“Extreme Neglect”, “Heart Breaking”, “Gut Wrenching”, “Nauseating”: these responses to the LTC Military Report are, sadly, nothing new to caregivers, families, and seniors’ advocacy groups. We have all seen, heard of, or experienced the passing of a loved one in a seniors’ care home. We are not surprised that nearly 82% of Canada’s COVID-19 deaths have been in long-term care homes, but the deaths in these homes are merely the tip of the iceberg.

When the provincial government wants to reduce its expenditures, it looks at cutting funding to the Ontario health care system, the largest budget envelope. Ageism then allows, even encourages, us to prioritize younger patients with acute conditions over older folk with increasingly complex chronic conditions.

Instead of wringing our hands in outrage (again), let’s look at alternatives. Better quality and improvements to home and community care can keep seniors safely in their homes and out of more costly institutions, such as nursing homes and hospitals.

In Ontario, care for most seniors is delivered at home and with community-based support. Let’s not be consumed by the flashier statistics (LTC homes) and forget the situation in home and community care. This sector is also suffering, if less dramatically, from some of the same problems as LTC homes – shortages of qualified staff, who endure precarious employment, as well as lack of personal protective equipment and clear infection control guidelines – guidelines much needed given the less than perfect conditions in some homes.

Ontario’s senior citizens need decisive action. We already have more than enough information to correct this sad situation and re-orient long-term care.

What exactly are we waiting for?

The Ford government is pursuing passage of legislation that will significantly affect the home and community care services available to all Ontarians. Care Watch applaudes the government’s goal of modernizing home and community care, but continues to have serious concerns about the proposed legislative changes.  Our submission to the Standing Committee on Social Policy calls for clarification of and changes to Bill 175.

The COVID-19 pandemic has highlighted what is very wrong with the way we care for Canada’s senior citizens.
Care Watch has long advocated that the Canada Health Act’s five legislated principles (public administration, comprehensiveness, universality, portability, and accessibility) should apply to long-term care services, whether those services are in institutions, at home, or in the community. We have also called for national senior care standards that would reflect those principles. We are not the only ones calling for these standards. This call is also trumpeted by organizations and unions supporting pandemic front line workers. Included are the Ontario Health Coalition, SEIU, ONA, and Unfor. Now, the Globe & Mail’s opinion editor Gary Mason (May 8, 2020) has gone even further by advocating that seniors’ care be formally included in the Canada Health Act.

Prime Minister Trudeau (Toronto Star, May 8, 2020) says the post-pandemic reviews will consider bringing long-term care under the Canada Health Act’s umbrella. However, the premiers of some provinces (such as Ontario and Quebec, which, ironically, are most affected by the pandemic) are already lining up against the potential of applying any national standards. They argue that it is unnecessary and that the federal government should simply give them more funding to address the issues.

We believe provinces should receive more funding only if that funding is tied to enforceable national standards. COVID-19 has shown us that neglect of standards leads to neglect of care. We assert that long-term care services – in the home and community or in facilities – are necessary components of our broader health care system and must be treated as such.
Post-pandemic, we can expect many of our systems to be restructured. Structures change and evolve, but values and principles remain constant. National frameworks such as the Canada Health Act provide a foundation and guidance for consistent and coordinated provincial/territorial action. We continue to learn from the pandemic experience, but we have already learned that long-term care needs to be guided by the Canada Health Act.

When we talk about our health care system – especially when the system is being restructured – discussion turns to the balance between public services (provided by government) and private services (provided by entities other than government). It’s a dynamic balance, which shifts constantly and depends on each government’s policies and programmes.

It is important to understand that balance, and where public and private interests and activities meet in our health system.

Read our latest backgrounder examining privatization in Ontario’s health care