A tangible response to physiotherapy cuts – the province finally adds community capacity

After significantly cutting outpatient physiotherapy at hospitals across Ontario, the government is finally putting something back.

The Ministry of Health says it is making a major investment in community-based physiotherapy, exercise classes and falls prevention services that will benefit up to 218,000 more Ontarians.

The Local Health Integration Networks (LHINs) will receive $10 million more for falls prevention and exercise classes – giving them an ability to serve 68,000 more seniors. This is in addition to $44.5 million to provide physiotherapy in community-based settings that will increase capacity to 90,000 more seniors and “eligible patients.”

These community-based settings could include Family Health Teams, Nurse-Practitioner led clinics and Community Health Centres.

Long term care homes will get the biggest share — $68.5 million for one-on-one physiotherapy with seniors in their care.

Community Care Access Centres are also to receive $33 million to reduce the wait list for in-home physiotherapy, giving them the capacity to add up to 60,000 clients.

Oddly the Ministry’s release suggests that “until now, a small number of for-profit companies have had almost exclusive control over the delivery of publicly-funded physiotherapy.”

Huh?

Did they forget about the 50 per cent of hospitals that recently cut outpatient physiotherapy services?

Also, while it’s good to see that physiotherapy will be integrated into a number of settings, many of these “settings” are already private for-profit. It’s not clear where the physiotherapists will be coming from for the long-term care homes (for-profit agency or in-house?), but more than half of Ontario’s publicly-funded long-term care beds are already in the hands of private for-profit companies.

Here’s a thought: if the government wants more not-for-profit or publicly delivered physiotherapy, why not let the CCAC’s themselves directly hire these individuals to do this new work? Several CCACs already maintain their own physiotherapists on staff. Most contract the work out to – you guessed it – the for-profit companies the province says it is now concerned about.

The problem the government has created for itself is that much of the community-based sector it wishes to transfer work to is already in the hands of private for-profit companies.

We’ve documented the problems with this, including the lack of stability for health professionals and the lack of continuity for patients. What’s been coming out of the hospital sector has seldom been matched in capacity by the private sector.

If Ontario truly wishes to move towards not-for-profit or publicly delivered community care, it needs to start taking a look at the bigger picture of where these services are landing.

We don’t yet know the physiotherapy volumes that have been cut from Ontario’s hospitals to assess whether they are putting back all or some of what they have already taken out, or whether this represents an increase in access. Given the present round of hospital cuts, the situation remains fluid.

However, after all our criticism about the delisting and defunding of physiotherapy, it’s good to see a tangible response.

4 responses to “A tangible response to physiotherapy cuts – the province finally adds community capacity

  1. I work for one of those for profit physiotherapy companies. I will most likely loose my job in two months because of these funding changes. I work in Long Term Care homes and Retirement Residences, with these changes many Long Term Care homes will be more able to hire their own Physiotherapist and Physiotherapist Assistants. These people however will most likely be doing double duty, which won’t be giving seniors the quality of care that I am proud to provide them. I’m sorry to say but I’m not sure this new structure will be for the benefit of everyone. I’m certainly thinking of myself and the other 20 people I work with who may also be laid off int this area alone. I will lose the first full time job I have had since graduating from college (I’m 26), and I don’t like it.

  2. “Here’s a thought: if the government wants more not-for-profit or publicly delivered physiotherapy, why not let the CCAC’s themselves directly hire these individuals to do this new work? Several CCACs already maintain their own physiotherapists on staff.”
    Here’s another thought:
    – Cost of 1 OHIP funded physiotherapy treatment provided by one of the private for-profit companies: $12.20
    – Cost of 1 physiotherapy treatment provided by CCAC: $118.00
    Yep, I can see how this proposal makes SO much more sense.

  3. DTodd – And yet the CCACs continue to maintain direct delivery in a number of locations across the province because the alternative was so much more expensive or simply not available. For example, prior to CCAC mergers, the cost of contracting out physio in the Renfrew area would have been $1 million more, allowing that CCAC to get an exemption from the Harris decree to divest all direct care delivery. You can provide physio in a clinic for less because physiotherapists can attend to multiple patients at once, but nobody is going to travel to somebody’s home for $12.20 per visit. Let’s get real here. Your comparison is completely deceptive.

  4. I also work for one of the profit companies and we’ve all lost our jobs starting July 31st. What doesn’t make sense to me is this drastic cut in physiotherapy. I believe Deb Matthews just wants all of our seniors in beds and wheelchairs. What quality of life is that!? She costing the government in general more money by doing this because the government does help pay 75 % of the cost of a wheelchair or walker for any resident in a retirement or LTCH. Not to mention all of us out of work physiotherapists, assistants, and kinesiologists on unemployment and trying for second careers which not all of us will get. That’s over 3000 people. There are not enough jobs for all of us out there. I also recently went into second careers for possibly going back to school. They told me I wouldn’t have all of my schooling paid for. I’m sorry but I don’t want to be 30,000 Dollars in debt from student loans when I’m done going back to school AGAIN.

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