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There's a reason non-profit home care in Ontario can be just as bad as the for-profits. From 1996-2004 and 2007-8, public home care (HC) contracts were awarded to lowest bidder. Non-profits competed with for-profits, driving down care and labour standards. https://www.cbc.ca/news/canada/toronto/covid-home-care-seniors-1.5870541?fbclid=IwAR3C26NX_TNi6NhbHBA-C8a7cTCGn0DwlfXPhuN-mPOkEE14DuJ8_GYhSdU
Here's more of the story: HC in Ontario began its great expansion in 1990s as 15,000 hospital beds were cut between 1990 and 2000. To set the parameters of growing sector, the NDP's 1994 HC reforms froze and capped the for-profits at 10% market share, and empowered non-profits.
But NDP reforms were gone in 2 years. Harris lifted the cap and instituted a lowest-bid contracting model. In a race to the bottom, a feeding frenzy for public money drove down standards. The for-profits grew their share of Ontario HC market from 18% to 64% between 1995 and 2011.
Non-profits had to adapt or die. To win contracts they had to adopt the methods of their for-profit competitors: speed-ups, thinning benefits, wage suppression, management by stress, cost-cutting, anti-unionism + lobbying for subsidies, less regulation, more managerial powers.
In the 25 years since Premier Mike Harris initiated the lowest-bid contracting of home care services, the management techniques and personnel of the non-profits have become almost indistinguishable from the for-profits (with some exceptions).
For-profits have also concentrated and centralized. Between 2012 and 2014, the large non-profit Red Cross was absorbed under ownership for-profit CarePartners. In 2015, ParaMed (a subsidiary of Extendicare) bought Revera Home Health.
As with the expansion of for-profit long-term care, the expansion of for-profit HC has resulted in a powerful business lobby calling the shots. It is a sector where the province tops up paltry PSW wages (about 75% of HC workers) while companies pocket public money as profit.
The HC lobby, like its sister LTC lobby, is integrated (as staffers and bureaucrats) into the Ontario Liberal and PC parties. Non-profit and for-profit HC companies + company union CLAC are also linked to the Ontario PSW Assoc - a troublesome 5th column among HC and LTC workers.
There's also no sign Ford's new Ontario Health Teams responsible for HC coordination will be freed from the means-tested austerity constraints of their predecessor LHINs and CCACs. In fact, Bill 175 passed in the summer removes even more public control. https://www.rankandfile.ca/ford-government-moving-ahead-with-home-care-privatization-bill/
A strategy and policy for 100% public home care in Ontario means wiping out the HC profiteers, and ending the brutal means-tested austerity of the LHINs and OHTs. But what to do about the non-profits?
The non-profits should be dissolved into a public system, not least because of their destructive corporatization. Furthermore, the for-profits will do all they can to build public support for the non-profits as a means of derailing any 100% public system. They all gotta go.
