I hate it when the government of the day uses sleight of hand to present service cuts as service improvements. And I hate it even more when that sleight of hand affects a vulnerable population.

If you had listened carefully recently, the Minister of Health made a major funding announcement touting increased access to physiotherapy services, exercise and falls prevention classes in long term care homes and communities.

What the minister did not say was that those same services would be withdrawn from where they were currently being provided in retirement homes. Not only that, she did not say that the actual service provision of physiotherapy services in long term care homes was being cut by 50%.

What I am about to say is somewhat self-serving. My spouse is a physiotherapist. My parents live in a retirement home and have received physiotherapy service right where they live, to their great benefit.

Currently physiotherapy services are provided to seniors in retirement and long term care homes, funded directly by OHIP. Those institutions have found it more expedient to contract for services to private companies, who employ physiotherapists and physio aides to do assessments, treat residents and lead exercise classes. They provide many services to residents on an ongoing basis.

Research has shown that if you keep people active, their risk of falling is greatly decreased, their balance skill increases and their potential for serious medical complications such as breaking hips declines significantly. The required activity can be as little as three times a week for 30 minutes.

Does it make a difference?

Preventative medicine always does. With fewer falls, there are fewer hospitalizations required, saving our health care system precious dollars which can then be reassigned elsewhere.

As of August 1, those preventative strategies will be gone in retirement homes in Ontario and the level of service will be reduced in long term care homes. In fact, the number of visits to an individual in a long term care home has been cut in half.

So where will the money go?

It will be sent to the LHIN who will transfer it in something called a funding envelope, directly to long term care facilities, Family Health Teams, Nurse Practitioner clinics and Community Health Clinics. Those facilities will then have to hire their own staff. The CCAC (Community Care Access Centres) will also receive additional funding for physiotherapy, but only for people who are bedridden in their own homes or retirement homes, following a hospitalization or surgery, and only for a maximum of 12 visits.

What the government is doing, it appears, is reducing preventative services to seniors and changing the funding model in one step.

I will leave it to the financial wizards to determine if this is a cost effective method. But as a pastor who has visited lots of people in the hospital with broken hips over the years, I have to ask whether a switch from preventative care, with an emphasis on health and wellness, to a post accident care model is truly effective.

I also have to ask if moving physiotherapy services from retirement homes, where people live, to centralized locations such as Family Health Team offices, is just another attempt to shift costs to seniors on a limited or fixed income.

In Grey Bruce we have really poor transportation networks. Doesn’t bringing the therapist to the senior make more sense than asking every senior to come to a central clinic for service from a therapist, while having to pay for their own taxi or friend to transport them?

As I said, I am not an unbiased observer on this issue. I am deeply concerned that these changes to our health care system, which were less than transparent in their introduction, will have a negative impact on the health of our seniors. Perhaps there is room for both models of care. That is for others to figure out. But if we can reduce injuries through falls by prevention and early intervention close to home, isn’t that better than fixing a human body after it is broken?

Rev. David Shearman is the minister of Central Westside United Church, Owen Sound and the host of Faithworks on Rogers TV - Grey County, Cable 53.