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.

Comments

Ford government fails to respond to 72% increase in COVID inpatient days, deepening the capacity crisis

COVID infections continue to drive up hospital costs and inpatient hospitalizations in Ontario. For the most recent fiscal year (April 1, 2022- March 31, 2023) hospital stays related to COVID cost $1.221 billion, according to new CIHI data. This is about 4% of total hospital spending, creating a very significant new cost pressure beyond the usual pressures of population growth, aging, inflation, and rising utilization. Costs for COVID related hospitalizations increased 22.2% in Ontario in 2022/23 from the previous fiscal year, rising from $999 million to $1.221 billion. That rise is particularly notable as the OMICRON spike of late 2021 and early 2022 had passed by the the 2022/23 fiscal year. The $222 million increase in COVID hospitalization costs came in the same year as the Ford government cut special COVID funding and, in fact, cut total hospital funding by $156 million. In total, there were 60,653 COVID hospitalizations...

The hospital crisis: No capacity, no plan, no end

While Canada has achieved universal public healthcare coverage, that does not mean conservative forces have given up trying to erode that coverage and expand corporate care where it does not currently exist. The battle has become particularly intense in Ontario under the Ford Progressive Conservative government, which is implementing serious cuts to the level of care and moving to bring in for-profit mini-hospitals. Inadequate Staﬃng. Less and less of hospital spending is on staff. Employee compensation as a share of hospital expenditures has consistently shrunk in Ontario. This is not some immutable law of hospital development. It is in stark contrast with the rest of Canada, where compensation has become a larger share and now accounts for 67.1%. Hospitals in provinces other than Ontario now have 18 percent more staﬀ per capita than hospitals in Ontario. Overall, if Ontario had the same staﬃng capacity as the other provinces and territories, there would be another...

The long series of failures of private clinics in Ontario

For many years, OCHU/CUPE has been concerned the Ontario government would transfer public hospital surgeries, procedures and diagnostic tests to private clinics. CUPE began campaigning in earnest against this possibility in the spring of 2007 with a tour of the province by former British Health Secretary, Frank Dobson, who talked about the disastrous British experience with private surgical clinics. The door opened years ago with the introduction of fee-for-service hospital funding (sometimes called Quality Based Funding). Then in the fall of 2013 the government announced regulatory changes to facilitate this privatization. The government announced Request for Proposals for the summer of 2014 to expand the role of "Independent Health Facilities" (IHFs). With mass campaigns to stop the private clinic expansion by the Ontario Health Coalition the process slowed. But it seems the provincial Liberal government continues to push the idea. Following a recent second...

Defend Public Healthcare

Search This Blog