New minister, same tired denials about cuts

Photograph of Ontario Health Minister Dr. Eric Hoskins speaking at the Ontario Hospital Association annual conference.

Dr. Eric Hoskin, Ontario’s Health Minister, speaks about his top four priorities at HealthAchieve November 5.

Dr. Eric Hoskins may be signing his name, but the latest Toronto Star letter-to-the-editor from the Health Minister sounds as tired and exasperated as those served up by his predecessor. Given Ministers seldom pen their own letters, we conclude it must be hard to get good help these days.

Hoskins (or his ghost writer) insists that Star columnist Bob Hepburn is wrong – that in fact no cuts are taking place in home care. Never mind Erie St. Clair CCAC’s new executive director sent out a memo announcing a 33 per cent cut in daily nursing visits or that Care Coordinators at the Champlain CCAC are beside themselves having to recommend out-of-pocket paid alternatives to long-term patients who suddenly find themselves without a caregiver. Both CCACs are staring down millions in debt and are in freefall. But hey, aren’t we glad that no cuts are taking place?

It’s the same old song and dance coming out of the Minister’s office. Hoskins insists that Windsor got $3 million more in funding this year and that overall $270 million has been added for home care. Demand is far outstripping this funding due to a planned multi-year freeze to the base budget of Ontario’s public hospitals. Care Coordinators are telling us that not only is this placing the CCACs under great pressure, but it is changing the very nature of the work they are doing. It’s all about post-hospital care, not about longer-term chronic care management and support.

The media at either end of the province have been highlighting heartbreaking stories of chronic care patients told they are being cut loose. The Ottawa Sun highlighted loss of service to a patient who has multiple sclerosis and cannot bathe, dress, or cook. The Windsor Star championed the case of an 89-year-old who had suffered two strokes, is paralyzed on one side and needs 24/7 help. Apparently her needs on the CCAC assessment scale were “mild.” Of course due to privacy the CCACs can’t talk about the specific cases. How convenient not only to them, but to the Health Minister too.

Instead it’s not about people, but about dollars. And if the dollars are going up, then there cannot be any cuts according to Hoskins and company.

Hoskins does point out that he has appointed former RNAO President Gail Donner to “lead a team of experts” to report back in the new year on improving “quality and value” in home care. There is only one page on the Ministry’s website about this review – it provides a list of who these “experts” are and little else. Donner, in a letter to “stakeholders” says the role of the panel was about consistency in access and delivery, and opportunities for “innovation and new approaches to care.” Those “stakeholder,” incidentally, didn’t include any unionized caregivers.

Donner says in the letter she will consult with “network partners” to generate recommendations. She says she wants to hear from individuals and their families. How individuals and their families would ever know about this is a mystery. After the Minister’s OHA speech November 5th we went looking for any reference to Donner’s panel. There is no press release on the Ministry website. We went looking for media stories – the only one that came up in our web search is the Minister’s letter yesterday, although Longwood’s site featured Donner’s stakeholder letter. None of our thousands of home care members knew about it. This panel is so low key they should use a limbo stick as their logo. If you’re still thinking about a submission: too late. The deadline for submission closed October 31, 2014. Happy Hallowe’en! Thanks for telling us about it now, Eric.

Ill winds are blowing in the home care sector. In September we endured a disruptive strike at ParaMed Home Health Care in Renfrew. CarePartners in Niagara seems to be hurtling towards the same end. They all say they are getting money for volumes only – nothing to allow a cost of living increase to some of the worst paid caregivers in health care.

The Health Minister can fluff off the building problems in home care as “still more work to do,” but clearly he needs to address these troubled regions now, not in the spring. He has the power to take over any CCAC much as he has with the leadership of any public hospital.

Saying what he did in the Toronto Star looked insensitive and indifferent to Ontarians left scrambling for care under his watch. Hoskins is still a relative rookie to the post – but he needs to do better than this.

Since we posted this the Local Health Integration Networks have informed us that they are soliciting input on behalf of the Donner panel.  If you would like to have your say, go to your regional LHIN site – there should be a link to a survey monkey questionnaire. It’s fairly basic, and they are simply looking for one suggestion to improve home care, not an analysis.  The suggestion is this will not be up for very long — better hurry.

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