Less access, increased privatization, new report finds
Despite the BC government’s recent $500 million injection of funding into the home and community care system, much remains to be done to provide adequate care for seniors and improve health care wait times for all British Columbians, says a new report released today.
While this is an important investment in improving staffing levels in residential care, it does not reverse 16 years of privatization, underfunding and declining access to home and community care services (home health services, assisted living and residential care), says the CCPA-BC report, Privatization and Declining Access to BC Seniors’ Care: An Urgent Call for Policy Change.
The report uses data obtained from the BC Ministry of Health and updates the state of access to home and residential care.
“For the past 16 years, underfunding, privatization and fragmentation of the system have left many seniors, their families and communities patching together care and even going without it,” said report author and CCPA-BC research associate Andrew Longhurst.
“This is not acceptable in a province as wealthy as ours, and it is the reason this report calls for urgent change in provincial policy direction,” he added.
BC seniors have less access to publicly funded home support today than in 2001, the report finds. And, access to residential care and assisted living spaces declined by 20 per cent between 2001-2016.
The report identifies four areas of concern:
Declining access to residential care and assisted living
- Between 2001 and 2016, access to residential care and assisted living spaces declined by 20 per cent measured as beds relative to the population of people 75 and over. There was reduced access in the province’s five health authorities.
Declining access to home health services
- BC’s seniors have less access to publicly funded home support today than in 2001. There was a 30-per-cent decline between 2001 and 2016, again with access falling in all five health authorities.
- Although more seniors receive home care services (nursing and rehabilitation) in BC compared to 16 years ago, on average, each client receives fewer visits with nursing and health science professionals.
Privatization and care quality
- Publicly funded residential care services delivered by for-profit businesses are increasing at a faster rate than those delivered in facilities operated by health authorities and non-profit organizations. The number of residential care beds operated by BC health authorities and non-profit organizations declined 11 per cent while beds in the for-profit sector increased 42 per cent between 2001 and 2016.
- Research shows ownership of residential care facilities affects quality of care and staffing levels, and that for-profit residential care is generally inferior to care delivered in public or non-profit facilities.
BC health care spending not keeping pace
- In 2001, BC ranked second in per capita provincial health care spending. By 2016, BC ranked eighth out of Canada’s ten provinces. BC also ranked last in average annual spending increases between 2001 and 2016.
“A well-funded and coordinated home and community care system allows seniors to live independent and healthy lives in their own homes and communities rather than being stuck in hospital,” said Longhurst. “Publicly funded home and community care services, available when seniors need them, reduce pressure on family members who often work full time and care for children and aging relatives.”
Increasing access to home and community care doesn’t just benefit seniors. It is widely acknowledged as a key solution to reduce hospital overcrowding and surgical wait times, resulting in better health outcomes for all British Columbians.
“Funding decisions are political choices that have real consequences on the availability and quality of seniors’ health care services,” said Longhurst. “Per capita provincial spending influences whether there will be improvements in the health of BC seniors and shorter wait times for all British Columbians.”
The report makes three recommendations to strengthen the system of home and community care in BC:
- Stop privatizing the home and community care system.
- Improve access to publicly funded home and community care provided by health authorities and non-profit organizations.
- Develop a home and community care framework and action plan to improve access and establish legislated standards including staffing levels.
The report updates four CCPA–BC reports (2000, 2005, 2009, 2012) that also showed declining access to home and community care services in BC.
By Jean Kavanagh, Director