You’re funny—big, for-profit home care providers. They are the only ones who will be able to answer that bid. You know what that means for the people of Nickel Belt, the people I represent? That means that there will never be people available.

Don’t take that from me; I will read you some examples of my constituents. I will start with the constituents who just contacted my office on October 5:

“Dear France,

“My mother ... had an assessment from the local LHIN today.” Home and community care keeps changing names. “She previously had a stroke in 2019 and then broke her hip in 2020 and then her back in 2021. She lives alone and was receiving four showers per week (often workers do not show up so it can be less than that in reality) as she tries to do everything else herself. She was visited” by “an assessment officer from the LHIN today and the woman said Mom would be cut back to two showers per week since that is the standard.... Mom then called their office and they said she could continue” to have “four showers per week. Then Mom received a call from the assessment officer who visited her in the morning and the woman told my mom, ‘You were fine with the two showers when I was there with you today.’ My mom was given no choice” so that she could say during the visit. “The woman said she would bring the matter up with her boss about the showers.

“I find it very sad that health care staff would put an elderly person through such” difficulty “when her life is already hard enough as it is. It seems like a power play at my mother’s expense. After a stroke, elderly people cannot handle stress the same as before and are vulnerable. Does the province want elderly people to have to go to long-term-care homes and occupy hospital beds when simple services are not available in their homes? Often workers do not show up or called to cancel in the past, so two showers a week will either be one per week or none” at all. “This is the reality of the system. Mom currently has a pretty stable PSW for her four showers per week but if these are cut back this PSW may have to find other work, and Mom will lose out in the end. Having a stable PSW is so important for things as personal as a shower. We are ... entitled to dignity. I hope you can help with this situation.”

That was one example. I have many, many that I could go through.

Maybe I’ll do another one right now. This is from Lionel Rudd, again from my riding—a very nice man. He says:

“Hi again,

“A follow-up to my previous email.... I was anticipating a call from a Bayshore nurse last evening (Saturday) or at least early this morning (Sunday) when I would be informed as to the time of the nurse’s visit.

“I did not receive any call—so I had to phone Bayshore. I was told that someone would call me at 10 ... no call. After 11:30 a.m. I called Bayshore again and was told eventually that a ‘nurse’ was coming on duty at 3 p.m. who would be able to see me.

“At around 2:15 p.m. I received a call from Bayshore telling me that there was no nurse available to see me today—maybe Monday.

“I was told that I was a level 3 patient ... whatever that might mean except that I was not in a critical condition ... and that I could miss the odd visit! Of course none of this was ever conveyed to me ... I had no idea of the whole set-up. It seems that Bayshore is not at all organized and appears that there is a level of management incompetence.

“It is most troubling that Bayshore did not have the common decency to pick up the phone and at least be honest and straight with me. I sat around for many hours not knowing anything. They appear to have an extremely arrogant attitude and uncaring culture towards at least me. I wonder who else goes through the same kind of dealings with Bayshore.

“Maybe you can raise this issue where it counts—or maybe add it to the pile that you already have.

“Best regards,

“Lionel Rudd”—a resident in my riding.

I wanted to share that with you because he is not—we have complaints like this non-stop. I wanted to make the link between having one care-at-home provider and looking for providers who can service the entire province. I’ll just read into the record and then show you how those two are related:

“Dear France Gélinas,

“I am writing to you because I have a growing concern” with Bayshore “not being provided for days at a time to the French River area.” The French River is an area in the south of my riding. “My husband is terminally ill and requires daily nursing for checkup and drawing up of medication. On”—she gave the date—“at 2:19 p.m. I received a phone message from Bayshore telling me that there was no nurse for the weekend, that they would be doing a virtual visit on the phone. I called back to Bay-shore at 2:29 p.m. and left a message that this was not acceptable as my husband needs meds drawn up daily and I missed the nurse that day as I had to go into Sudbury myself to pick up the meds needed for my husband, which meant the meds were not there when the nurse came on Friday....

“I then called my husband’s caseworker, Linda Emms, at the North East LHIN to report this to her. Linda said she would look into it and then called me back to verify no nurse was coming for the weekend. After I verified once again no nurse she then called Bayshore and told them that this was not acceptable, that my husband had to have daily care. Bayshore assured Linda ... that my husband would have a nurse, but no nurse came that weekend. Our nurse practitioner”—there’s a nurse practitioner who doesn’t work for home care who is in the French River area—“Ann Desrosiers came to the house every day that weekend,” on Friday, Saturday and Sunday.

