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Long Term Care Forum
Delahaye Room
Kingston Public Library
Central Branch
February 22, 2001

Submission from the
Kingston and District
Labour Council

I would like to begin with a quote from Justice Emmett Hall who sums up for me what is truly unique about being Canadian.
He said...

"Our proudest achievement in the well-being of Canadians has been in asserting that illness is burden enough in itself. Financial ruin must not compound it. That is why Medicare has been called a sacred trust and we must not allow that trust to be betrayed."

The Canada Health Act, Canada's federal health insurance legislation, was passed in 1984 to ensure that all residents of Canada have reasonable access to medically necessary insured services without direct charges.

Here in Ontario, the present government is reshaping our health care system. We are seeing our hospitals closed and funding reduced. The shift is to care delivered at home, in the community or in care facilities. We must insist that the national standards established by the Canada Heath act are not sidestepped.

These five principals are: universal coverage, accessibility, portability, comprehensive coverage and public non-profit administration.

Our Health Minister, Elizabeth Witmer has stated that "The Ministry's goal is a first-class health system that provides better and more accessible health services for all Ontarians when and where they need them, at every stage of their lives."

The only thing that doesn't seem clean in this statement is who is going to pay for it!

The local Access Centre advertises that it is your hospital without walls. A hospital that can leave you alone and completely unattended because there is not enough money to give you the care you need. Currently the province has cap on community care budgets and does not allow access centres to run deficits. As a result care is restricted to those who need it most and there are waiting lists for many services.

As our population continues to age at an accelerating rate, and as hospital stays are shortened the numbers of people who need car at home and in the community will climb. In Ontario, seniors currently represent 12.6% of the population and consume 50% of health care dollars. It is the home care sector of the health care system that will enable our aging and dependent populations to remain in their own homes for as long as they can. Adequate funding must be provided for the long term care system to ensure that people receive the care they need when and where they need it. The government must recognize that waiting lists are not acceptable. There must also be an end to the limits on homemaking and personal support. We must allow the case managers to work with patients and their families to determine their needs without financial restrictions and to ensure that those needs are met.

The province is constitutionally responsible for the administration and delivery of health care services. They control our ability to access quality Long Term Care services. The legislation must spell out that liability and we need a mechanism to hold the Ministry of Health accountable if they are found negligent.

The 43 Community Care Access Centres currently act as brokers, awarding contracts to home care providers in regions across the province. All agencies, non-profit and for-profit, are required to compete in an open market through the Request-for-Proposal process. As a result, home care provision has become a race to the bottom. Quality of care is being traded off against costs. What Ontarians need and want is a publicly funded, publicly adminstered and publicly delivered community care system.

We need meaningful community control and adequate provincial standards that ensure quality care. The not-for-profit public provision of Home care and Community care services is essential. The public administration of medicare has saved Canadians billions of dollars. The practice of "deinsuring" health services by eliminating them from Medicare coverage, forcing people to pay privately for care has created a two tier health care system where private insurance companies profit. There is no room for profit and inequity in health care.

We need to let all Ontarians participate in health decision making. Bring everyone - patients, members of the public and health care workers into the reform and evaluation of the health care system. If what we are striving for is a first class health system it must be democratic, accountable and representative.

A uniform process for becoming a member or board member of any Community Care Access Centre should be mandated. Bylaws for elections to the Board of Directors must be public documents, easily accessible. There must be full public disclosure of all financial agreements and contracts between the CCAC and providers.

The people who work in the health field are incredible people. They are dedicated, caring individuals. Homemakers and personal support workers, who provide in home services, play a critical role in our health care system. The RFP system denies these health care workers any sense of job security or stability. It is no surprise that this has led to significant problems recruiting and retaining staff in this sector. We must ensure fair wages for all health care providers. The burden of providing health care is being shifted on to poorly paid workers in the community and unpaid family care-givers in the home. The shift to home care should not rob communities of good jobs or contribute to the development of a low wage economy. Wage parity with existing institutional jobs would recognize that fair wages and decent working conditions contribute to quality of care.

The Government of Ontario has an opportunity to reach it's goal of a first-class health system in this province. They can provide a continuum of care from large institutions to the home by providing good quality care with appropriate treatment and supports. The people of Ontario have spoken out in a dozen forums across the province. They are alarmed at the increased need for patients and their families to pay privately for quality care. It is critical that everyone have equal access to quality health care, no matter where they live or how much money they have. That is our sacred trust. Don't let this government betray it.

Thank you.

Submitted by
Kingston & District Labour Council