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CCACs discover that coordination is the better way. But Ontario Liberal government policy of compulsory contracting out undermines coordination

The Toronto Star today makes a major big deal about changes in Ontario's home care system that are being developed by the Central West Community Care Access Centre (CCAC).

Apparently, the CCAC is trying to improve coordination by making sure that "everybody in the circle of care is in the communications loop and knows what they are doing so that you look at the person as a whole being," according to Margaret Mottershead, CEO of the Ontario Association of Community Care Access Centres.

In the past such care has been uncoordinated because it has involved multiple community health-care agencies and multiple health professionals, says Dr Brian Golden who is working with the Central West CCAC on this reform.

One agency sends a nurse to a patient’s home, another dispatches a personal support worker and another an occupational therapist. ...To this end, a single agency will be responsible for all aspects of a patient's care - not only healing the wound, but addressing the causes. In the case of a patient with diabetes, a dietitian could be sent to the home as well as a nurse who specializes in wound care and a chiropodist who specializes in foot care. "We have to start seeing the full person - from the foot ulcer, to the diabetic, to the full person," Golden said

Big bucks can be saved, they suggest. 

But, if lack of coordination and multiple provider agencies is such a problem (as surely it is), why not get rid of our current home care system which requires Community Care Access Centres to contract out services.  Surely direct provision by a single public, not for-profit agency would allow the strongest coordination. 
But no -- this Liberal government is committed to home care competitive bidding and compulsory contracting out.  Rivalry, multiple provider agencies, and lack of coordination are inherent to the system.  So true coordination is going to have to wait this government out.

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