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We need action, not another commission on long-term care

In May, as the COVID-19 death toll in long-term care homes climbed, the Ontario government announced it would convene an “independent commission” to review the state of nursing homes in the province.

To date, 2,099 people have died in seniors’ homes in Ontario – most of them long-term care. In total, 168 Ontario homes have recorded COVID-19 deaths, according to information compiled by freelance journalist Nora Loreto.

As stories grew of the Ford government’s delays in creating and communicating clear guidelines that would have minimized the spread of COVID-19 in long-term care homes – and saved lives – public pressure built.

In response, the government announced it would launch an “independent” commission. (How “independent” remains to be seen given the number of big corporate players there are in long-term care in Ontario. At 57 per cent, Ontario has the highest number of private operators in Canada. The Ministry is also headed by Merrilee Fullerton, a known supporter of privatized, two-tier health care.)

“We must act quickly and decisively, and that is why an independent non-partisan commission is the best way to conduct a thorough and expedited review,” said Minister Fullerton. “Ontarians need and deserve answers, and let me assure you, they will get them,” she added. (In other words, the commission may not have political ties, but will it have private interest and corporate ones?)

Military sounds the alarm

The government initially planned to launch the commission in September. Then the Canadian Armed Forces released its devastating report later that month, revealing immensely troubling conditions in the seven long-term care homes in Ontario military personnel were helping in. When their report of cockroaches, bug infestations, rotting food, soiled linens and other disturbing conditions in the homes hit the media, the Ford government went into further damage control.

People rightly asked how the government could not be aware of what was happening in the long-term care homes they license and regulate? Many called for Minister Fullerton’s resignation, but Premier Ford backed the embattled minister and assured the public that the government would get to the bottom of what was happening in the homes and those responsible would be held accountable. (A sadly ironic statement since ultimately, it’s the government’s responsibility to ensure people can live safely and with dignity in the homes.)

In response, the government pushed the timeline for the independent commission forward to July. We are heading into the last week in July and details of the commission have yet to be announced.

Before moving forward, we must ask: do we even need a commission?

For years, families of those in long-term care, seniors’ advocacy groups, health care organizations, frontline workers and their unions and others have provided the Ontario government with clear and detailed information about the changes needed in long-term care homes. Reports have been written and delivered, meetings have been held, pleas have been made. Families have even called both Premier Ford and Minister Fullerton repeatedly only to be ignored.

Last report less than a year ago

You don’t have to go back in time very far to see the government’s last commissioned report on long-term care. The report was released on July 31, 2019, less than one year ago, reviewing the tragic actions of Elizabeth Wettlaufer, a nurse who confessed to killing eight seniors in long-term care homes in southwestern Ontario. The commission looked at the fractured and disjointed long-term care system that failed to protect Wettlaufer’s victims.

The Wettlaufer commission was announced in June 2017 and took just over two years to complete. It resulted in more than 60 recommendations.

With more than 2,000 deaths in Ontario’s long-term care homes to date, and a looming second wave of COVID-19 that could begin anytime, does a publicly funded commission even make sense now?

Dr. Doris Grinspun, head of the Registered Nurses’ Association of Ontario, wrote recently in the Globe and Mail that we are well past the time for commission recommendations. “There is no time to wait for the results of an Ontario government commission looking into how the [long-term care] system responded to COVID-19,” she said. “The commission will deliberate until the sting of our failures wears off and our memories become clouded. We already have 21 years of evidence and 35 reports detailing the changes needed within the [long-term care] sector – all of these are collecting dust. We do not need more reports – we need immediate corrective action.”

Second wave is coming

Health experts say we must prepare for a second wave of COVID-19. Despite seeing what happened in other countries during the first wave of the virus, our long-term care system was not prepared, and thousands of vulnerable people died. In fact, according to the Canadian Institute of Health Information, Canada performed the worst in long-term care homes out of all OECD countries. We spend one-third of the OECD average on long-term care, we have fewer workers, and we had almost double the number of COVID-19 deaths in long-term care homes.

We can’t let it happen again. And we don’t need a commission to tell us what families, advocates, workers, the military and others have already repeatedly identified, including:

  • Long-term care homes are dangerously understaffed. When costs for food, supplies and housing are closely regulated and can only be spent on those items directly, the one variable – staffing – becomes a target for cuts.

  • All workers within the homes need access to personal protective equipment as required.

  • There must be clear and effective guidelines to isolate residents of the homes (and staff members with sick pay) when they are infected.

  • Communication lines must be clear and acted on quickly.

  • For-profit motives must be removed from long-term care. Ontario has a significantly high number of for-profit long-term care home operators including large corporations such as Chartwell, Revera, Extendicare and Sienna Living. For-profit operators’ primary concern is making money for shareholders, not caring for seniors and others in the homes. The SEIU Healthcare union blasted Extendicare after the company revealed during its Annual General Meeting in May that it only spent $300,000 of its own money on measures related to COVID-19, while passing over $10 million to shareholders during the initial months of the pandemic.

If provincial governments aren’t going to lead the way, then we need a federal strategy that ensures those living in long-term care homes are safe and have the care they need.

We owe it to every person who died in long-term care homes and their family members to make changes now. There is no time to wait.