Restructuring Health Services: It’s a Matter of Principle!

November-December 2019

We’ve seen it before, and we’ll see it again. Ontario is overhauling health services – or, to be precise, the structures that deliver them. Newly formed Ontario Health Teams will plan and deliver a range of services, including the supports Ontarians need to age safely and productively in their homes and communities.

Each team will work within what government calls a “low rules environment.” We don’t yet know what the rules will be and how they will affect home and community care. So far, hospitals are taking the lead in creating the teams. Does this mean resources for home care and community support services will be protected, or could they be redirected to bolster underfunded hospital budgets? Taking funding from community-based services would not reflect reality.  Currently, individuals referred directly from the community, and not from a hospital, account for 85% of home care visits. In addition, when a lack of community-based alternatives keeps too many Ontarians in hospitals, hospital services and budgets are stressed. Everyone loses.

Let’s look at a couple of all-too-plausible situations.

When Susan, 82, fell down the stairs, she broke a hip and needed surgery. Before she returned home, her health team arranged and coordinated in-home services. The team in her area had designated funds for home care, so she had what she needed until she was back on her feet.

Josef, 78, tripped on a rug. He sprained his wrist and ankle, so managed to avoid surgery, but still found it hard to navigate his apartment and prepare meals. He didn’t know where to turn. He finally learned there were some, but not enough, in-home services in his area, and people discharged from hospitals seemed to get priority.

Care Watch asserts that home care and community services are necessary components of our broader health care system. We advocate for high quality, affordable, and equitable access to home and community care within any structures Ontario adopts.

Whatever systems the Ontario Health Teams establish for home care and community support need to be based on the Canada Health Act. Taken together, its five legislated principles – public administration, comprehensiveness, universality, accessibility, and portability – define a system that:

  • protects, promotes, and restores physical and mental well-being
  • gives everyone the same, equitable access to all necessary services without financial or other barriers
  • is transparent and accountable to members of the public about how it uses their money

What can you do?

Ontarians need and expect a unified, comprehensive system with services they know and can rely on.

Look behind broad statements made by government and its agencies, and ask for specifics. For example:

  • How will resources for home care and community support services be secured and protected?
  • How will people coming from the community rather than from a hospital get services?
  • What home care and community support services will be available to all Ontarians who need them?
  • What care standards will be guaranteed across Ontario Health Teams?