Long Term Care Forum
Submission on Behalf of the Kingston Health Coalition
22 February 2001

The Kingston Health Coalition is a community coalition made up of individuals and organizations committed to maintaining and enhancing our publicly funded, public administered health care system.

This coalition has grave concerns about the future of Long Term Care in this province under the current provincial government. Though the government has promised consultations with the public - they have yet to materialize. So the Kingston Health Coalition will take this opportunity to share with you recommendations we seriously urge the government to adopt to ensure that individuals and families in this province have access to care which meet their needs and the needs of their families.

1. First off, the Long Term Care / Community Care system must be publicly funded, administered and delivered.
2. People are entitled to receive quality care where and when they need. This care should be available from the public system, whether it is delivered at home, in the community or other facilities. All care plans must be based on the needs of the patients - we can not be satisfied with a system which only allows care while funding permits. All care plans must meet the patient's needs - period! As such the act must clearly outline that those who use Long Term Care / Community Care have the right to full written information which states includes the act's bill of rights, eligibility criteria, hours of care available, and their care plan. Furthermore, all patients have the right to be consulted with and agree to their plan of care.
3. There must be clear accountability by all parties involved in organizing, delivering, and regulating Long Term / Community Care. The obligations of the government include funding, regulating and setting standards and ongoing monitoring. The bottom line is the government is ultimately responsible for Long Term Care Services - therefore a mechanism must be in place to hold the government accountable. And to truly ensure a meaningful process there needs to be full disclosure in a transparent manner.
4. There must be a user-friendly enforcement mechanism for those who feel their rights have been violated. The establishment of a Long Term Care Appeal Board to review complaints must be fully independent from the government. All issues before the Board must be dealt with in a timely, accessible, and confidential manner.
5. Continuity of care is a critical issue for both patients and health care workers. Low wages, poor working conditions, and weakened unions can have devastating effects on patient care as it is difficult to retain and recruit trained staff. Fear is another factor affecting the quality of care. As reported in "The Cost of Contracting out Home Care: A Behind the Scenes Look at Home Care in Ontario" the competitive bidding process creates a climate of fear among workers. They are reluctant to criticize Community Care Access Centre's policies on patient care for fear of repercussions when submitting future bids. It is important for any Long Term Care Act to include Whistle-blowing legislation to protect healthcare workers who report situations which compromise patient care, unethical and dangerous practices or illegal activities. In addition to Whistle-blowing legislation, successor rights are essential to retain capable health care workers in the Long Term / Community Care system and to ensure workers are treated in a fair and just manner. Successor Rights allow workers to move with the work - so if beds move from one facility to another - workers have the opportunity to move with them and be able to retain their salary and conditions of employment. Successor rights supports the ongoing retention and recruitment of qualified competent health care workers. And finally I would like to mention the injustice of the annual pay equity cap put in place by the current provincial government. The majority of workers in the long term care / community care system are women. This cap means that many women will be cheated out of pay equity adjustments which would bring their salaries on line. The government must remove the cap and ensure private sector employers meet these obligations.

In closing, I urge other groups and individuals to make their voices heard on this matter. Ensure that long term / community care is a publicly funded, administered and delivered system which meets patient's needs in an accountable and fair manner to patients and health care workers.