Singh would end private long term care homes

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jerrym
Singh would end private long term care homes

The staggering death toll in Canada's private long term care homes has led NDP leader Singh to promise he would end these death traps if elected. 

An NDP government would ban the opening of any new for-profit care homes for seniors, NDP Leader Jagmeet Singh said Tuesday. Speaking to reporters on campaign trail in Mississauga, Ont., he said his party, if elected, would implement a plan to take profit out of long-term care homes and would create national care standards to hold institutions to account.

“It is wrong that for-profits exist in the system,” Singh said. He said seniors living in for-profit facilities had higher infection and death rates during the COVID-19 pandemic.

Singh made the comments outside the office of Revera, a for-profit company and one of the largest long-term care home operators in the country. It is wholly owned by the Public Sector Pension Investment, the Crown corporation managing public servants’ pensions. If elected, Singh said he’d nationalize Revera and make it public. “We fund long-term care and some of that money is going to the pockets of shareholders,” Singh said. “That is wrong. It should be going to (protecting and caring) for our loved ones.” He said he’d work with provinces and territories, which have jurisdiction over long-term care homes, but admitted it would be a challenge. “It’s not going to be easy, but it is essential and we have to get profit out of long-term care,” Singh said.

He said he’d use “all the tools” at the federal government’s disposal, including the use of the Canada Health Act, to get for-profit companies out of the industry.

Long-term care homes were devastated by COVID-19 across the country. The Ryerson University National Institute on Aging has tracked 15,217 COVID-19 deaths among long-term care residents since March 2020, which amounts to 57 per cent of all deaths from the pandemic in Canada to date.

Nearly 3,800 people have died from COVID-19 in Ontario’s nursing homes since the pandemic hit in early 2020. An independent commission found long-term care homes were underfunded, suffered severe staffing shortages, had outdated infrastructure and poor oversight. Those factors, the commissioners said, contributed to the deadly toll in Ontario.

Singh said federal money for long-term care homes would have conditions attached to it. “We provide funding and that funding should go toward the best quality of care, it should go toward staffing, it should not go toward profits,” he said. “We need to do better.”

https://www.theglobeandmail.com/politics/article-singh-pledges-to-end-fo...

 

jerrym

A CBC National broadcast at 28:25 of the url below in 2020 found long term care worker staffing be changed from 4 residents to worker to 10 residents to worker in private homes, with workers begging inspectors to increase the staffing so that patient needs can be met and inspectors in Ontario saying there is nothing they can do as there are no regulations requiring this. 

https://www.youtube.com/watch?v=Cb5C25jjoOk

jerrym

Considering the wretched conditions for workers and residents vividly described in the CBC broadcast discussed in the previous post the Toronto Star's findings during an investigation of long-term care homes are hardly surprising. 

An analysis of long-term care home deaths by the Toronto Star concluded that "For-profit nursing homes have four times as many COVID-19 deaths as city-run homes".

Residents of for-profit nursing homes in Ontario are far more likely to be infected with COVID-19 and die than those who live in non-profit and municipally-run homes, the Star has found.

A Star analysis of public data on long-term-care homes shows the facilities have been hit by outbreaks at approximately the same rate, regardless of ownership. But once COVID-19 makes it into a nursing home, the outcomes have been far worse for residents of for-profit homes.

https://www.thestar.com/business/2020/05/08/for-profit-nursing-homes-hav...

jerrym

As a result of 82% of all Covid-19 deaths  by May 2020 in Canada occurring in long-term care homes and of the evidence in the last two posts of the four times greater death rate in private long term care homes compared to public ones, the Canadian Labour Congress last year demanded a complete overhaul of the long-term care home system and the removal of private operators from the system with long-term care must operating under a national plan based on the principles of the Canada Health Act.

The Canadian Labour Congress is calling for an overhaul of the country’s long-term care facilities, saying they must be taken out of the hands of private operators to avoid the tragic loss of life experienced during the novel coronavirus pandemic.

CLC president Hassan Yussuff said the fact that the vast majority of the 4,280 Canadians who have died from COVID-19 lived or worked in long-term care facilities should be a wake-up call for all governments. ...

According to the National Institute of Ageing at Ryerson University in Toronto, 82 per cent of COVID-19 deaths in Canada were connected to long-term care homes. On Thursday, Chief Public Health Officer Dr. Theresa Tam also said that about 81 per cent of deaths are linked to long-term care facilities. ...

