Costly agencies that oversee home care across Ontario may soon be on life support themselves, The Free Press has learned.
Health Minister Eric Hoskins may be weeks away from changes that would take power and money away from 14 large bureaucracies that act as gatekeepers to home care — community care access centres.
In an interview this week, Hoskins said he wanted to make changes but would wait until Auditor General Bonnie Lysyk releases her report on access centres.
“I didn’t want to pre-empt that report and it will be very instrumental in informing me of what further steps might be necessary,” Hoskins told The Free Press. “That (report) will likely point to some other changes and reforms that are required . . . I’m certainly looking at the potential for structural changes.”
The premier is being coy when he should be bold, NDP health critic France Gelinas said Thursday. The report from the auditor general — which her party requested — is expected to be released by month’s end, and Hoskins has no doubt been briefed by his staff about the contents.
“Our home care system is broken,” Gelinas said. “Everything will need to change.”
Hoskins has previously taken steps in that direction by seeking to dismantle walls that separate care in hospitals with care in communities, walls that disrupt the co-ordinated care patients need. Hoskins has proposed funding follow patients wherever they go, a change that could leave agencies competing on price — a yardstick in which unwieldy access centres may come up short.
While it will be Hoskins who will have to drive the path to change, others have been the engine demanding reform they say will save money and deliver better, more seamless care. They include Ontario associations that represent registered nurses, pharmacists and primary care doctors.
Hoskins is moving in the right direction but needs to do so much more quickly, said the chief executive of the Registered Nurses Association of Ontario, Doris Grinspun.
Her association wants to make major changes in two steps:
n Move those who co-ordinate each patient’s care, mainly nurses, to offices of family doctors and teams who oversee care in the community without a large bureaucracy.
n Close access centres and shift oversight of each region’s home care to agencies already responsible for other aspects of health care — local health integration networks.
That new model would cost less but provide better, more seamless care, Grinspun said.
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ABOUT HOME CARE
- Requests for home care go through one of Ontario’s 14 community care access centres.
- The centres decide who will get home care and how much. They also place patients in long-term care.
- The centres also hire agencies to provide the care.
- The centres have been criticized for spending too much on administration and gate-keeping and not enough on care of patients.
- Access centres defend the status quo and say primary care is already too burdened to look after home care.