We welcome this opportunity to participate in the review of the competitive bidding process and to convey the views and recommendations of Ontario’s registered nurses. In announcing the review, the Minister stated:
It is important for people receiving home care services to know they are getting the highest quality services possible. There are significant concerns that the scale of contract changeovers is causing instability in the home-care labour force and in the homes of patients. This review will look at how the process is working for patients and how it can be improved to ensure a consistently high level of care.
We believe these and other statements provide Ms Caplan with the opportunity to use a broad approach to reviewing how to secure quality of care, restore a vibrant workforce, and ensure value for money in home-care services.
In this brief, we provide an overview of home health care nursing practice, describe the impact of competitive bidding on home care, including increased for-profit delivery and financial and other costs associated with contract turnover, and outline the impact of competitive bidding on human resources issues.
We argue that competitive bidding is an ineffective method of allocating health care services, and urge the review to recommend moving to another method of allocating these services. However, should Ms Caplan recommend that the competitive bidding process continue, we have made a number of recommendations that will shift its focus away from price and toward quality and continuity of care and caregivers.