As the Federal and Provincial governments embark on a program to reduce daycare costs to parents in Nova Scotia we need to develop the policy to obtain the best mix of public and private organizations to deliver the early childhood care that provides the most benefit for our children.
Childhood care resources
The decision of Michael Godsey, a contributing writer for The Atlantic and an English teacher based in San Luis Obispo, California, to work as a Public-School Teacher but send his daughter to a Private School has parallels to decisions that parents make about placing children in daycare. The large number of students in the public high school seems to reduce the likelihood of teaching a love of learning in contrast to the private school where it can be observed in the attitude of the students.
Public schools have my tax money, my lifelong employment, and almost anything else they need of me; pulling my daughter—one student—out of the system is probably the least of its worries. And on a more abstract level, the above criticisms fail to acknowledge the cumbersome, almost fixed nature of the dominant culture I’ve seen at public schools—one that occasionally isolates students who love learning, are teased by the "cool" kids and even bullied into joining the masses. No matter how much she voluntarily recites Shakespeare, the student I envision my daughter becoming would never be able to single-handedly transform a public school into an environment that is cool to learning.1
The important learning of preschoolers is in their play. The Arrive web site provides information to newcomers about daily life in Canada. Regulated family child care (home child care – provided in caregiver’s home) in several provinces, is “approved” rather than regulated. Most family child care is not regulated, monitored or approved. No province/territory requires all family child care homes to be regulated, so long as they don’t exceed the maximum number of children.
Helen Ward, President of Kids First Parents Association, advocates that If we want to help families afford child care, then we should fund families and not certain types of child care.
Is the federal $10-a-day child-care system the only valid option for Ontario? No, says Helen Ward, President of Kids First Parents Association. If you want to help families afford child care, then fund families, not certain types of child care. #childcare https://t.co/yYBW7MJX27
— Cardus (@cardusca) January 20, 2022
Preston Mulligan, of CBC News, reports that some daycare owners say they feel bullied and backed into a corner by the province.
Adam Axworthy of Axworthy and Associates provides accounting services to two daycares in the Yarmouth region and two more in Cape Breton. He said they've all reached out to him for some kind of guidance about how to respond to the governments' demands. "We are in a time where we should be embracing equality and pushing female entrepreneurship," he said. "We shouldn't be restricting it, and we certainly should give them the decency of adequate answers to form an opinion. We haven't done that here. "There is so much of a push federally, at the moment, for female entrepreneurship and equality. I find this to be quite … an affront to that." Marcia Nickerson, who started Allegro child-care centre in Halifax 25 years ago, said she has other concerns about the proposal. While she supports a more generous subsidy for child care, she said this approach "institutionalizes" child care.3
In research published by Dani Filc, Alon Rasooly, and Nadav Davidovitch in the Israel Journal of Health Policy Research, looks at lessons to be learned from public vs. private to public/private mix in Israeli and Spain.
In support of private provision of healthcare, some researchers [13] claim that private provision allows for a more efficient utilization of resources. For example, operating room utilization in the private healthcare system is perceived as more efficient compared to such in the public healthcare system. However, numerous studies have shown that the patient composition in those two systems is entirely different [14,15,16,17]. Compared with their counterparts in the public sector, patients receiving private elective surgeries are younger, have less comorbidities, and are from a higher socioeconomic class. This widespread difference has led researchers to claim that the apparent efficiency advantage of private provision is related to “cream skimming” patients according to their risk [17,18,19,20]. Beyond the adverse outcomes concerning equity and the doubtful gains in efficiency, private provision and finance of healthcare can result in unnecessary, and sometimes harmful, cases of overtreatment. A systematic review of 21 studies [21] found that the odds of a Caesarean section (C-section) being performed was significantly higher in relation to women with private health insurance compared with women using public health insurance. In Chile, for example, three out of four publicly insured women who opt to give birth in a private hospital will have a C-section, while in public hospitals only one out of four women will undergo this procedure [22, 23]. Mixed-methods studies suggest that private obstetricians have women undergo non-medical C-sections since this procedure is more lucrative for the private practitioner and allows the “programing” (scheduling) of births [23, 24]. Evidence from Spain and Israel indicates that mixed provision of private and public services does not necessary lead to better performance, while harming equitable access and provision of health services.4
Stella Creasy, Labour MP for Walthamstow UK, offers the opinion that waiting lists must not be a pretext for privatising the National Health Service.
Patients need to have confidence that if they are referred to a private provider, it is in their interests, not their consultant’s. So, too, that any delay does not reflect the cost of treatment. A constituent who was booked in for urgent NHS cancer surgery at a hospital run by a major healthcare firm just before Christmas had the surgery cancelled at the last minute. They were told that this was because the facilities were needed for private – and so likely more lucrative – patients. This incident, and the pressures behind it, should concern anyone who understands that the NHS will only thrive if it is medical urgency, and not money, that drives decisions. Ministers may argue that more than 300,000 people left waiting more than a year for surgery is a side-effect of the pandemic, but lists have been creeping up for years. Rather than invest in NHS capacity, recent years have seen a conscious decision to divert funding to profit-making private healthcare companies. Without more scrutiny, this could see healthcare outcomes shaped not by need but whether you have the money to jump the queue, with taxpayers and patients alike paying the price.5
The struggle to provide the highest quality health care and early childhood education by publicly funded organizations is to equip the public institutions with more highly qualified personnel to deliver the services. Continued neglect to properly fund public education and health by neoliberal governments not only establishes two tier care but ultimately increases the cost to society in poorer educational development and more serious illness treatment.
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