“I followed up with Linda ... on Monday ... and she said she would file a complaint against Bayshore. Our nurse practitioner, Ann Desrosiers, has had to come to our house several times to draw up meds because” the home care nurse does not “draw up enough or none at all or the meds are not here as we are waiting on the delivery. It’s not just my husband that was without a nurse for the weekend but several others in the French River community that some are even sicker than my husband and they did not have care” at all this weekend.

“I had put this letter away for a while but here we are again ... and my husband has no nurse for the weekend. The nurse from Bayshore came today and drew up a lot of (syringes) meds to last the weekend. She told me no nurse” would be coming this weekend. “I did not receive a phone call out of courtesy from Bayshore as of yet. I have left a message again with my husband’s care coordinator Linda Emms at the North East LHIN but have not heard back from her as of yet. Again not just my terminally ill husband without a nurse for the weekend but several other French River residents that require home care will be without home care as well. If Bayshore has a contract to fulfill they need to fulfill it. Maybe Bayshore should make it mandatory that their staff should have to come to the French River one weekend every other month and maybe then French River will have a nurse every weekend. I have cc’ed our nurse practitioner ... on this.

“With kindness...” and she signed her name. She is from Alban in my riding.

I wanted to share that with you because there are solutions available. There is a little home care provider in the French River called Aide aux Séniors. Aide aux Séniors is a not-for-profit group of health care providers who are more than willing to go and help their neighbours, who are more than willing to provide home care on weekends, on day shift, to people who need it.

But do you really think that the little Aide aux Séniors in Alban in the French River will be able to fill out a request for proposals like you see on the website for Ontario Health? No, there’s absolutely no chance of that, Speaker. The only one who will be able to meet the new requirement that the minister was so proud of saying, “Oh, we will have a centralized procurement process to make sure that everybody is treated the same”—what that means for the people in northern Ontario, what that means for the people that I represent, is that more and more people will never have the home care that they need.

That Bayshore will get those contracts I have no doubt. When it comes to writing up proposals, as I said, it looks like Mother Teresa works for them and will be delivering care to every single home care patient in Ontario. It’s just a beautiful thing to read. But in reality, none of this comes through. In reality, they cannot recruit and retain a stable workforce.

Why can they not recruit and retain a stable workforce? Because they don’t offer good jobs. What do good jobs look like? They look like permanent, full-time jobs, well paid with benefits, sick days, a pension plan and a workload that people can handle.

Do you feel like I’m repeating myself a bit there, Speaker? It’s because I am. We have been saying this for a decade now. For decades, since Mike Harris brought us the privatization of the delivery of our home care system, our home care system has not been able to recruit and retain a stable workforce, because they don’t offer good jobs, and people suffer.

Now, for the few not-for-profit home care deliverers that still exist in parts of the province, because the local CCAC, LHIN, home and community care support services, call it whatever you want—they existed locally. They knew the number of complaints they were getting about the people who get the big contract. Bayshore has a contract in my area. They know how many complaints that they get. They know the areas that they’re not able to support and they go, sometimes, out of contract.

Sometimes they do have a small contract with a not-for-profit agency that will service a little pocket. In Nickel Belt, it’s 33 little communities, none of them big enough to be a city. They don’t have a municipality. They don’t have a mayor. But they have good people who live there, who love where they live, who work there, who age there, who become frail there and who need care.

Does Bayshore have a nurse who goes to Westree, Shining Tree, Biscotasing, Gogama, Mattagami First Nation or Alba? No. Do they have the contract for them? Yes. Do they provide care? No.

Things will get even worse with the change that this bill will bring forward because now it won’t be that you have a contract for the city of Greater Sudbury and the little communities around; you will have to sign a contract that is province-wide. Aide aux Séniors is not going to be able to bid on one of those contracts—and neither are the other little home care providers that exist in my community—to help in those little communities. And what will happen to those good people? The same thing that I just read to you, and I have many, many more.

Before I go on to share more of the problems that we already have, I want to talk a little bit about the second part of the bill that would allow care coordinators to be incorporated into other health care providers. This is such a good idea that it is already happening. If you come to Health Sciences North, the name of our hospital in Sudbury, you will see that we have a health and community support—call them whatever you want—care coordinator who works there. We have very good family health teams called City of Lakes Family Health Teams in Sudbury that have many sites in my riding, one in Lively and one in Val Caron. They also have a care coordinator who is part of that family health team.

