by Robert Devet

At a home care town hall in Halifax Angela Giles talked about her fears that quality of care will deteriorate if and when the government's plans to introduce competitive bidding materialize. Photo Robert Devet

KJIPUKTUK, (HALIFAX) - Last night's town hall meeting in Halifax, organized by the Nova Scotia Health Care Coalition, tackled the privatization of home care.

In November of last year Leo Glavine, Minister of Health and Wellness, first talked about his intention to move to a competitive and profit-driven home care model. Currently home care services are mostly provided by nurses and home support workers employed by not-for-profit organizations such as the Victoria Order of Nurses (VON).

Reimbursement rates for the non-profits are negotiated, rather than procured through competitive bidding.

The driver for the new approach, as with so many of this government's recent initiatives, is the perceived need to cut costs and balance the budget.

Members of last night's panel, as well as most people who attended the event at the Halifax Central Library, fear that privatization will lead not to savings but to a deterioration in services.

Home care and home support are much needed and highly valued by the many Nova Scotians who receive it, not all of whom are elderly.

Panel member Angela Giles, for once not speaking on behalf of the Council of Canadians but simply as a private person, listed the many services her father, who lives with Multiple Sclerosis, receives on a twice-daily basis.

“In the morning they help him get out of bed, which is not terribly easy, he uses a sling and a ceiling lift. Then he gets dressed, they help him wash, they shave him, help him with his bathroom needs, serve him breakfast, help him with eating, they brush his teeth and his hair, turn on his computer with a voice command system,” she said.

“It allows him to live in his own home with his family and his cat, and it takes the pressure off his partner and his family, because we know he is well taken care of,” said Giles.

It's that quality of care, and the relationships her father has established with his caregivers over time, that the proposed competitive bidding will put in jeopardy.

“There is a fear that the quality of service will change,” said Giles. “That his workers will change, that they will not receive benefits and a living wage, and that because of that more cancellations will result.”

James Hutt, who works for the Nova Scotia Health Coalition, believes that such fears are justified.

He points to the Ontario experience to make his case. Roughly 60 percent of home nursing and home support in Ontario is delivered by private for-profit companies.

These companies promptly reduced the time support workers were allowed to spend with patients and increased their workload, said Hutt. Typically these workers would not be unionized.

And wages and benefits were pushed downwards, added Hutt. As a result employee turnover increased from 15 percent before competitive bidding was introduced to 57 percent.

Two panelists who worked in the home care sector spoke about their fears.

“I am worried about destabilizing good benefits and wages, and the threat to continuity of home care that this implies,” said Laurel Taylor, who is a Home Support Worker.

“And I am not happy with the lack of consultation and concerned that there doesn't seem to be a long term strategy provincially or nationally,” she added.

Debbie Townsend is a District Community Visiting Nurse and a Wound Resource Nurse who has worked for the VON for 17 years.

Townsend too is worried about the changes competitive bidding will bring.

“I am concerned for the patients and for me as a nurse. Will I be able to do the quality of nursing I want to do?” she asked.

Townsend, as did many workers in the audience who spoke later, testified to the allegiance they felt to their patients.

It's clearly not just a job to these workers.

“Patients make you feel so valued and they are so appreciative to be in their home and not in a hospital,” said Townsend. “To sleep in their own bed, to have their pets with them.”

“You become almost part of their family,” she said.

Audience members raised many issues and concerns.

Some argued that space for private for-profit companies could be warranted if strictly regulated.

But most of the roughly 100 attendants echoed concerns raised by the members of the panel.

“Our tax money should not go to profits, but rather to wages and training,” said one. “There is no need to line somebody's pockets.”

Yesterday's Halifax Town Hall was the fifth in a tour of the province. Additional events are in the planning stage.

The Nova Scotia Health Care Coalition is organizing a province wide day of action on Wednesday May 6th. Instead of a central rally, they are targeting 9 MLA's around the province and calling on them to keep the heart in home care.

Follow Robert Devet on Twitter @DevetRobert