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Labour + Industry

Here’s How to Fix the Broken Long-Term Care System

Bringing seniors’ residences under the Canada Health Act and ending for-profit care are critical steps.

Larry Brown 19 May 2020 | TheTyee.ca

Larry Brown is the president of the National Union of Public and General Employees. The union represents over 390,000 members across the country, with the majority working to deliver public services like health care, home care, community care and residential care. The BCGEU and HSABC are its provincial components.

There are many words we can use to describe what is happening in long-term and residential care homes across the country.

Horrific. Unnerving. Heartbreaking.

It’s this one that sticks with me. Avoidable.

As we’ve seen, there is an almost unimaginable crisis befalling many of the nursing homes, long-term and residential care facilities in this country. The horrific details of an outbreak at Montreal’s Résidence Herron linked to 33 deaths are only the most recent among stories of how seniors, some of our most vulnerable and dependent citizens, and the people that care for them, are paying a disproportionate price in the face of COVID-19.

Unfortunately, Résidence Herron isn’t the only residence with overwhelming outbreaks and deaths. And the numbers are increasing every day.

It is clear nursing homes are among the hardest hit locations for COVID-19. Not just residents, but staff. Those Canadians who made a lifelong contribution to improving this country, and those who care for them, are among those facing the greatest risks in this pandemic.

What is infuriating, however, is that, in many of these instances, these tragedies could have been avoided. Not just with piecemeal reforms, but by bringing these residences into the health care system under the Canada Health Act.

The current broken system of nursing home care in this country is contributing to these disasters. It appears that a disproportionate number of these tragedies are taking place in privately owned and operated facilities.

Sadly, if that proves to be the case, that will not be a surprise for our members working in private nursing homes.

We know, from the frontlines, that residents and staff are not among management priorities in private long-term care homes.

• Maintaining their profits is a priority, so private long-term care homes must pay their workers the least amount of money they can get away with. These workers, in turn, must work at multiple locations to earn enough to survive.

• Training is often seen as an added expense and kept to the minimum.

• Providing personal protective equipment for staff in the privately operated homes is seen by the owners as an added expense to be minimized.

• Following provincial guidelines is seen as adding costs, and only the bare minimum should be done to adhere to them.

How is this possible in places where we place our loved ones for care and security?

The answer is simple. Nursing homes, along with home care and other medical services, were not included under the provisions of the Canada Health Act. This has resulted in a confusing mix of services across the country. In addition, we have seen a proliferation of for-profit companies stepping in to reward themselves off the backs of our seniors.

This pandemic has laid bare the multitude of flaws in the system.

Yet none of this is really new information. For decades, the evidence has shown that for-profit long-term care residences have seriously underperformed publicly owned and operated ones. Now, with the death toll in nursing homes rising, the time for further research and discussion has passed.

Governments have been forced to step up in many ways by providing wage subsidies, financial assistance, support for businesses and funding for social services directly working with COVID-19 communities.

It’s great that income has been increased for people working on the frontlines and putting themselves in harm’s way, but what happens once the virus has been tamed? Will the important people we’re relying on now, go back to the low wages they were being paid prior to the crisis? Low wages in these facilities are a symptom of the bigger problem — private care and neglect.

Some provinces have promised action, with the B.C. government saying wage increases and job stability measures will be made permanent.

It’s time that the federal government stepped in to end the travesty that is private for-profit long-term care in Canada. We are calling on the government to extend the provisions of the Canada Health Act to include Canada’s long-term care residences. By doing so, they would have to meet the five principles of the act: public administration; accessibility; comprehensiveness; universality and portability.

The government needs to take the steps to adequately fund the necessary support that workers and residents in long-term care desperately need. This funding needs to be ongoing to ensure that a quality public health care system exists in Canada.

Now is the time to learn from our mistakes in this crisis, and from our past.  [Tyee]

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