Home-care program thought to be $5.6M over budget highlights P.E.I. union's privatization fears
'I think that's a prime example of privatization,' says UPSE executive director
The P.E.I. Union of Public Sector Employees is raising concerns about a home-care program that it says is an example of health-care privatization — and seems to be millions of dollars over budget.
It's called the Self-Managed Care Program. According to a Health P.E.I. client handbook obtained by UPSE, it's designed to provide funding for private support at home for seniors with needs that make them eligible for long-term care.
That raises a red flag with UPSE executive director Jason Rendell.
"I think that's a prime example of privatization," he told CBC News.
"This was an existing public service that was offered through the home-care support program ... In addition to that, the individuals that actually work underneath home care, which [are] our members, are being advised that they ... can't work for these private entities, therefore taking our work away."
Finding out about the program is challenging too, he said.
"There's nothing on the website," he said.
"The biggest concern, basically, would be the quality of care that people are getting... We just feel that the service should be provided through the public [system], where again, I said before, there's accountability, transparency and trained, quality care."
In a statement to CBC News, Health P.E.I. said the program is a pilot meant to "complement the suite of programs helping Islanders who are eligible for long-term care stay in their home as long as possible."
The agency said clients can secure respite and personal care from relatives not living at the same address, from friends or from private-hire care supports.
"It also allows clients to decide for themselves the nature and timing of care that suits them — even in the evenings and overnight hours when home care isn't available," said the statement.
There just appears that there's a trend moving toward privatization — and it's concerning for unions as a whole.— Jason Rendell
In January 2025, the union filed a freedom of information request with Health P.E.I. seeking information about the program.
The information provided by Health P.E.I. says the "forecasted spending for the Self-Managed Care Program for the [fiscal year] 2024- 2025 is $350,000."
However, another document with information taken from Health P.E.I.'s third-quarter forecast for 2024-2025 says the "forecasted spending for the Self-Managed Care Program and the Long-Term Care at Home Program for the [fiscal year] 2024-2025 is $6,015,941."
In an email to CBC News, Health P.E.I. said those numbers are estimates, since the final expenditures will not be available until about mid-April.
UPSE points out in its news release that this money is funding around 113 clients and could have been used elsewhere. For example, it said, had that money been invested into P.E.I.'s publicly funded home-care program, more than 100 full-time, trained home-support workers could have been hired.
Home-care programs supported
The Island has previously struggled with a shortage of beds in long-term care facilities, both in the government system and in the publicly supported private system. Because of that, seniors have occasionally ended up waiting in hospital beds, which are in short supply too.
Health P.E.I. said demand for the pilot project has been very high, and home care is playing an important role in helping to ease the demand for long-term care beds.
The highly skilled staff of the Provincial Home Care Program are an important part of the team helping Islanders age at home. The Self-Managed Care Program in no way diminishes or replaces their valuable contribution.— Health P.E.I.
"More than a quarter of clients were approved to the Self-Managed Care Program to facilitate hospital discharge, contributing to improved system access and flow while promoting patient and family-centred care," the statement said.
UPSE also supports Island residents being able to age in their homes, if possible. That's not only because it can be better for the health-care system, the union said, but also because it can be more comfortable for the seniors themselves.
Where the two organizations differ is on who should be able to deliver that service: Private employees, public ones, or both?
"The highly skilled staff of the Provincial Home Care Program are an important part of the team helping Islanders age at home," said Health P.E.I. "The Self-Managed Care Program in no way diminishes or replaces their valuable contribution."
But UPSE said it worries that continuing down what it calls a "privatization path" will create a two-tiered health system that only some people can access.
"Only thing that we're advocating for would be for individuals to be cared for through the public service," said Rendell. "There just appears that there's a trend moving toward privatization — and it's concerning for unions as a whole."