If contracting out works, why do they keep suspending it?

The Ontario government's system of contracting out for home care services (the so-called "competitive bidding" system) has been put on hold for another two years, it seems.

Following a meeting with government officials, various bosses and mucky-mucks in the Ontario home care industry have come out and declared the following:

As proposed in a first step in a phased transition, new contracts would be developed and then negotiated with existing service providers outside of a competitive bidding process, effective October 1st, 2012 for the subsequent two year period (2014). These new contracts would reflect the realities of our environment; quality imperatives, fiscal restraint, greater focus on client-centred care and defined client populations, and the requirement to collaborate and implement change over a short period of time. In subsequent phases it is proposed that all home care contracts will be renewed based on clear performance metrics related to transition, quality improvement, client satisfaction, innovation and value for money. Opportunities for new entrants to obtain contracts would be provided through joint ventures, subcontracts or other arrangements.

They claim “the Ministry looks forward to receiving a proposed plan from the sector for moving forward in order to establish new service contracts by October 2012.”

This is just the latest suspension of compulsory contracting. In the face of community opposition, the government has been forced to suspend the process for years. Most recently, Health Minister George Smitherman tried to bring it back in 2007, but that quickly blew up in his face.

If you can believe the home care bosses, this time around they are trying to stop providers losing contracts and limit new entrants to the industry even after October 2014.

The good news is that this may provide a bit more stability to an industry that, for decades, was supposed to be the cornerstone of government reform, but was actually being restructured back to the stone age.

The bad news is that this will cement the role of for-profit providers -- who took most of the work away from not-for-profit community providers after compulsory contracting was introduced by the Mike Harris government.

The government plans to introduce a similar contracting system for surgeries and other health care services. Health care privatization really is like the zombies: they may take a blast to the head but they still keep getting up.

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