Politics Blog: With long-term care, we can’t just return to “normal”

Toronto – June 5, 2020 – As provinces start to lift restrictions and reopen parts of the economy, many have been saying that after COVID-19, we can’t just return to “normal.” NDP Leader Jagmeet Singh pointed out that normal was workers without paid sick leave, families struggling to get by, people essential to our health and safety unable to make ends meet, and a health care system starved of funding. “We need to do better than normal,” said Singh.

One issue that has clearly illustrated that we must do better than normal is the crisis in long-term care (LTC). Things have gotten so bad in this sector that the Canadian military was called in to help run LTC homes in Ontario and Quebec. The recent report by the military on the conditions witnessed in these homes helped expose serious problems in our long-term care system, but these issues were around long before the COVID-19 pandemic. For far too long, activists, workers, and their unions have sounded the alarm on the serious deficiencies in long-term care, but in most cases their concerns have fallen on deaf ears.

Over 80 percent of deaths related to COVID-19 in Canada are linked to outbreaks at LTC facilities, with private, for-profit facilities experiencing 4 times as many deaths as non-profit homes. The shift over time to more and more privatization in the LTC sector is one of the leading causes of the crisis we are facing today. Since the late 1980s and early 1990s, governments have opened the system to further privatization, to the point where today over 50 percent of Canada’s LTC system is run by for-profit operators.

A report from the British Columbia Office of the Seniors Advocate found that between 2016 to 2018, not-for-profit homes spent 59 percent of their revenues on direct care for residents, while for-profit homes spent 49 percent of revenues on such care. In the same period, for-profit homes generated 12 times the profit produced by non-profit homes, raking in over $34.4 million in profits compared to $2.8 million for non-profit facilities, which spent an average of $10,000 more on care for each resident. For-profit homes failed to deliver over 200,000 hours of funded direct care, while non-profit homes exceeded direct care targets delivering an additional 80,000 direct care hours beyond what they were publicly funded for.

For-profit homes are in the business of making profits for their shareholders. Worse, out of the 35 individuals who serve on the Board of Directors of the four largest for-profit LTC chains in Canada, only three are certified health care professionals. For-profit providers have treated long-term care homes as housing stock, instead of focusing on care, in part because 40 percent of the directors are real estate developers. For-profit has also negatively impacted working conditions and quality of service, with an emphasis on efficiencies like more casual and part-time staff and contracting out food delivery and housekeeping. Most importantly, for-profit homes constantly face a conflict between investing in resident care or increasing shareholder profits, and it is the shareholders who consistently win this battle.

The for-profit LTC providers are also a powerful lobby group. In Ontario, former Conservative premier Mike Harris is the Board Chair of the largest for-profit provider in the province. James Shlegal, CEO of a for-profit chain, is a leading member of the province’s Incident Management System for LTC. Conservative staffers and Doug Ford allies have also recently signed up to lobby on behalf of these providers, with a focus on protecting profits.

Provincial governments have been slow to respond to the crisis in LTC, except in British Columbia. The B.C. NDP government acted quickly when COVID-19 outbreaks first began.  For starters, the provincial government took over the operation of all homes. They required workers to work at one site only and committed to full-time hours for these workers. They also significantly raised the wages of many workers by guaranteeing that all employees would be paid the unionized industry standard rate. This helped the province lessen the impact of COVID-19 in long-term care. Meanwhile, Quebec and Ontario were slow to react and now face the largest outbreaks in the country and the most deaths linked to the virus.

For years, activists, workers, unions, and opposition parties have raised the serious issues faced by the LTC sector. Low pay, casual and part-time work, and few if any benefits have forced many LTC employees to work at numerous homes. Meanwhile, a lack of personal protective equipment (PPE), workplace safety, and insufficient infection control have all contributed to the spread of COVID-19 in LTC homes. In Ontario, the NDP have repeatedly introduced private member’s bills to guarantee a minimum number of hours of care in homes, only to be rejected by Liberal and Conservative governments. And Doug Ford’s government has almost completely eliminated unannounced inspections of homes.

The long-term care of our seniors should not be in the hands of profiteers. “We must put an end to privatized facilities and establish a universal framework for seniors care,” Jagmeet Singh recently stated. “We must bring long-term care under the Canada Health Act, make it federally regulated, and do away with the private system all together,” he added.

The for-profit providers and others will lobby and fight to keep the system the way it is so that they can continue to profit off the backs of seniors. But we must fight back and ensure that profit never takes precedence when it comes to how we care for our seniors.