Unlike hospitals or doctor visits, long-term care is currently not a core, publicly insured service under the Canada Health Act, and is not subject to federal statutes and regulations, the CLC said.

Instead, the sector is governed by a patchwork of provincial and territorial legislation, policies and regulations. Each jurisdiction provides a range of services at different costs. The CLC said this has led to inconsistency in the level and quality of care provided, how facilities are managed and how ownership is regulated across the country.

Although health is a provincial responsibility, the CLC said the federal government must lead a process to harmonize the patchwork system and set national standards of care in seniors homes.

https://www.theglobeandmail.com/politics/article-canadian-labour-congres...

jerrym

The Canadian Federation of Nurses Unions is also demanding that a national plan for seniors' care be established. 

The Canadian Federation of Nurses Unions joins with other Canadian Labour Congress affiliates in supporting the calls to action in the report, Lessons from a Pandemic: Union Recommendations for Transforming Long-Term Care in Canada, released today. The CLC report reflects the CFNU’s previous recommendation for a national plan for safe seniors’ care, that supports seniors’ care as they transition through the health care system. Like the Canadian Labour Congress, the CFNU believes that our publicly funded health services need to be more comprehensive, and include community care, long-term care, mental health services and affordable access to prescription drugs through a national pharmacare program. ...

Given how vastly residents outnumber staff, it comes as no surprise that a CFNU survey found that residents often suffer from lack of timely care and, at times, omitted care. Current staffing levels are insufficient to meet the needs of this vulnerable population. The CFNU has also revealed in a recent discussion paper that violence between residents and against staff is endemic in this sector. Decades-old research shows that 4.1 direct hours of care per resident per day is required to ensure that seniors’ health isn’t eroded; according to research commissioned by the CFNU, quality care for seniors requires a minimum of 4.5 hours of direct care per resident per day, with at least one RN on site per shift.

https://nursesunions.ca/we-owe-it-to-canadians-to-transform-long-term-care/

jerrym

These deathly problems occurred across the country including in Manitoba, making the need to end private LTC homes essential to the health of their residents. 

The most recent provincial inspection of the personal care home at the centre of Manitoba's deadliest outbreak of COVID-19 found big concerns with cleanliness and infection control, including evidence of cockroaches and filthy washrooms that smelled of urine.

It was under the safety and security standards section that reviewers noted infection control issues. 

They found:

  • Numerous washrooms in need of attention in their flooring, undersized toilets and a strong smell of urine.
  • Cockroach issues dating back to 2018, based on a review of exterminator reports.
  • Outstanding repairs recommended to prevent insects from getting into the kitchen were not completed.
  • High surfaces in kitchen including top of range hood over cook stoves found to have very heavy grease-laden dust.
  • Numerous cracks, gaps and missing baseboards which provided a collection point for dirt.
  • Damaged drywall.
  • A need for "greater attention to high-level cleaning is required."

https://www.cbc.ca/news/canada/manitoba/parkview-place-cockroaches-rever...

jerrym

When two private LTC operators received $157 million in Covid relief funding, they passed on $74 to company shareholders, illustrating how money is drained from private care into profits that don't benefit LTC residents. In fact almost 500 of their residents died from Covid. 

"Two of the largest long-term care providers in the Toronto area have received more than $157 million in federal and provincial COVID-19 relief while also paying out tens of millions of dollars in dividends to their shareholders. Extendicare Inc and Sienna Senior Living Inc have paid a combined total of $74 million in dividends this year. Meanwhile, more than 480 residents and staff have died of COVID-19 at the companies' care homes in Ontario."

https://www.cbc.ca/news/canada/toronto/big-spend-long-term-care-aid-divi...

jerrym

In January 2021, 

217 doctors in Ontario have signed a letter calling for an end to for-profit long term care homes.

With hundreds of Ontario long-term care residents dead and COVID-19 outbreaks continuing to ravage facilities across the province, a group of health experts is pushing the province to abolish for-profit long-term care facilities. ...

Out of more than 5,900 COVID-19-related deaths in the province, more than 3,400 were in long-term care, according to provincial statistics.

After a lull in cases in the summer, Dosani said long-term care homes are still seeing poor infection-control practices and a delayed response to outbreaks. ...

