A recent survey of Ontario Health atHome, OH atHome, community and in-home care coordinators, team assistants and system planners, represented by CUPE points to a health system restructuring that is failing to solve care and access gaps while deepening health service privatization. All these factors are further demoralizing staff who are dealing with increasing workloads and mounting concerns of losing their job.

Taken as a whole, the survey gives insights into the now all too frequent stories from patients and their families about medication, supply and staffing shortages plaguing the home and community care sector.

Overall, 1052 respondents completed the survey, and hundreds took the time to write in thousands of comments about how the system changes are impacting them at work and in their lives. Respondents report very significant frustration with the ongoing restructuring and the uncertainty it creates. Workplace stress, overwork, and a lack of clear management communication were frequent themes. A recurring theme among those who had worked in the field for years was that they have never seen things this bad in the sector.

Brett Geneau, a team assistant from eastern Ontario says “many on the front-lines are frustrated by the endless changes, secrecy and increasing workload. They feel defeated, undervalued. Constantly, we are learning new processes that get changed the next month, so it is very difficult to keep pace with the changes and what managers are telling us what they actually want done. The impact on both patient care and OH atHome staff is adverse, not what this government wants Ontarians to believe.”

The survey findings (https://oh-home.cupe.ca/) include the following:

  • 74% say workload has increased since the merger into OH atHome;
  • A very high percentage of respondents (84%) are concerned about whether they will have their job in the future;
  • 62% identify staff retention as a problem;
  • 65% say they are concerned about increasing privatization.

“We think that with the sceptre of U.S. tariffs looming and an early provincial election imminent a distracted Premier is missing the instability and uncertainty that years of health system restructuring has brought. There’s a gradual drip, drip of our work being transferred to other agencies that are for-profit, and it is very unclear what our roles will be in the future or even if we will have jobs. We are mostly a female workforce and the way we are being treated would never happen in a male dominated workplace,” says Maxine Laing, a team assistant in the Halton Peel area.

Issues cited in the survey include work being taken over by the contracted service provider organizations, known as SPOs. Others mention the growing role of hospitals, which are themselves struggling to provide adequate patient care under severe underfunding.

“The lack of information from OH atHome about future restructuring plans is a big concern. Despite management and government’s talk about “transparency” we are seeing the opposite on the front-lines. Many say the Ford government is committed to health care privatization, and there is tremendous fear for the loss of our jobs,” says Lorna Shipley a team assistant with Central East Ontario Health atHome.

Over one-half of the survey respondents were team assistants and almost one-quarter were care coordinators. Other small, but significant occupational groups were in finance (2.5%), administration (5.1%) and IT (3.3%). Just over 11% reported other occupations.

Ontario is undergoing the fifth home care restructuring since the last PC government privatized home care. None of these attempts have ended the basic problems that come with compulsory contracting out: low wages, bad working conditions, high staff turnover, and staffing shortages.