Canada’s long-term care facilities were the orphans of health care policy before COVID-19 hit. Let’s fix things now.

AJ Insurance

L. Ian MacDonald

May 29, 2020

 

It is no longer very surprising to read about living conditions in long-term care residences for seniors, but that doesn’t make it any less shocking or scandalous.

The element of surprise was essentially removed by the publication on Easter Weekend of Aaron Derfel’s explosive Montreal Gazette story of a private seniors’ home in Dorval, where residents were abandoned by caregivers, left wearing dirty diapers and sleeping in unchanged beds.

The silence, from the system and the other provinces, was eloquent. And it quickly became evident that LTC residences were the epicentre of the COVID-19 pandemic in Canada, claiming 80 percent of the more than 7,000 deaths to date in this country.

As the horrific nature of the emergency became clear, Ottawa readily agreed to deploy members of the Canadian Armed Forces in LTC homes where residents were dying in droves in Quebec and Ontario.

A few weeks after their emergency postings at home, the soldiers did what soldiers do — they wrote up what they’d seen and sent it up the chain of command.

Quebec had already been shocked, and in fairness shaken into action by the original Gazette story, which the paper and other Quebec media continuously followed-up on with one story of neglect after another, to the point where the headlines about incompetence became almost routine.

If there was any sense that Ontario would be different, it was dispelled by the CAF report dropped this week detailing something the armed forces detect by training —dereliction of duty. Residents left to feed themselves while lying down? Hypodermic needles being used more than once? It’s all in there.

To say nothing of the chronic shortage of supplies, of surgical and non-surgical masks, and gloves being used on more than one patient.

The provinces and Ottawa are in this together in asking, what can be done for it? The public response has been quite unequivocal—never mind who’s to blame, do something about it.

Ontario Premier Doug Ford, whose instincts have served him well in the pandemic crisis, said he would immediately appoint an inquiry and accepted responsibility for the mess, adding, “It’s on me.”

Can Ontario and Quebec get out of this alone? They might have constitutional jurisdiction, but only the feds have the money for what’s needed. And as Ford put it during his daily briefing on Wednesday — “We need the money.”

For his part, Quebec Premier François Legault was speaking the same day of the human resource shortfall in caring for seniors. Legault set a goal of hiring and training 10,000 people as orderlies, and paying them a living wage of $49,000 a year to care for Quebec seniors. That’s nearly $500 million a year, just for residential care.

And he, too, knows the money can come from only one place — Ottawa.

As for Justin Trudeau, who found the CAF report on Ontario so “disturbing” and “troubling”, he is always careful to preface his comments by acknowledging his acceptance that health care is a provincial jurisdiction.

Well, there’s nothing new or revealing in that.

Since his father’s time and before that, during the Pearson years that gave us Medicare, the scenarios of First Ministers Conferences on this issue have always been scripted along constitutional and financial lines.

The provinces, led by Quebec, have always said, “This is provincial jurisdiction, just give us the money. Never mind us saying ‘please’, just do it.”

To which Ottawa has always replied, “Yes, but we insist on national standards.”And the feds invariably end up signing a cheque to the provinces with the stipulation that it be used for health care. Given the circumstances, they can do without the time and bother of a federal royal commission on long term-care.

It’s really no mystery why the patient is in such poor health, or why care is so inadequate. Everyone agrees on the problem — Canadians are getting on in years. The question is, what is to be done for it? Well, if there’s a $250 billion federal deficit to stimulate economic recovery, Ottawa can find a few billion dollars in a jobs fund for seniors’ homes.

That’s a question that falls uniquely on the shoulders of the prime minister and the premiers, who, to their credit, have struck a close working relationship during the pandemic. Again, during their weekly Thursday night conference call, Trudeau said Friday, they discussed the issue of long-term care.

A sense of history doesn’t hurt, either. Lester B. Pearson and Quebec’s Jean Lesage struck a dialogue, back in the mid-1960s, that eventually gave us Medicare. Paul Martin and Quebec’s Jean Charest found a way at the 2004 First Ministers Conference that increased federal funding by more than $40 billion over a decade.

These were political solutions to urgent issues of health care. It’s called leadership, and it’s what Canadians expect now. As for our seniors, they deserve nothing less.

L. Ian MacDonald is Editor and Publisher of Policy Magazine.