Actually, the Ontario Medical Association is at Queen’s Park today. They came with three asks. The first was to ask for integrated primary health care teams. They all want to work in an integrated, interdisciplinary team. That means a community health centre. That means Indigenous primary health care. That means nurse-practitioner-led clinics. That means family health teams. That means a place where a physician is not a fee-for-service solo practitioner anymore. They are supported by nurse practitioners, nurses, dietitians, social workers, physiotherapists, psychotherapists, development workers and health promoters who work as part of a team so that they can focus on being a family physician and have the support of the integrated, multidisciplinary team to work with them. That was their number 1.

Number 2: Decrease the amount of paperwork that they have to do. We still have to go to a family physician three days after we feel better to ask them to sign a sick note; it is a capital waste of resources and we could do away with it. An electronic health record that works would be really good.

Then, number 3 of their recommendations to us is home care. They want a strong and robust home care system that meets the needs of the patients, that meets the needs of the patients where they are. Those care coordinators should be available to most integrated primary care teams, but they are not.

We all know that the government has dedicated $30 million to new integrated primary health care teams. We expect those 17 teams to be announced any time now. Well, Ontario has 15 million people. What do you want 17 teams to do? We need 25 times that amount. In the northeast alone, we could use that $30 million and those 17 teams, never mind the rest of the province.

Just to put an emphasis as to how important home care is, you have a group of physicians represented by their association. The Ontario Medical Association represents 42,000 physicians, and what are they asking us for? They’re asking us to fix home care so that they know that if their patient needs somebody to help them transfer from their bed to their wheelchair, or somebody needs help to transfer into the tub or onto the toilet, or needs help with feeding themselves or changing beds or whatever, the service will be there. This is what their patients want. This is what the OMA and their 42,000 members came to Queen’s Park to tell us, but none of that is in the bill.

The bill talks about basically creating province-wide home care, Ontario Health atHome, and then that would be responsible for procurement of home care services. Let me tell you that the inequality that you see—somebody who gets assessed and scores an 18, 20, 21 or 22 in my riding gets two baths a week. That’s all they have resources for. Somebody in Ottawa who gets assessed for a 21 or 22 will get a whole lot more. They will have one or two hours of home care a day. They will get two or three hours of respite per day for their family caregiver.

It’s not because the people in the north don’t know that the need is there; it’s because there is no money. If you look at the home care and support services, some of those agencies—not on the home care side, but on the support services side—there are still lots of not-for-profit agencies that do that work. They haven’t seen a base budget increase in 12 years. That is when the Liberals were in power. For the last five and a half years that we’ve had a PC government in power—they have not seen a base budget increase for 12 years. Has the demand for their services increased during that period of time? Absolutely. Has the cost of providing those services increased during that period of time? Absolutely. Have they seen any of this actually acted upon by government after government? Absolutely not.

And now we see a bill—there is money in the bill, $122.2 million, that would be to help the teams learn to work together. There’s nothing wrong with helping teams work together, but that doesn’t provide one hour of home care to anybody who needs it. That does not provide one extra bath a week to people who would like to have more than two baths a week, because they know full well that for at least one of those two, the PSW is not going to be able to show up. Having one bath a week—I couldn’t live like that; I can guarantee you that. Why are we asking frail elderly people and people who need home care to live like this? Why aren’t we able to show them respect? Why aren’t we able to meet the needs where they are? This is what people are asking for.

The minister also talks about new models of care. So rather than being paid for—you get 50 bucks to send a PSW for one visit to Mrs. Such-and-Such to do whatever needs to be done—usually a bath—and leave, and Bayshore gets 50 bucks, the PSW gets $8.50, and end of story.

Now there’s what they call care bundles. A lot of people have heard about total knee surgery. A lot of people have heard about total hip replacement, total knee replacement. The care afterward is being standardized. After you have a hip replacement, we know that you will need somebody to come and change your dressing. For a hip replacement, you used to have to stay in the hospital for 10 days, then you stayed in the hospital for seven days, then you stayed in the hospital for four days, then you stayed in the hospital for two days. Now you go home that day—yay! Nobody wants to stay in the hospital. You go home with home care. So we know that you will need somebody to come and change your dressing. We know that you will need access to a physiotherapist so that you regain strength, balance and range of motion. We know that you will need support from a PSW to make sure that you do your transfer in and out of bed, to the toilet, to the bath etc. Now they bundle that care together.

