Quebec faces gray tsunami Home care: more private, less sustainable

In Quebec, 30% of home maintenance hours were performed by independent workers last year. According to experts, an event has been on the rise since 2015, which is not without implications for the quality of services provided to the public.

Ariane Lagorsier

Ariane Lagorsier

In some regions, more than 50% of housing assistance is provided by private sector employees, learned. Press. “It’s totally crazy to help the private sector so much,” says Natalie Dazil, director of restructuring. Especially if we know that agency staff are less stable. “

Former Health Minister Regina Hebert notes that home care budgets in Quebec have increased in recent years. But many healthcare companies, especially due to staff shortages, have “subcontracted to the private sector”. A situation he describes as “state deviation”.

Anne Plord, a postgraduate researcher at York University and the Institute for Socio-Economic Research and Information (IRIS), examined the annual financial statements of healthcare organizations in Quebec and found that 27% of hours worked by health and social service assistants (ASSS) in 2020-2021, or home care Equivalent to assistants of providing beneficiaries, carried out by independent workers. In 2015-2016, the rate was 20%.

This information shows that the government has left home assistance to the private sector.

Anne Plord, postgraduate researcher at the University of York and Institute for Socio-Economic Research and Information (IRIS)

The researcher, who plans to release all of his data in January, notes that this increase was already visible in 2019-2020 and therefore cannot be the only cause of the epidemic.

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73% of hours are worked by the private sector

At CIUSSS de l’Ouest-de-l’Île-de-Montréal, 49% of domestic assistance hours were worked by the private sector in 2020-2021, according to M dataMe Plot. CIUSSS de l’Ouest-de-l’Île-de-Montréal refers to “services that require medical or specialized expertise”, with very little support for independent labor. For example, less than 3% of nursing care is provided by private partners, according to CIUSSS spokeswoman Melanie Arrows. This confirms that the private sector is particularly active in “home support services such as morning and evening procedures” and that CIUSSS “provides quality and stability of service”.

At CISSS de la Montérégie-Ouest it is important to seek private housing assistance during the 73% of hours worked last year.

The situation did not surprise Simon Beaulieu, president of the local 3247 of the Canadian Public Employees Union (CUPE), which represents the region’s ASSS. “If they give that money to the public, we can care more,” he says. The CISSS de la Montérégie-Ouest says it has “almost doubled the number of home supports in recent years.” Of all domestic services, 34% of the hours are provided by independent workers. This rate reaches 10% for nurses, but 73% for ASSS. Spokesperson Jade Saint-Jean notes that CISS has recently released several home care ASSS positions and 50 patient assistant positions. There are “alternative measures” to reduce the use of freelance workers, he said.

Essential Partners

In the Ministry of Health and Social Services (MSSS), it is pointed out that if independent employees represent 27% of the working hours in domestic assistance, it would be less than all professional housing services. In nursing, 9% of hours were worked by the private sector. MMe However, Plord noted an upward trend: in 2015-2016, the rate was 3.4%.

MSSS includes private companies in the independent housing assistance staff, but also socio-economic organizations and community groups. Without these partners, “the public network alone will not be sufficient to provide all the services required”, MSSS indicates.

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Director of the Cooperation Network of Socio-Economic Institutions in Housing Assistance, J. As Benoit Karan points out, private companies in particular have recently increased their presence in housing assistance. For the past five years, the population of Quebec has been stable at about 100,000 people served by socio-economic organizations. Mr. Karon explains that socioeconomic firms are increasingly finding it difficult to compete with the private sector in calls for tenders. “I saw a case where a socio-economic firm bid for $ 25 an hour, while the private sector came in for $ 18 an hour,” he says.

Halein Growell, president of the Association of Private Companies for Nursing Employees in Quebec, promises that as the population ages, “the need for home care is increasing.” If MMe “Solutions must be found for the public network to be in better health,” Crawl believes, underscoring that “nature hates a vacuum” and that “agencies respond to government demands.” For meMe Even with gravel, drawing profit margins of 7% to 10%, the use of private companies does not cost more than the general public, especially since administrative costs are lower.

Impact on services

According to DR. “The principle of stability cannot be achieved with employment agencies,” said Rajian Hobart.

Photo wave Roberg, archiving pressure

D.R. Rajan Haybert, former Minister of Health

This can be done with socioeconomic institutions. But the private sector is for profit, which is incompatible with human care.

D.R. Rajan Haybert, former Minister of Health

“It is obvious that the use of independent workers increases employee income,” says Jeff Beckley, president of the Federation of Health and Social Services (FSSS-CSN).

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MMe Conversely, Gravel insists that companies, such as the network, must meet the requirements that control the movement of employees. He points out that of the entire health network, the private sector in Quebec provides only 3% of care. “We support the network,” he says.

Very concerned about the direction home care will take in Quebec, Mr. Karon asked the government to work on home maintenance for a few weeks. “Currently, Quebec is no more or less in the process of monetizing home care, we did the same as the shelter,” says Mr. Coron.

Read tomorrow: “Home Care: Caregivers Looking for Services”

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