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Ontario Health Coalition |
Presentation |
Comments by Dora Jeffries, OHC Board Member.
Press Conference on Homecare in St. Catharines, December 6, 2004
Our comments today are directed to Health Minister George Smitherman and Premier Dalton McGuinty. It is their government that has so narrowly defined Ms Caplan‚s review. It is their government that promised to review competitive bidding, not the procurement procedures for competitive bidding. It is their government that ran on a promise to rebuild the public health system and stop privatization not entrench it in our system.
Why do I say competitive bidding equals privatization? The figures answer this question. The percentage of homecare nursing market share provided in Ontario by for-profit service providers increased from 18% in 1995 (2 years prior to the introduction of competitive bidding) to 48% in 2001. And unfortunately not-for profit providers with deep roots in communities, such as VON, St. Elizabeth’s have had to adopt a number of the negative practices of the for-profits in order to compete and "win" contracts.
Large multinationals and large not-for-profit providers are squeezing small local agencies out of the sector. I call this the "Wall-Mart" effect. Small providers complain that the ability to win or maintain a contract depends on their ability to write a legal document rather than on their ability to serve clients in that area. The small providers can’t pay for a team of lawyers or consultants to write a document. Ironically, a "phantom
" company could win a contract and then hire the same workers. So the competitive bidding process has destabilized the working conditions of nurses and support workers. They feel like they are being "rented out" to the lowest bidder. Workers in Cornwall employed by the Red Cross have had to reapply for their jobs at least three times since the introduction of competitive bidding. They have lost their holiday pay and other benefits.
The Ontario Health Coalition calls for democratic and flexible community governance that is responsive and transparent. This does not seem possible with the current system of appointed CCAC boards and the climate of competition rather than cooperation fostered by the competitive bidding process. Disturbingly it has been reported that some CCAC’s (Niagara) have contracts that prohibit agencies from publicly criticizing homecare policies.
Competitive bidding is justified by false claims of innovation and greater efficiency. There is evidence that "efficiency
" means lower wages for workers, and the introduction of strict limits per service of piecework - as if the workers were in a factory. Homecare workers refer to this as "dip and skip" a reference to the scant amount of time personal support workers have to bathe clients. I found that phrase profoundly disturbing. It reminded me of the excellent care my mother-in-law received after her stroke from a Red Cross Homemaker. This woman was allotted TIME. Her visit was relaxed, social as well as helpful.
Home Care should be seen part of the health care system - a continuum of care. Yet other providers such as hospital do not have to "bid" for contracts. The competitive bidding process equals privatization. It means a small number of companies are gaining a larger and larger market share. When this process was introduced it was hoped that it would provide a means to control homecare costs, improve quality and provide innovation. It has not. It has actually become a cost-driver in the system and lowered the quality of care.
In this region you have experienced the deleterious effects of a long-standing community based not-for-profit agency losing a contract for home care. Your local MPPs have received a lot of feed-back on this issue and have championed the cause of the VON.
It is time for our politicians to support us and call on Health Minister Smitherman to conduct a true review of the competitive bidding process.