He also referenced this report from Ontario's COVID-19 Advisory Table, which found that in the first wave of the pandemic, the province saw 78 per cent more deaths in people with COVID-19 in for-profit homes than in their public counterparts.  "It's not a fluke," Dosani said. "This system was actually built this way. It's built to put profits over people. When you think about for-profit homes, they're by design created to have one thing in mind and that's profits for shareholders. It's not care for our seniors," Dr. Naheed Dosani, said Tuesday on CBC Radio's Metro Morning. "This is a humanitarian crisis." Dosani, a palliative care physician for the William Osler Health System, which has hospitals in Brampton and Etobicoke, is one of more than 215 Ontario doctors and researchers who have joined the Doctors for Justice in Long-Term Care campaign. ...

The group of doctors is also calling on the province to take the following measures with respect to long-term care:  

  • hire appropriate levels of staff
  • set a minimum pay standard for front-line workers
  • ensure at least 70 per cent of staff at every facility are working full time
  • let family caregivers have access to facilities 
  • work with hospitals to establish partnerships for care
  • Keep hospital teams on standby
  • Call upon the military if required
  • Accelerate vaccination rollout to LTC homes

https://www.cbc.ca/news/canada/toronto/ontario-long-term-care-1.5888226

jerrym

In Ontario, the move towards privatization started under Mike Harris with his helping financialed firms to enter the sector, something that he himself profited from. Linda McQuaig discussed evidence that showed financialized firms in charge of LTC homes do an even worse job than other private sector firms, which, in turn, do worse than non-profit and public sector LTC homes. 

The move toward privatization got started under then-Conservative premier Mike Harris, whose government made long-term care more attractive to private business by removing minimum staffing levels in the homes, making them ripe for profit-making. ...

From his vantage point as premier, with projections showing a coming explosion in the demand for seniors housing, Harris had little trouble spotting the lucrative potential for financialized firms in the industry. After retiring as premier in 2002, he quickly became chairman of a newly formed REIT called Chartwell Retirement Residences, which operates both publicly funded LTC homes and privately paid retirement homes. Over the past decade, Chartwell has distributed $798 million to shareholders and paid its executives $47.3 million, including an annual salary of $229,500 for the former premier's part-time chairmanship, which he still holds.

Mike Harris' involvement in the dubious rise of privatization -- and financialization -- in the long-term care industry makes it all the more outrageous that the Ford government recently awarded him the Order of Ontario, even as the pandemic continues its relentless slaughter of helpless LTC residents.

https://rabble.ca/columnists/2021/01/rise-private-ownership-steroids-fue...

jerrym

A March 2021 study concluded that Canada had the worst death rate by far among developed nations for people living in long term care. A lot of this has to do with the private sector placing profit over life under all circumstances through understaffing, poorly built facilities etc. It's time to take all long term care homes in Canada into the public sector. Little was learned by governments during the first wave as the death toll was even higher in the second wave, with only Quebec improving its death rate during the second wave, and that primarily because the monstrous death toll there forced the Quebec government to hire 10,000 additional staff for long term care and carry out other measures or face a huge political backlash at the next election. BC, with only 9% of LTC homes having Covid infections, compared to Quebec's 44% and Ontario's 34% infection of LTC care home having infections during the first wave, shows what increasing wages and conditions, making all workers full-time but at a single place to reduce infection spread can do to reduce the risk of Covid infection and death. 

Canada has the worst record for COVID-19 deaths in long-term care homes compared with other wealthy countries, according to a new report released on Tuesday by the Canadian Institute for Health Information (CIHI).

The study found that the proportion of deaths in nursing homes represented 69 per cent of Canada's overall COVID-19 deaths, which is significantly higher than the international average of 41 per cent.

In Canada, between March 2020 and February 2021, more than 80,000 residents and staff members of long-term care homes were infected with the coronavirus. Outbreaks occurred in 2,500 care homes, resulting in the deaths of 14,000 residents, according to the report.

"COVID-19 has exacted a heavy price on Canada's long-term care and retirement homes, resulting in a disproportionate number of outbreaks and deaths," the report's introduction says.

The study, which primarily focused on the first six months of the pandemic, found that across the country, nursing home residents received less medical care. They had fewer visits from doctors, and there were also fewer hospital transfers when compared with other years. ...

Researchers also looked beyond the coronavirus to all deaths in care homes."Resident deaths — for all causes, not just from COVID-19 infection — increased by 19 per cent in British Columbia, Alberta, Manitoba, Ontario and Newfoundland and Labrador," the report said. "There were 2,273 more deaths than the average in the five years prior to COVID-19, with the largest increase occurring in April 2020." ...

