The provincial government walked into a hornet’s nest with its plans to enhance home care access for Islanders. How could a good news announcement go so quickly off the rails?
Last week the province unveiled three new programs - two focusing on rapid-bridging between hospital, home and palliative care; and a check-in program for seniors. They are to help seniors remain in their homes longer; and allow patients to be discharged earlier from hospitals.
The enhanced supports are part of a new federal funding deal with the province which targeted home care and seniors, along with mental health initiatives. It all sounds like a win-win situation. Wrong.
Public sector and nurses’ unions, and health-care advocates are up in arms because large parts of the new agreements involve using a private, for-profit group – Island EMS - a company owned by Medavie. Paramedics will provide much of the extra care but will not replace the current services being delivered through the public system or bump any current employees.
But on principle, unions feel that health care is a public right and should be publicly-funded and publicly-administered by registered nurses (RNs), licensed practical nurses (LPNs) and resident care workers (RCWs).
Seniors, who can stay in their homes longer, and patients able to return to the comforts of home earlier from hospital, are probably not too concerned who provides the care they need – as long as it’s available.
The province makes the argument there are parameters for how the federal funding can be used. “Targeted home care funding must be invested into new and innovative approaches. The funding cannot be used to subsidize existing services.”
So, a private company must be used? It’s an unusual interpretation. How is this a new or innovative approach when it’s simply enhancing current programs? Why can’t these approaches be handled by current home care workers, bolstered by additional hires?
There are other issues.
If the province felt there were no other options but go to the private sector, why didn't it tender the contract – for the sake of transparency and accountability? Perhaps no other private group is so uniquely qualified, in place and trusted as Island EMS paramedics? But now we’ll never know.
A contract valued at some $450,000 has been awarded without tender or much stakeholder input. On principle, such contracts should be tendered and not decided in discussions behind closed doors.
Unions and advocates see the province’s decision as a dangerous trend towards privatization and for-profit care. The fear is, that once Medavie gets another foot in the door, it will start pushing public sector employees out.
Island EMS is eager to build on the success of the Paramedics Providing Palliative Care at Home program. And that is part of the problem. Unions had misgivings with this earlier initiative and are now drawing the line. UPSE supports enhancing home care services, as long as they remain within public health care.
The province thought it had everyone on board after what it called several months of collaboration and discussions. Apparently not.