Parliament shuts down, election looms — without action on long-term care

Parliament Hill is in its annual frenzy to clear the decks before closing down for the summer on Wednesday. And, with a fall election in the air, MPs who are not planning to run again are delivering farewell speeches (at last count, 19 of them).

Many Liberal promises are in limbo. If the summer break ends in an election, unkept promises will be wiped off the slate.

This, I fear, will be the fate of the promise that Prime Minister Justin Trudeau made last September — to work with the provinces to establish national standards for long-term care, enforceable standards to prevent another crisis like the one wrought by COVID-19.

There has been a proliferation of reports, federal and provincial, on why the LTC crisis occurred and how it could have been avoided — more reports than any one person could be expected to read.

However, there is a compact analysis, published on May 28, that pulls the pertinent information into one report and supplements its sobering statistics with short eyewitness observations of the appalling conditions in some homes, along with comments drawn from 94 Zoom and telephone interviews.

Titled “From Cruddiness to Catastrophe: COVID-19 and Longterm Care in Ontario,” the paper is the work of Dr. Ellen Badone, a professor of anthropology at McMaster University.

Although her focus is Ontario, she put the province’s experience in a

Canada-wide context, noting that 80 per cent of the country’s deaths in the pandemic’s first wave in 2020 occurred in LTC homes.

In Ontario, in the second wave — between Sept. 1, 2020 and Jan. 14, 2021 — 7,090 residents contracted COVID-19 and 1,237 of them died.

The federal legislation, the Canada Health Act (CHA), does not provide insurance coverage for longterm residential care or social services for people unable to care for themselves.

As Badone notes, the provinces go their own way, each permitting a mix of private and public ownership and funding of LTC facilities — “There are no national standards for the provision of long-term care, although since the beginning of the COVID-19 pandemic, there have been calls for such standards, or for the inclusion of long-term care in the CHA ...

“The high percentage of Canadians who have died from COVID-19 in long-term care, and the deplorable conditions in some facilities during the pandemic have generated shock and outrage among Canadians. ‘This is Canada!’ was a phrase that echoed in my interviews, implying that ‘these types of things should not be happening here,’ and highlighting a breach of trust by the state due to its absence of oversight into long-term care.”

In Ontario, 58 per cent of the province’s 626 LTC homes are owned by for-profit operators. Low wages and understaffing are systemic.

The province recommends (but does not enforce) that patients, on average, receive a minimum of 4.1 hours of direct personal care per day; for-profit chains average 2.63 hours.

Government cutbacks are another problem. Prior to Mike Harris’s “Common Sense Revolution” two decades ago, all LTC homes were subjected to annual unannounced inspections of three-to-seven days’ duration.

Premier Harris scrapped those intense inspections. Still, provincial inspectors visited nearly all homes once a year as recently as 2017.

That changed in 2018, the year the Doug Ford Conservatives took office; only half of the homes were inspected that year. In 2019, only nine (of the 626) were given thorough inspections.

The corporatization of long-term care is not unique to Ontario. It is a Canada-wide issue.

As Badone reports, in 2020, 40 per cent of the directors of the country’s four largest chains came from the real estate business, 17 per cent from finance, 14 per cent from private health or pharmaceutical organizations, and only nine per cent were certified health-care professionals (e.g. doctors or nurses).

Long-term care is evolving from a public service to a lucrative business. That, to borrow the professor’s words, is “breach of trust” — a breach for which the prime minister and premiers are responsible.

The corporatization of long-term care is not unique to Ontario.

It is a Canada-wide issue