COVID-19 exposes gaps in for-profit long term care

Ontario Premier Doug Ford reduced inspections in long term care homes prior to COVID-19
Ontario Premier Doug Ford, part of the problem

There has been stunning news recently about hundreds of older people dying of COVID-19 in long-term care facilities (LTCs), most of them private, for-profit homes. In some cases those people had been left alone and drenched in their own urine and faeces.

This is absolutely shocking and unacceptable. Advocates for the frail elderly, and unions representing workers in those LTC homes which have unions, have been saying for years that government and corporate actions have undercut both the quality of care to residents and the health and safety of front line workers. It took the pandemic to break an already compromised system. In Canada, almost half of the approximately 1000 deaths from the virus as of April 14 occurred in LTC homes. In Ontario, where I live, as of April there were 14 COVID infections in 114 of 626 LTC facilities.

At a news conference, Ontario Premier Doug Ford looked shaken. He said, among other things, that he would make it illegal for individuals to work in more than one care home simultaneously, a situation which potentially allows the virus to either enter or leave the premises with those workers. But Ford has been a big part of the problem. Having people work in multiple locations has become commonplace primarily because the corporations that own for-profit LTC homes hire workers part-time so that they can pay them poorly and avoid providing benefits. Until now the Ford government has turned a blind eye to this. As well, the previous Liberal government was set to raise the minimum wage in Ontario, a move that would have helped many LTC  workers. Yet one of Ford’s first acts when elected in 2018 was to cancel that planned increase.

Much to answer for

Ford has much to answer for. The CBC reported on April 14 that in 2019 only nine of the province’s 626 LTC homes received a comprehensive resident quality inspection, or RQI. The CBC reviewed reports from the last five years for all LTC homes in the province. They found that most received RQIs in 2015, 2016 and 2017, but that number dropped to just over half in 2018 and to only nine in 2019. That means, to be blunt, that under Kathleen Wynne’s government there were a good number of comprehensive inspections, but Ford cancelled almost all of them. This kind of behaviour is nothing new for the Conservatives.

Corporate cronyism

Back in 2006, I did the wordsmithing for a report researched by The National Union of Public and General Employees (NUPGE). The report was called Dignity Denied: Long-Term Care & Canada’s Elderly. The document talked about a culture of political and corporate cronyism that was overtaking the LTC sector.  It was occurring throughout the country but was especially prominent in British Columbia, Alberta and Ontario.

Mike Harris, who was Ontario’s premier from 1995-2002, responded in 1998 to growing waiting LTC lists by announcing that more than $1 billion would be spent to create 20,000 new spaces. When the contracts were awarded for construction of beds, 68 per cent of them were handed to the private sector.  Three giant companies, Extendicare, Leisureworld and Central Park Lodges, received 40 per cent of the contracted spaces. The public was to pay for building facilities to be owned and operated by corporations to enrich their shareholders.

Provincial election finance records showed that between 1995 and 1999 for-profit LTC companies donated almost $340.000 to the Ontario Conservative party. That did not include thousands of dollars donated to the provincial leadership campaigns of Ernie Eves, Tony Clement and Jim Flaherty.

One of the biggest players in the private sector LTC field is Chartwell Retirement Residences. Mike Harris now sits comfortably as the chair of Chartwell’s board of directors and according to Unifor, another union in the sector, Harris pulls down $237,000 a year for this part time job. Meanwhile, Unifor, says the company pays only the minimum wage to many of its front line employees.

Better and safer

The 2006 NUPGE report says that the long term care model promoted by Harris drains the profits from care into the pockets of owners and shareholders.  The public sector model provides better care and keeps people safer than a for-profit system governed by the same market forces that motivate software developers, cable companies and fast food chains. Yet Harris and some other premiers consistently pushed privatization.

The major recommendation in NUPGE’s 2006 report was that long term care should be integrated into the Canada Health Act and become an insured service under the umbrella of Medicare. That would ensure that not-for-profit care is available to everyone, regardless of income, and it would also improve the safety and working conditions of front line LTC workers.

COVID 19 has exposed a shortcoming in a long term care system that should be there to protect the health and very lives of our beloved parents and grandparents. That has not been done and it’s time for change.

7 thoughts on “COVID-19 exposes gaps in for-profit long term care

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  1. Scandalous dereliction of our societal responsibility for vulnerable folks – thanks for setting the context, Dennis. I once worked as a “nursing assistant” in an extended care facility. I was always the only male on shift, surrounded by women almost exclusively from Jamaica and the Philippines…great, underpaid, committed caregivers…my heart goes out to these terrific people, as well as to the residents, today…

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  2. Long term care facilities have rightly become an issue of concern as COVID-19 threatens the health and safety of people living there. While it’s true that private long term care facilities have had the largest number of deaths, it’s also true that many public facilities have serious problems. The public facility where I live only recently stopped having part time PSW’s and only when the government made this demand. Part time PSW’s needed to work in more than one facility because of the very low salaries. But even with full time work, the workers in this public facility only received a 1 percent increase in income this year. One PSW commented to me that if her husband wasn’t also working, they’d have problems buying food and other essentials. I’m somewhat hopeful that all the media attention and the recognition that the staff in long term care facilities are ”essential workers” will bring some needed increase in salaries and benefits.

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  3. All good points Dennis. I have been reading the reports from both the Ontario and Quebec governments on Covid-19 cases and mortality rates. I was shocked to find that one consequence of the extraordinary mismanagement of Long Term Care in both provinces is the high percentage of deaths among residents. While cases are spread across the population 20 and older, more than 90% of mortality is in the 60+ age group in both provinces and a large percentage is among residents of care homes.

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