Health Committee on May 5th, 2020

[The Chair (Mr. Ron McKinnon (Coquitlam—Port Coquitlam, Lib.)), Liberal, Marcus Powlowski]

I call this meeting to order. Welcome to meeting number 17 of the House of Commons Standing Committee on Health. Pursuant to the orders of reference of April 11 and April 20, 2020, the committee is meeting for the purpose of receiving evidence concerning matters related to the government's response to the COVID-19 pandemic.

In order to facilitate the work of our interpreters and ensure an orderly meeting, I would like to outline a few rules to follow.

First, interpretation in the video conference will work very much like in a regular committee meeting. You have the choice, at the bottom of your screen, if you're on a PC, of either floor, English or French. If you're on an iPad, that's slightly different, but you have the same choices. If you will be speaking in both official languages, please ensure that the interpretation is listed as the language you will speak before you start. For example, if you are going to speak English, please switch to the English feed, then speak. This will allow for better sound quality for interpretation.

Before speaking, please wait until I recognize you by name. When you are ready to speak, click on the microphone icon to activate your mike. Should members need to request the floor outside of their designated time for questions, they should activate their mike and state that they have a point of order. I remind everyone that all comments by members and witnesses should be addressed through the chair.

When speaking, please speak slowly and clearly. When you're not speaking, please ensure that your microphone is on mute. If you have earbuds with a microphone, please hold the microphone near your mouth when you're speaking.

Should any technical challenges arise, please advise the chair or clerk immediately, and the technical team will work to resolve them.

Before we get started, can everyone click on the screen, and for those with a PC it's in the top right-hand corner, to ensure that we are on gallery view? With this view we should be able to see all of the participants in a grid-like fashion. It will ensure that all video participants can see one another.

I would now like to welcome our witnesses. Each witness group will have 10 minutes for an opening statement followed by the usual rounds of questions from members.

On our panel today, from the Canadian Trucking Alliance, we have Mr. Stephen Laskowski, president; Mr. Geoffrey Wood, senior vice-president, policy; and Mr. Lak Shoan, director of policy and industry awareness. From Canadian Manufacturers & Exporters, we have Mr. Mathew Wilson, senior vice-president, policy and government relations. From the Canadian Produce Marketing Association, we have Mr. Ron Lemaire, president. From the Canadian Union of Public Employees, we have Ms. Amanda Vyce, senior research officer; and Ms. Lou Black, research director, hospital employees' union.

We'll start with the Canadian Trucking Alliance. Mr. Stephen Laskowski, please go ahead for 10 minutes.

[Stephen Laskowski, President, Canadian Trucking Alliance]

Thank you very much, Mr. Chair, and committee members for having the alliance here today.

CTA represents over 5,000 trucking companies from coast to coast serving all sectors of the economy. CTA would like to open our comments by thanking the Government of Canada for its tremendous support throughout the COVID-19 crisis.

Our sector touches multiple sectors and multiple ministries. Numerous departments and offices have worked with CTA in a collaborative manner in extremely trying circumstances. We want to thank all departments for their assistance. It truly has been tremendous. A special thanks to Minister Garneau and his team who have been outstanding in working with our sector throughout this crisis.

I'll give a bit of an overview with regard to—

[The Chair, Liberal, Marcus Powlowski]

Pardon me, Mr. Laskowski. Could you maybe move your mike a little closer to your mouth?

[Stephen Laskowski]

Okay.

I'll provide an overview here with regard to the economic condition of the industry and the specific asks of our sector as a result of COVID-19.

The Canadian trucking industry has worked as hard as it can during the crisis to ensure Canadians continue to have access to essential items such as food and sanitary products. However, it is becoming increasingly clear that, as our industry continues to serve the supply chain and the economy as required, it faces its own unique challenges and rapidly escalating challenges that require tailored solutions to protect the stability of the supply chain during the COVID-19 crisis and into an eventual economic recovery.

The Government of Canada has introduced several much-needed financial measures to assist Canadians and businesses generally suffering financial hardship as a result of this pandemic. Simply put, our sector needs additional focused assistance above what the Canada emergency wage subsidy provides due to the nature of our sector and the critical relationship it has in the supply chain.

Also, the CEWS may work for many sectors, but it simply doesn't stabilize the trucking industry enough, and I'll explain a little bit why that's the case.

To ensure stability in the supply chain, CTA is asking the Government of Canada to introduce a payroll tax deferral program, providing fleets the needed cash flow to maintain operations. Additionally, CTA wants to increase the meal allowance for all truck drivers who are facing rising costs associated with operating during COVID-19.

For our payroll ask, we are asking a three-month deferral with a 12- to 18-month payback, very similar to the GST/HST program introduced earlier.

For the meal allowance for drivers, we are asking for an increase in the daily amount, in percentage, that drivers can deduct from their taxes as it relates to meal costs on the road.

