Report: Ontario home care in disarray and unable to keep up

Report from the Ontario Health Coalition finds that the province's home care system is in disarray and unable to keep up.

Toronto (12 March 2015) — Ontario’s home care system is struggling and urgently needs reform, was the message raised at Ontario’s Legislature. The Ontario Health Coalition (OHC) brought home care patients and advocates for the frail elderly to the Legislature as it released a new report promoting a vision of reform that would see the principles of Public Medicare extended to cover home care.

The Ontario Health Coalition represents more than 400 member organizations and a network of local health coalitions and individual members including the Ontario Public Service Employees Union (OPSEU/NUPGE). 

Report the result of extensive consultations 

The report The Care We Need includes the results of a cross-Ontario consultation with those most directly affected, including approximately 100 family members of home care patients, front-line nurses and Personal Support Workers, health professionals, discharge planners, nurse practitioners, and representatives from community provider agencies, seniors’ organizations, health and social service agencies, and others. Consultations were held in Hamilton, Niagara, Kitchener, London, Sarnia, Thunder Bay, Sudbury, Peterborough, Ajax and Toronto.

  • In every round-table consultation people described community members suffering without needed care, sometimes in horrifying circumstances. 
  • Everyone, without exception, described home care as inequitable and unresponsive. There was total consensus that home care must be accountable and responsive to the communities it is supposed to serve.
  • Everyone reported that home care is poorly coordinated, bureaucratic, top-heavy, and fragmented; and many were concerned that resources are not making their way to improving care.
  • Everyone wanted compassion to be a guiding principle for home care. 
  • There was a wide consensus of concern over the increasing salaries among the top leadership at the Community Care Access Centres while home care workers and community care workers are suffering under precarious or poor working conditions, worsening continuity of care and causing high-turnover and problems with training staff.
  • Everyone wants real reform. There was no attachment to the current system.

“People are suffering because publicly-funded home care is very harshly rationed and the cost to buy care privately is extremely high,” said Natalie Mehra, executive director of the Ontario Health Coalition.

Funding not keeping pace

While both the number of clients and their acuity (complexity of care needs) are increasing, funding is not keeping pace. "There is not enough money to cover the range and scope of services needed," noted Sheila Neysmith, spokesperson for Care Watch, a home care advocacy group for the elderly. "Instead of peoples' need determining the level of service they get, we have a situation in which the amount of funding determines whether or not people get services, with little or no regard for their needs."
The coalition is calling for a public non-profit home care system provided through reformed CCACs with democratic local governance and firm accountability to the community. Among the coalition’s recommendations: improving access to care is paramount – every patient with assessed need should be enrolled and any unmet need should be measured; home care should be provided as an integrated public service and the structure of home care must be streamlined to move money to front-line care and away from hundreds of duplicate administrations; there should be a vital role for locally-supported non-profit community organizations; new leadership and a cultural change are needed; working conditions and training must be improved.

More information:

Ontario Health Coalition


The National Union of Public and General Employees (NUPGE) is one of Canada's largest labour organizations with over 340,000 members. Our mission is to improve the lives of working families and to build a stronger Canada by ensuring our common wealth is used for the common good. NUPGE

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