NOTE: This post has also been cross posted to my SWRK4200 CLASS BLOG
A recent report by the Canadian Healthcare Association indicates that private spending on home care now outstrips public spending. There is an increasing trend to shifting the responsibility for home care to the the private sector. One of the many impacts is that for older people who can't afford to pay for care, informal caregivers (mostly women) have to carry much more of the care.
Having worked in a Quebec CLSC specializing in the development and provision of services to older people, I observed the superiority of public home care services over most for-profit services. Our workers, who had to fulfill certain educational requirements to be hired, were paid a fair wage, unionized, received benefits, and were properly trained. Private sector workers are paid much less (for example, an Ontario study shows they are paid $6 per hour less in that province).
In my Quebec CLSC, our home care workers were part of the multidisciplinary health care team. They are the professionals who see the older person on a day-to-day basis. Often it was the home care worker who drew our attention to serious problems such as elder abuse and they were often an important part of the solution. When home care services are privatized, they no longer have this connection with the larger health care team and it is the older person who often suffers.
I suspect this trend to privatizing home care and health care will continue under a Conservative government, even though there is some evidence that privatizing home care does not save money in the long run (Shapiro, 2006) and a Winnipeg experiment to do so was deemed a failure (Shapiro, 2000). The Romanow Commission called for a National Strategy on home care and we are still waiting for it -- a strategy that will ensure that every older person has equal access to the services they need.
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