly improved equity of access to home care. Public values align with non-profit service delivery and its ethos of caring before profit-taking. Tight budgets necessitate efficient administrative structures that prioritize funding of front-line services. All of these would be better served through the creation of a stable public/non-profit home care system in Ontario.

As more services are cut and moved out of hospitals, all of us who support public health care and its principles of equity and fairness should be concerned about the privatization of home- and long-term care and the negative influence of the growing for-profit home care companies on Ontario’s health care system.

Natalie Mehra
Director, Ontario Health Coalition

Check out OPSEU’s video about competitive bidding at


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