"It really tells us that there were things that we could have done to avoid a lot of the deaths that we saw in Canada and that countries, frankly, that were better prepared prior to the pandemic, that had better funded systems, they performed far better than Canada has," said Dr. Samir Sinha, director of health policy research and co-chair at the National Institute on Ageing, a partner in the study with CIHI. "Relative to other nations in the world, Canada has actually the worst record overall." ...

But it appears that lessons learned in the first wave didn't lead to changes in outcomes during the second wave last fall, which was "bigger and broader" in Canada, resulting in "a larger number of outbreaks, infections and deaths." The study found that the number of COVID-19 infections among nursing home residents increased by 62 per cent in the second wave compared with the first. ...

https://www.cbc.ca/news/canada/ottawa/canada-record-covid-19-deaths-weal...

 

Badriya

jerrym, thank you for all of the excellent documentation on this issue.  It makes me sick to think of people profiting while the elderly suffer.

JKR

Aren't long term care homes a provincial jurisdiction?

jerrym

JKR wrote:

Aren't long term care homes a provincial jurisdiction?

So is medicare, although the federal government still has a major impact on what happens in this sector, or do you prefer to attempt to do nothing in what the international study in post #10 referred to as the highest death rate in a  long term care system in the western world because it is under provincial jurisdiction. Or do you prefer the private sector systems that Liberal and Conservative governments have set up? 

lagatta4

I agree with all that has been said, but people must have choices. The right to die in dignity is certainly as vital as the right to live in dignity, especially given that many of these residents are in such a state that "live" should go in quotes. I will certainly opt for assisted, painless suicide if I should ever approach such a state when I'm no use to anyone. That is also a matter of dignity.

jerrym

lagatta4 wrote:

I agree with all that has been said, but people must have choices. The right to die in dignity is certainly as vital as the right to live in dignity, especially given that many of these residents are in such a state that "live" should go in quotes. I will certainly opt for assisted, painless suicide if I should ever approach such a state when I'm no use to anyone. That is also a matter of dignity.

Having well-run LTC homes rather than people dying at the highest rate in the western world because of inadequate care is a separate and quite distinct question from the right for people to assisted suicide.

JKR

jerrym wrote:

JKR wrote:

Aren't long term care homes a provincial jurisdiction?

So is medicare, although the federal government still has a major impact on what happens in this sector, or do you prefer to attempt to do nothing in what the international study in post #10 referred to as the highest death rate in a  long term care system in the western world because it is under provincial jurisdiction. Or do you prefer the private sector systems that Liberal and Conservative governments have set up? 

I think the current privately run provincial systems are train wrecks. I work in the mental health system here in BC where it's been obvious for a long time that private long term care homes are inandequate for the vast majority of people who cannot afford good long term care homes. Here in BC the provincial NDP  government has improved the system but not as much as is required. I think the federal government will require provincial cooperation in order to improve long term care homes. That would require the Feds to "bribe" the provinces much in the way they have recently been "bribed" to go along with new $10/day childcare initiatives. I think the biggest issue in this election is maintaining the $10/day child care systems being set up in the provinces. BTW, I would prefer having a unitary political system or at least a much stronger federal government but that's not in the cards.

laine lowe laine lowe's picture

I definitely agree that long term care should be covered by the Canada Health Act and be public with universal access. Do the obscenely rich really need private long term health care in an institution? Perhaps we need to marry this change with better home care supports so that those who can and can afford it, can stay in their homes. Although there are also models in the Scandanavian countries that support public home care approaches for long term care that are not private. All in all, the situation needs to change and people should not have to depend on two monopolies - Revera and Extendacare.

Good backgrounder on the timeline and players here:
https://www.rankandfile.ca/putting-the-long-term-care-profiteers-out-of-...

lagatta4

I certainly support quality long-term care and thought that was clear. But it's not for everyone. I don't want to be kept around as a useless thing, even with clean toilets.

jerrym

JKR wrote:

I think the federal government will require provincial cooperation in order to improve long term care homes. That would require the Feds to "bribe" the provinces much in the way they have recently been "bribed" to go along with new $10/day childcare initiatives. 

Every social program in the country, even the equivalent of medicare which was started by the NDP in Saskatchewan and childcare which was first implemented in Quebec, needed "bribes" to get implemented across the country, because of the federal government's deeper pockets. That's why Singh's announcement that he is willing to end private LTC homes through federal government action.