So now Bayshore will get an amount of money to look after you after a total hip replacement or total knee replacement that includes that we will have at least four visits by the nurse, three visits by the physiotherapist and 10 visits by the PSW to look after you as a care bundle after you have your hip replacement. That all makes sense. The first visit, the physio will do the assessment; after the second, we’ll make sure your range of motion is coming; and by the third, make sure the strength and balance is back. The nurse will go make sure that you’ve had the dressing changed, make sure that the staples came out when they were supposed to come out. The PSW will be there to help you with your bath while you have a big bandage on your hip, blah blah blah. It all works—on paper. Bayshore gets paid to do all of that.

How much of that do they deliver? Very little. How many people who were put through the bundle process actually got what the bundle was supposed to include? Very little.

Did you know, Speaker, that 25% of the people who have a hip replacement will never walk again if they don’t have access to physiotherapy? Let that sink in. We do those expensive surgeries so that people can continue to be active, and 25% of them won’t be able to walk again—never mind going up and down the stairs or on an incline or on uneven ground—if they don’t have access to physiotherapy.

But, coming back to Bayshore, who now gets a bundle of money to offer the four visits from the nurses, the three visits from the physio, the 10 visits from the PSW, because this is what you need to make a good recovery from your hip replacement—well, they had one physiotherapist, but she has been on maternity leave for the last two months, with a brand new, very cute little baby, and is not available to work. The nurse never came to change the dressing. The stitches got infected. You had to be admitted back into the hospital and treated because we were afraid you were going to get septic because your stitches were badly infected because the nurse never came to change the bandages. And the PSW did come some of the time. She was not supposed to change the dressing. She ended up lifting the dressing because it didn’t look too good and had been there too long, and she’s the one who said you had to go back to the hospital really quickly. Bayshore got the money for the bundle of care.

This is supposed to be the innovation that comes from this new way of providing home care, but this innovation has already been tried here in Ontario. But because we have for-profit companies who dominate the home care system, the for-profit companies’ number one objective is to make money. They exist to make money for their shareholders—and they do, in the hundreds of millions of dollars for their shareholders, at the expense of not being able to recruit and retain a stable workforce because they don’t provide good enough jobs to allow PSWs to pay their rent and feed their kids.

Interjection: So out of touch.

C’est un plaisir de continuer le débat avec la députée de Nickel Belt.

Ce projet de loi devant nous propose de remplacer des réseaux locaux d’intégration de services avec un nouvel organisme. Le nouvel organisme s’appelle Santé à domicile Ontario. C’est quelque chose qui a été demandé par des professionnels : de remplacer les réseaux locaux d’intégration de services avec quelque chose de nouveau.

Est-ce que la députée est d’accord avec les professionnels qui veulent remplacer les réseaux locaux? Est-ce qu’elle est d’accord avec ces professionnels?

Thank you so much to the member for Nickel Belt for those remarks. I don’t think there’s a person in the House who understands our health care system better than the member for Nickel Belt. The government would do well to listen to her.

I’ve been speaking with organizations in Ottawa West–Nepean that are providing not-for-profit home care and community care services—Carefor, the Olde Forge Community Resource Centre, Jewish Family Services, Meals on Wheels—and all of them are struggling so much due to the underfunding of these home care and community care services by this government. They are struggling because, yes, the government promised additional funding but then hasn’t delivered it, so they are bleeding money every single month, waiting for this money to actually flow. They are losing staff every month because they can no longer compete with other sectors. The staff feel like they are being asked to do the impossible, to fill in the gaps of the social safety net this government has broadened.

My question to the member from Nickel Belt is why should anybody trust this government’s changes on home care and community care when they’ve done such a bad job managing the system to date?

The member opposite who asked the question, the member from Nickel Belt, whom I respect a great deal, who has been here for 16 years, knows that not everything is in each bill. We don’t do that. We don’t reiterate all the promises in every bill and discuss everything at once. So it’s kind of a disingenuous question, I think.

Interjection.

We know we have more work to do, but part of what we’re doing here with this bill, with Ontario health teams and with the expansion of interprofessional primary care teams, is making sure that the care is provided within the integrated context of a team so that the PSWs can have better schedules, can be part of a team, can have people to talk to, can talk to the nurse or the doctor or the other care providers and be part of a team and not be isolated. So, it’s not just about the money for the PSWs. That’s part of it for sure and that’s why we raised wages, but it’s also about better work conditions.

Everybody wants to make sure when they need home care that it’s going to be there when they need it. We all want that. I have constituents too who want to make sure it’s there. We want to deliver it for them. That’s what this is about.