They were the darkest of days for Canadians during the pandemic, but the most promising in terms of political collaboration.
As long-term-care homes reported wave after wave of fatalities due to COVID-19, a horrified country cried out about the conditions, lack of investment and financial underpinnings of the system we have set up helter-skelter to take care of aging people.
Ontario Premier Doug Ford shed tears, and Justin Trudeau promised to do better - especially as it became clear that Canada had the worst record among rich countries for COVID-19 deaths in long-term-care homes. More than 80,000 residents and staff caught COVID, more than 14,000 died, and outbreaks gripped 2,500 long-term-care homes.
The collective scream didn’t fix the problem, but it helped. Governments mobilized resources, aggressively tracking down personal protective equipment and mobilizing the military, the Red Cross and volunteers. There was an immediate, compelling consensus that long-term care should be a top priority for the country to repair, not just for the ongoing pandemic but for the future.
And now, there’s hope on the hustings as the country heads toward the Sept. 20 election.
The federal party leaders aren’t pulling their punches when it comes to mandatory vaccines, family values, public finances or personalities. But underneath the cutthroat campaigning for power, the consensus seems to be holding up.
Every party has a collection of serious proposals for long-term care, and while the amplitude, focus and degree of government intervention differ from party to party, they all agree on the main elements: The system is broken, it needs infrastructure, more workers, and better options for aging at home.
And heaps of federal-provincial co-operation.
“It would be frankly political suicide to not recognize this was a policy failure,” says Samir Sinha, director of health policy research at the National Institute of Ageing at Ryerson University.
It’s reassuring that every party has dedicated political capital towards fixing long-term care, he says, but it’s vitally important to look closely to see how their solutions line up with the needs of Canada’s aging population.
Indeed.
The federal government has already earmarked more than $3 billion for helping the provinces bolster long-term care, although only a few provinces have signed on to a $1-billion fund set aside last fall to improve ventilation, better control infection and hire more staff.
For the campaign, the Liberals put forward a $9-billion proposal last week that would aim (with support from the provinces) to increase minimum wages for personal support workers, and also train up 50,000 more of them. They’d double an existing tax credit for seniors to make their homes more accessible. And they’d give the provinces $3 billion more for infrastructure, to improve the quality and capacity of long-term-care homes. On standards, they want to work with the provinces to embed them into law.
Meanwhile, the NDP would bring an end to privately run, for-profit long-term-care homes - an idea that the party’s political opponents denounce as unworkable. But like the Liberals, the NDP also wants to develop national standards, put them into law, and then spend enough federal money to make sure they can be properly implemented. On the labour front, the party envisions better pay and stiffer protections.
The Conservatives, like the Liberals, want to put $3 billion into infrastructure for the provinces to spend on long-term-care homes. And they, too, want to build up the roster of personal care workers, by tweaking immigration programs to entice more from other countries. On compensation, they pitch a doubling of the Canada Workers Benefit which would go to all low-income workers, not just PSWs.
And on the home care side of things, they want to create a new benefit that would go to people who are taking their aging parents into their homes.
When it comes to setting national standards, however, the Conservatives don’t envision legislation. They want to increase health care transfers to the provinces and work with them to develop best practices - a guide to standards rather than a law.
Overall, all three parties have zeroed in on building quality long-term-care spaces and improving conditions for workers. They have an eye on home care options, too. And while the proposals differ on how, they all recognize they must work with the provinces - a necessity in a federation where provinces have most of the responsibility in this area.
So, lots of commonality on priorities and plenty of goodwill, but a tricky requirement to march in tune with the provinces, and differing approaches to how heavy-handed the federal government should be.
But in an election purported to be about learning from the harsh lessons of the pandemic and repairing the country after the crisis, this is the least our political leaders can do.
Their approaches are all quite institutional, and an important legacy from the pandemic is a growing insistence that seniors be able to avoid institutions and stay in their homes or with family as long as possible, says Sinha. He also notes that the waiting lists to get into long-term-care homes are enormous and growing longer in tandem with demographics. And even when a family member gets a coveted spot, the price tag could break the family’s bank.
We’ve only begun to scratch the surface of the affordability side of aging safely and with respect.
Heather Scoffield is a National Affairs writer.