Other organizations like Teamsters Canada; the independent truck drivers association, referred to as OOIDA; the Private Motor Truck Council; and the Women's Trucking Federation of Canada have joined CTA in its call for both the payroll ask and the meal allowance ask.

Why are we asking for these tax measures? CTA recently performed a business condition survey. It will introduce some new findings later on this week. During our first round of the surveys completed in late March and early April, on average carriers experienced a 27% decrease in revenue. Since then we're expecting the number to come in at around 35%.

Carriers are also seeing empty miles increase significantly. “Empty miles” in our sector refers to when a truck is moving empty. Obviously, the goal of any trucking company, business 101, is to move from point A to point B, and from point B back to point A, with goods in their trucks. What's happening during the COVID-19 crisis is that there is product going one way, but nothing coming back. That means that our costs stay the same, and the revenues are dramatically decreasing.

It has been indicated by 63% of our fleets that their customers have asked for payment deferrals. Typically, our carriers would collect from their customers within 35 to 40 days. That's being pushed to 60 to 90 days, and over 90 days.

As I mentioned, we'll have new results of our business conditions survey later this week.

With regard to driver respect and treatment, before COVID-19 the issue of driver respect at shipper and receiver facilities was a significant issue. After the onset of COVID-19, when drivers were regularly refused access to washrooms and could not get food on the road because of drive-through policies that did not accommodate commercial vehicles, CTA launched a hashtag campaign called “Thank a Trucker” to help raise awareness to address these issues.

The response from the Government of Canada, provincial leaders, corporate Canada and regular citizens has been incredible.

Our industry is appreciative of this response, but there is still work to do. We're on the right path and we'll hopefully continue to see improvements in this area.

With regard to crossing the border, as we all know, 70% of our trade moves by truck from Canada into the United States and from the United States back into Canada. The border has undergone significant changes since the restrictions of non-essential traffic. We'd like to thank the CBSA for working with our industry and the trade community. This transition wasn't easy, but they dealt with it very well and worked with our sector and importers and exporters to make it go as seamlessly as possible.

According to the CBSA, the number of trucks currently entering Canada from the U.S. has fallen nearly 33%. This coincides exactly with what we're saying with our business conditions survey.

The CBSA has also worked collaboratively with the Public Health Agency of Canada in ensuring that border interactions with our drivers remain safe from a health perspective. It's been a good process. CTA will continue to work with the CBSA to ensure the Canadian economy moves in a safe and efficient manner across the Canada-U.S. border.

With regard to commercial vehicle licensing, plates, permits and regulatory flexibility, the CTA would like to once again thank Transport Canada, the Canadian Council of Motor Transport Administrators, and all the provinces and territories that have worked with the CTA and its members on regulatory flexibility with respect to extending the validity of licence plates, driver's licences and driver medical exams, in addition to many other compliance-related requirements, such as annual vehicle inspections and accommodations under the International Fuel Tax Agreement.

We would also like to thank the regulatory and enforcement agencies, both in Canada and the United States, for working with us with regard to interactions with our drivers in a safe manner during the COVID crisis.

With regard to PPE, the Minister of Public Services and Procurement announced recently this week that she would bring together a diverse group of 17 private-sector leaders to form the COVID-19 supply council. This group, which includes the Canadian Trucking Alliance, would be tasked with providing the government advice on the procurement of critical goods and services required as a part of the COVID-19 response and recovery efforts. We look forward to working within this committee and council and thank the minister for the invitation.

With regard to securing personal protective equipment for drivers, including face masks, gloves, hand sanitizers and disinfectant wipes, this continues to be a challenge for our sector and others, but we continue to work with it to ensure our drivers are protected.

Thank you, Mr. Chair and committee members. I look forward to any questions.

[The Chair, Liberal, Marcus Powlowski]

Thank you, Mr. Laskowski.

We will now go to the Canadian Manufacturers & Exporters.

Mr. Wilson, please go ahead for 10 minutes.

[Mathew Wilson, Senior Vice-President, Policy and Government Relations, Canadian Manufacturers & Exporters]

Thank you very much.

Good morning, Mr. Chair and committee members. Thank you for inviting me to participate in today's discussions.

It is my pleasure to be here on behalf of Canada's 90,000 manufacturers and exporters and our association's 2,500 direct members to discuss COVID-19 and Canada's manufacturing sector.

CME’s membership covers all sizes of companies, from all regions of the country and all industrial sectors. From the early days of this crisis, we have been working with our members and governments to increase the manufacture and supply of critical PPE and health care technologies needed in the response. We have also been educating and informing the manufacturing sector on the latest developments in the crisis, including how to access government supports and how to protect their employees and supply chains We have been working to understand the impact on our sector and advocating for policy, regulatory and program supports from all levels of government.

Like the CTA, we would like to thank all levels of government for their efforts today. Their actions through this crisis have been frankly remarkable, and the partnership is well noted by the industry and the CME right across the country.

