Family Doctors Want to See a National Home Care Strategy

Posted by Steve Jones

Tue, Mar 17, 2015

Home care is important to Canadians. About 80% believe it is an expression of Canadian values. It is also usually less expensive than hospitalization or care in a long term care facility. Yet the Federal government has no national home care policy. A number of organizations are calling for a strategy to meet the home care needs of all Canadians. Two reports released last fall illustrate a growing discontent with the situation as it stands.

In September 2014 the Statistics Canada released a report titled Canadians with Unmet Home Care Needs underscoring the growing disparity between the needs of Canadians for home care and the resources available for home care. If you live in Ontario or have read a newpaper in the last six months, this is not exactly news.

The report identified a number of disturbing statistics:

• In 2010, the national average of healthcare spending per capita was $3,957. Of that, $159 was for home care.
• In 2012, 461,000 Canadians who needed home care for a chronic health condition did not receive it, and 331,000 received only part of what they needed.
• People with lower incomes tend to be in poorer physical and mental health and also are more likely to have unmet or partially-met needs, primarily because they cannot afford to pay privately for home care.
• Immigrants are also likely to have unmet needs for home care, possibly because they do not necessarily have a family and community network they can call on to provide care.
• Finally, a large portion of caregivers themselves (38%) have unmet home care needs, 35% of whom provide more than 10 hours of caregiving a week.

In November 2014, the College of Family Physicians of Canada (CFPC) published a set of recommendations to improve home care (as well as child and youth health, which is outside the scope of this blog).

CFPC is an organization of about 31,000 family physicians across the country. They want the healthcare system to focus less on care delivered in hospitals and long-term care facilities and more on home and community-based care. Such a strategy would give elders and those with chronic health conditions more independence and dignity by allowing them to live comfortably in familiar surroundings, participate in their communities and maximize the financial resources of the healthcare system.

The report urges the government to take these steps by 2016:

1. Establish a national Home Care Strategy by 2016. This strategy should include a set of standards to provide provinces and territories with benchmarks they can use to implement and improve home care services.
2. Develop meaningful indicators and effective measurement systems to verify the performance, quality, and accountability of home care programs across Canada.
3. Integrate continuous preventative care, effective management of chronic disease, and home care within the health care system, to reduce hospital admissions and shorten length-of-stays.
4. Prioritize provision of home care to strive for greater independence, dignity, and well-being.

The previous was quoted from the CFPC report, From Red to Green From Stop to Go.

While it is debatable whether a national strategy could achieve the goal of meeting all the home care needs of all Canadians, the debate could push both Federal and Provincial governments to reform home care strategies with more urgency, and perhaps even encourage more action, and less lip service. Public opinion can sometimes be a mighty influence on governmental action.