Failing Workers and Patients



    • Home Care in Ontario is delivered by Community Care Access Centres (CCAC), which are administered by 14 regional Local Health Integration Networks throughout Ontario. But the actual delivery of care is contracted out to companies, many of whom make a profit from providing the care that is paid for by your tax money!
    • Companies bid on contracts to provide home care through a competitive bidding process. The workers who deliver home care are caught in the middle of this bidding war, and, as such, the continuity of care they deliver to the elderly, sick and disabled is compromised and unstable. Competitive bidding means home care clients may have to get a new personal support worker ever time a contract expires. This so-called innovation has meant a lack of continuity of care for clients and unstable jobs for workers.
    • Contracts have been awarded to companies with no experience in the communities, no offices and none of the front line staff who actually provide the service if the company is awarded the contract.
    • The system of competitive bidding has not made home care any better for clients or workers. It has caused a costly crisis across the home care system. A 2000 study found that the cost of preparing to bid on a contract came to $30,000. Another study found that contracting out and competitive bidding took up 19.4% of a nursing agency's expenses. The funding for home care now goes through 4 levels of administrative costs instead of going from the government directly to the worker providing home care.
    • In order to outbid their competitors, while making room for profit, these companies have driven down wages and benefits for their workers. These so-called innovations, introduced by both for-profit and not-for-profit providers, include piecework, split-shifts, strict time limits on care services such as bathing times, the elimination of travel pay for workers, as well as wage and benefit reductions. A Ministry of Health study found that average wages for home care workers were approximately $12 per hour. That's about $6 less than what they would earn in a hospital or long term care facility. The government's 2006 response to an outcry over these paltry wages was to increase them to $12.50 .
    • This process is hurting workers and home care clients. Because of these cost-cutting cutting measures, workers are leaving the sector in droves. The top three reasons why home care workers leave their jobs are lack of job security, low wages, and low benefits. If home care workers change companies during the competitive bidding process, they also stand to lose their collective agreement, seniority, and benefits gained over years.
    • An attack on worker benefits is an attack on the quality of care they deliver. A Ministry of health study found that 57% of home care workers surveyed changed jobs over a 12 month period.  Home care is intensely personal and unique to each individual. The changing of care providers impacts clients in many clinical and emotional ways. Employers owe it to their clients and employees to provide stable, high quality home care.
    • It is time for employers to recognize and reward PSWs for the valuable work they do serving 500,000 Ontario home care recipients. Home care workers are doing their best to provide high quality care for their patients - the sick, elderly and disabled - but are constantly being undermined by a competitive bidding system that undercuts standards and continuity of care. If employers and governments are serious about improving home care in Ontario, they should talk to those on the frontline who work long hours, drive many miles, and earn minimum wage - and still find a way to provide a high-quality care. The home care system is running on empty, and its time for some changes before we hit rock-bottom.