Ontario NDP


Assessment of Ontario New Democratic Party’s Platform on Home and Community Care Services

May 11, 2022

“Every Ontarian, no matter their income, deserves dignified, affordable, quality care as they age, whether that’s excellent home and community care so older adults can stay in their own homes longer… or long-term care that prioritizes the well-being of residents over corporate profits.”

The Ontario New Democratic Party’s 2022 provincial election platform — Strong. Ready. Working for You. — explicitly recognizes the value of home and community services. It also recognizes that these services and those delivered in long-term care homes are part of a larger system.

Investment in Home and Community Care Services

“The Ontario NDP has a plan to ensure people can live at home longer as they age, with reliable and expanded services to support their needs.”

The NDP acknowledges that most Ontarians would prefer to stay in their own homes as they age, but often don’t have the choice. Home and community care is fragmented, underfunded, and inadequate.

As key initiatives of the plan, the platform names:

  • Provincial standards for a basket of home and community care core services
  • Aligning home and community services to communities’ needs, with attention to culturally appropriate resources and training
  • A program to match workers to communities with shared cultural and linguistic knowledge
  • A caregiver benefit program to recognize the contributions of unpaid caregivers

The remainder of the platform outlines these and other initiatives.

Workforce Capacity

“Health care workers like nurses and Personal Support Workers (PSWs) are underpaid and burnt out… Home and community care and long-term care are chronically understaffed.”

The Ontario NDP considers care work, or the “caring sector,” important to its jobs plan. They also note that these workers are “disproportionately women, people from racialized communities, and recent immigrants to Canada,” whose work is undervalued and underpaid. They emphasize giving them respect, compensation, and working conditions that recognize the value of what they do.

They plan to recruit, retain, and return thousands of nurses and personal support workers province-wide and remove employment barriers to internationally educated health care workers. Specifically, they commit to:

  • Taking immediate action to begin hiring 10,000 personal support workers, the number experts estimate Ontario is short
  • Ending any further cuts to nurses and other health care workers
  • Increasing health care workers’ wages and giving personal support workers a raise of at least $5 above pre-pandemic levels
  • Repealing Bill 124, which caps wage increases (particularly in women-dominated caring sectors) and prevents health care workers from negotiating wages
  • Committing to good faith bargaining with the public sector
  • Prioritizing a system to recognize the skills and credentials of foreign-educated workers, with a focus on health care
  • Expanding family reunification and the Ontario Immigrant Nominee Program to attract more skilled immigrants to Ontario
  • Developing and implementing a strategy to address violence against health care professionals

“The Ontario NDP recognizes the invaluable role that family caregivers play, and all the ways they help with their time and money.”

The platform therefore commits to:

  • Creating a provincial Caregiver Benefit Program that provides direct support to family caregivers who do not qualify for the existing federal tax credit programs or respite care. This means-tested program would provide $400 a month.

“… an employee is an employee no matter where they work, and … every worker deserves the same rights and protections.”

Some commitments address general labour practices and therefore also apply to people working in home and community care. The NDP commits to:

  • Raising the minimum wage to $20 in 2026, with stable $1-an-hour increases annually
  • Legislating 10 permanent personal emergency leave days for all workers
  • Working with businesses to provide supports for these transitions
  • Creating Ontario Benefits to cover all workers including those in part-time, casual, app-based, or contract jobs
  • Giving all workers a basket of benefits – including dental care and vision coverage – that meet a standard of quality coverage. Benefits will follow the person, not the job.
  • Enforcing and strengthening employment law
  • Removing barriers to unionization
  • Proactively enforcing health and safety and increasing the number of jobs covered under Employment Standards and the Workplace Safety and Insurance Act

Accountability, Standards, Oversight, and Planning

“We’ll hold service providers accountable to ensure they meet the provincially regulated criteria for basic services.”

The platform commits to:

  • Establishing provincial standards for home and community care services by creating a basket of core services Ontarians are entitled to receive
  • Holding providers accountable for meeting the provincially regulated criteria for basic services

Planning is based on the needs of communities and specific populations. The platform commits to:

  • Aligning home and community care to communities’ needs, languages, food, and practices
  • Matching personal support workers to communities that share their culture and language
  • Collecting race-based data in all areas of health care to identify and fix systemic inequities
  • Expanding Indigenous health to serve more communities, make delivery culturally sensitive, and recruit and properly compensate Indigenous health professionals

The NDP’s plan for learning from this pandemic, strengthening the system, and preparing for future health crises includes commitments to:

  • Expand paid sick days, provide retention pay, and suspend evictions
  • Stockpile personal protective equipment
  • Develop triage protocols that are accountable to vulnerable communities
  • Protect health workers from harassment
  • Require annual reporting to the legislature of public health emergency preparedness

Privatization

“… there is no place for profit when it comes to our health, or the health of our families. We believe strongly that care must be based on a person’s needs, not their ability to pay.”

Throughout the platform, the NDP calls attention to the harms of uncontrolled privatization in all sectors. It pledges to replace profit-driven corporations, in both home care and long-term care, with municipal and not-for-profit ownership and full public delivery of home and community care. Every public dollar spent in long-term care and home and community care is to go directly to care and not to corporate profits. It commits to:

  • Ending unfair user fees on patients and their families in every part of the health care system
  • Making the home and community care and long-term care system public and not-for profit

Some Comments

The NDP has set out an ambitious plan, with many emphases dear to the heart of Care Watch – strengthening home and community care, improvements to pay and working conditions of personal support workers, a standard basket of home and community services throughout Ontario, and an end to profit-driven privatization. It’s hard to quarrel with these promises.

There are, however, some missing pieces. What the NDP hasn’t told us is what steps it will take to make these initiatives happen and also what their plans will cost. We don’t know how much would be invested, where the money would come from, and what other programs or initiatives might need to be sacrificed to make these investments.

The NDP says it will freeze taxes for low and middle income families. It will “manage Ontario’s finances responsibly and invest to fix and deliver the services that our communities need.” It will generate revenue by making the wealthiest Ontarians and big corporations pay their fair share, cancelling wasteful projects, and cracking down on speculation. We don’t know how much revenue could be generated and how it would be used.

The NDP’s October 2020 plan – Aging Ontarians Deserve the Best – was more specific. It told us exactly what would need to be invested to establish a sustainable system of home and community services. It also had more information about proposed timelines.

The NDP devotes considerable attention to its workforce strategy. This strategy is, however, less detailed than its strategy for child care, which specifies establishing a wage grid and standards (including benefits and a pension), daily on-site paid planning, paid professional development, and a strategy to help child care workers upgrade their qualifications – all with the goal of making these jobs good careers.

We would look forward to seeing more detail about the home and community care workforce strategy and also about the caregiver benefit program. This means-tested program would provide $400 a month to unpaid caregivers. It’s not clear how this means testing would work and whether the benefit would apply only to family caregivers. In addition, $400/month can’t compensate for the employment income unpaid caregivers are forfeiting.

We commend plans to increase wages for personal support workers, but a flat increase of $5 would still leave workers in the community earning far less than their counterparts in hospitals and long-term care homes. We do note references to fair wages, decent work conditions, a comprehensive staffing and HR framework, and good faith bargaining. We hope we can interpret these references as showing a willingness to work through legal and collective bargaining processes to give personal support workers in the community their rightful compensation.