Almost Home: Reforming Home and Community Care in Ontario

[Rae]'s NDP government envisioned a more drastic change to the system. They proposed the creation of quasi-governmental organizations which would replace existing service providers. These organizations would serve to assess, manage, and provide direct service to citizens. As a concession to exi...

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Bibliographic Details
Published in:Labour 2006, Vol.57 (57), p.211-214
Main Author: Sussman, Tamara
Format: Review
Language:English
Subjects:
Baranek, Patricia M
Canada
Canada Health Act
Community care
Community health care
Deber, Raisa B
Government
Health care delivery
Health care policy
History
Home
Home health care
Long term health care
Managed competition
Nonfiction
Nonprofit organizations
Ontario
Reviews/Comptes Rendus
Social reform
Stakeholders
Williams, A Paul
Online Access:Get full text
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Summary:[Rae]'s NDP government envisioned a more drastic change to the system. They proposed the creation of quasi-governmental organizations which would replace existing service providers. These organizations would serve to assess, manage, and provide direct service to citizens. As a concession to existing service providers the Multi Service Agencies [MSAs] would be entitled to contract 20 per cent of services to outside agencies, preferably to not-for-profit service providers. Further, the government drafted and eventually passed the Long-Term Care Act (1994) which officially governed over community services, nursing home services, and home care services. Although the NDP did succeed in passing the legislation, they met more resistance than the Liberal government. One reason was that community organizations had formed a provincial association and had been given some funding from the government to consider alternate delivery models. Another was that for-profit and not-for-profit providers found themselves jointly opposed to these changes. The authors emphasize that divergent interests still existed among hospital-based workers and home-based workers. With pending hospital cuts, displaced hospital workers would be competing with community workers for employment in the new MSAs. They suggest that these competing interests interfered with lobbying efforts. In the end, the Long-Term Care Act was successfully passed but the MSAs were not established because the government lost the subsequent election. The authors highlight that this NDP term represents another example of a "loosely" organized policy environment. However, their analysis also provides evidence of a mobilization effort which delayed program implementation and required the government to offer concessions. More attention to the "exception" of this case may have provided useful insight into how communities can impact upon policy.
ISSN:0700-3862
1911-4842