Our team just learned that the Ministry of Health has taken a concerning approach that could embed for-profit interests in its new long-term care funding model. In a recent request for proposals, the Ministry plans to contract a private sector consultant to help create and implement the new funding model, rather than the public service developing the model itself.
Outsourcing to a private sector consultant risks giving for-profit long-term care operators a disproportionate voice in crafting the new funding model. A large corporate consultancy like KPMG, Deloitte, or Ernst & Young is likely to get this contract, which is itself a form of privatization. Many private sector consultants work for the for-profit industry, and may have a vested interest in developing a funding model that will be advantageous to for-profit long-term care operators.
But more importantly, private sector consultants are not accountable to the public, seniors or those working in long-term care. Their work is not based on public interest research or the evidence which has already been exhaustively conducted. They can influence which stakeholder voices are consulted and the transparency of the process. One prominent economist calls governments’ reliance on private sector consultants “the big con” because they harm democracy and the public interest.
For example, when the corporate consulting firm Ernst & Young was contracted to conduct a review of the Ministry of Health’s long-term care COVID-19 response, the process was criticized for its close ties to the for-profit long-term care industry and for failing to adequately engage health care workers and community. EY provided no explanation of how stakeholders were selected, and, when questioned, the private firm claimed it was “not able to comment on client work”. The Ministry of Health also declined to comment on the subject.
That's why one of the key elements of the new funding model we're advocating for is that it be co-developed with key stakeholders in the long-term care sector, including workers and their unions, resident and family councils and seniors organizations.
And we know the public is with us. When we sent out a survey last fall about priorities for long-term care funding reform, for-profit operators were ranked as the least important group to be involved in developing a new funding model, with only 30% of respondents saying it was very important to seek their input. In contrast, 75% or more of respondents said it was very important for not-for-profits, seniors, long-term care workers and their unions, and residents and their families to be involved.
We don't stand a chance to address the misuse of public funds and unchecked profit motives in long-term care if we ask the for-profit sector to design its own payment model.
In December, over 1,600 seniors, their loved ones, workers, and other British Columbians mailed postcards to Minister of Health Adrian Dix sharing their support for a new funding model. The postcards outline the criteria for a standardized funding model that adequately improves transparency and accountability for public funds:
- Require that funding for care be spent on care.
- Improve accuracy and transparency of reporting to keep operators accountable for publicly funded care hours.
- Ensure common employment conditions across the sector by standardizing wages, benefits and working conditions.
- Be co-developed with key stakeholders in the long-term care sector including workers and their unions, resident and family councils, and seniors organizations.
With this news, we learn that there is still a need to keep up the pressure, especially to ensure the right voices are engaged and the new model is not designed exclusively by the private for-profit sector.
We are renewing our call for Minister of Health Adrian Dix to fulfill his promise to bring in a new funding model that improves accuracy and transparency of reporting and ensures public funds intended for care are spent on care, not profits.