Long-Term Care is Sidelined

Long-Term Care is Sidelined                  By: Clinton Halladay                   November 8, 2020

On November 5, 2020 The Provincial Finance Minister, The Hon. Rod Phillips, rose at Queen’s Park and delivered the 2020 Ontario Budget. This is an extensive document intended to address many of the economic and social circumstances we are experiencing both now and in the foreseeable future.  Admittedly it contains a great deal of   planning and commitment.  There are many facets to the budget outline; however, my focus at this point is that portion entitled “Protecting Our Loved Ones in Long-Term Care Homes”.  Although there is much detailed analysis due this important subject, I will limit my comments to two key components: Investing in Personal Support Workers and Bed Development and Increasing Sector Capacity.

Investing in Personal Support Workers:

• Wages:
  • The wage issue applies across the full spectrum of health care and social services, including personal support workers (PSWs);
  • The budget acknowledges that PSWs are integral to the delivery of health care and social services, BUT continues to repeatedly categorizes compensation as “temporary wage increases”;
  • The government goes so far as to say “this temporary wage enhancement will be reviewed regularly and could extend through March 31, 2121”;
  • Through this colossal failure to permanently and fairly compensate PSWs, clearly the Ontario Government does not see these “integral” workers as actually “integral”;
  • This temporary investment is intended to help with retainment and recruitment.  I cannot reconcile how a promise to reduce wages in five months could induce anyone to study and train for such a career;
  • A living wage representing, to a small degree, the magnitude of the responsibility entrusted to our front-line workers is paramount; however, staffing, educational and training alternatives are also necessary. Although I have previously written on this topic, some points are worthy of repeating:
    • Staffing could be augmented by:
• Secondary school students could provide social interaction and support for residents which would count towards their required volunteer hours;
• Nursing and PSW students could receive practicum credits by working in LTCs;
• Construction of new LTCs could include dormitory residences for health care students who would provide LTC health care support in lieu of rent.

Bed Development and Increasing Sector Capacity:

The budget outlines high-level plans for the acceleration and development of new and upgraded beds as well as fast-tracking the construction of new Long-Term Care Homes. While being time sensitive, it is understood that the period between inception and completion takes time.

What is missing from the budget is any mention of for-profit homes. No distinction is made in the funding formulas or models relative to for-profit, not for-profit or municipal LTCs. The obvious conclusion is that no distinction is being made.  This is a fundamental mistake at a time when important, mandatory changes could be implemented. 

            The Ontario Government states: “it is committed to protecting the most vulnerable people of Ontario…”, and yet does not adopt the policies crucial to this protection. The root funding envelope and the Case Management Index aside, there are fundamental structural issues with the delivery of long-term care. The need for change is underscored by the record of for-profit LTCs. The privatization of long-term care, subjecting our loved ones to the profit before people mentality, is unconscionable. The record is clear:

• Approximately 57% of LTCs in Ontario are for-profit (the highest in Canada);
• For-profit LTCs receive the same government allowance per bed as other LTCs, yet:
  • In the midst of the pandemic, deaths relative to the number of beds are reported as:
    • 9% in for-profit LTCs;
    • Just over 5% in non-profit;
    • Less than 5% in municipal.
• For the same period, for-profit corporations paid shareholders a $58 million ($58,000,000) investment return;
• New for-profit LTC construction should be stopped, and current ones phased out;
• During the phase-out period, investment returns should be eliminated or at least capped, ie. Savings account or variable mortgage rates.

These are challenging times; however, each challenge is an opportunity. Let’s take advantage of the opportunities and make intelligent, long-lasting improvements to a broken system, rather than short-sighted band aid ones.  Our loved ones deserve no less!

            The future is ours, what do we want it to be?