Ontario Health Action Plan slows homecare growth

The Ontario Liberal government's "Action Plan for Health Care" sought to divert attention from the cuts to hospitals by claiming that it is moving patients from hospital by focusing on building homecare.

While many in the media bought this, more careful observers might have noticed that this has been pretty much the same line from government for many years, if not decades. The result has been the elimination of 30,000 hospital beds, backed up Emergency Rooms, ambulance off-load delays,repeated hospital crisis designations, and very high bed occupancy. Oh yeah -- and 10,000 people on homecare waiting lists.

Rolling out the Health Action Plan, the government recently (and loudly) announced 3 million hours of homecare personal support over three years.  (Now it's not very clear if they mean 3 million hours over three years, or building to 3 million hours in the third year, but let's assume the best and say they mean the latter.)

Such an increase sounds good -- until you consider that it is actually a reduction from the most recent report on homecare services.  Over the two years ending 2009/10, personal support hours increased by 3.3 million hours.  In other words, personal support hours were increased more rapidly over a shorter period of time.  

So, despite the rhetoric, we are actually seeing a marked slow down in the growth of this aspect of homecare. And this is happening while the government has squeezed hospital funding much more sharply.

One last thing: the government's announcement focuses on only one aspect of home care (personal support).  The other parts of home care (nursing visits, occupational therapy, physiotherapy, speech language therapy) however have been squeezed for some years (even as personal support increased). Occupational therapy visits fell, for example, by 230,000 in two years while physiotherapy visits declined by 89,000 visits.   

So far, there is no media announcement from government stating they are going to stop that trend, although the Action Plan did state they would  be expanding access  "to house calls from health care professionals, like doctors, nurses and occupational therapists."
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Apr 1 to Mar 31	2007/08	2008/09	2009/10
Individuals Served:	572,950	586,423	603,535
Client Demographic: Age 65+	53%	54%	54%
Age 19-64	30%	29%	30%
Age 0-18	17%	16%	16%
Clients Placed in Long-Term Care Homes:	35,289	39,652	40,759
Full-Time Employees (approx.):	5,072	5,370	5,603
Services
Personal Support/Homemaking Hours:	17,063,415	18,777,549	20,358,189
Nursing Visits:	5,892,707	5,981,762	5,962,097
Shift Nursing Hours:	1,698,887	1,480,078	1,735,137
Occupational Therapy Visits:	736,134	556,147	506,154
Physiotherapy Visits:	572,725	519,168	483,163
Speech-Language Therapy Visits:	461,484	274,068	251,740
Dietician Services Visits:	59,690	58,584	52,877
Social Work Visits:		79,278	70,202