In the public there tend to be two areas of discussion as it pertains to manufacturing and COVID-19: How can Canada manufacture more of our own health care products, and how can manufacturing continue to operate safely during the pandemic? I will touch on both of these issues and hope to provide some advice to the committee as you look to form Canada’s response.

With support given by the CME, other groups and, of course, governments across the country, the manufacturing sector has performed exceedingly well throughout. The sector has largely maintained production and employment of the nearly 1.7 million Canadians who work in manufacturing. Hundreds of companies, if not thousands, have changed their production to making health products, including critical PPE such as masks, ventilators, face shields and gowns. Others are aggressively working on developing better tests and a vaccine for COVID-19.

[The Chair, Liberal, Marcus Powlowski]

Pardon me, Mr. Wilson. Interpretation is having difficulty. Try to speak very clearly and maybe a little slower.

[Mathew Wilson]

Okay.

This does not mean things have gone as smoothly as hoped for. The challenge in standing up domestic industry to produce goods for the crisis has largely been a lack of understanding of what products were needed and in what quantity, the technical specifications of the products, who could produce each part necessary and the regulatory approval processes needed before delivery. However, product by product and issue by issue, we worked with a range of companies and government officials to help patch together the solutions needed to deliver the products.

There are three areas that CME suggests we focus on to improve response times for any possible future crisis. First is to conduct a complete a mapping of Canada’s domestic manufacturing capabilities. The challenge—

[The Chair, Liberal, Marcus Powlowski]

I'm sorry, Mr. Wilson, they're having difficulty still. Maybe we'll suspend for a couple of minutes and get this sorted out.

The meeting is now suspended.

[The Chair, Liberal, Marcus Powlowski]

Thanks everyone. The meeting is now resumed.

Please continue, Mr. Wilson. Thank you.

[Mathew Wilson]

There are three areas that CME suggests we focus on to improve response times for any possible future crisis.

The first is to conduct a complete mapping of Canada’s domestic manufacturing capabilities. The challenge in standing up the domestic supply chain wasn’t who could manufacture the final product, it was what the subcomponents were and who could make each piece. If we know what is made in Canada, we have a better chance of connecting the various elements of the supply chain to make the goods that are needed, regardless of the crisis.

Second, there should be full alignment on production and supply of health care equipment between Canada and the United States in a similar way to how we co-operate on defence production. This would reinforce and strengthen existing North American supply chains and provide continual access to this critical equipment.

Third, Canada should strengthen domestic procurement in two ways. First, more coordination is needed on what equipment is needed and by whom. Second, Canada should establish the health equivalent of the U.S.’s Defense Advanced Research Projects Agency, DARPA. In short, Canada could set aside a small percentage from the country’s nearly $200 billion in public health care spending for research, development, scale-up and commercialization of new health innovations that could be procured by government and possibly spun into consumer-focused products. This would allow us to create new products and technologies to improve health care for Canadians and to develop new export opportunities.

The second area that's getting a lot of attention from policy-makers and the public is around safe manufacturing during and following the pandemic. The sector was deemed an essential service by the federal government and most provincial governments, and production has continued throughout the crisis, although with enhanced safety practices and at much lower volumes. Social distancing in most manufacturing environments is standard practice, with workers operating in stations safely at a distance from each other. On the rare occasions when problems have been found, the facility has been immediately shut down, all workers have been sent home and the entire facility has been cleaned to provide a safe work environment. The challenge, like the health care system, is that manufacturers rely on the same N95 masks and other protective equipment as front-line responders, which have been difficult to procure.

CME itself has been working with our members to provide them the best guidance possible to protect their operations and workers. We have developed industry-leading safe operating guidelines and we are continually training companies and providing support to maintain their operations. However, as the economy returns to normal and companies look to ramp up production, there will be tremendous new costs for industry that the government should look at supporting. This could include investment support programs to bring plants up to new health and safety standards and training offsets to cover the training of all new employees in the new protocols that will surely be developed.

Thank you again for inviting me here today, and I look forward to the discussion.

[The Chair, Liberal, Marcus Powlowski]

Thank you, Mr. Wilson.

We'll go now to the Canadian Produce Marketing Association, Mr. Lemaire, president.

Go ahead, please, for 10 minutes.

[Ron Lemaire, President, Canadian Produce Marketing Association]

Thank you.

Honourable members of the Standing Committee on Health, on behalf of the Canadian Produce Marketing Association, I would like to thank you for the opportunity to speak today about the Canadian response to the outbreak of COVID-19.

CPMA is a 95-year-old, not-for-profit trade association representing over 860 companies doing business in Canada, supporting roughly 249,000 jobs. We are responsible for 90% of the fresh fruit and vegetables purchased by Canadians.

Our comments reflect a complex supply chain that works tirelessly to provide fresh fruit and vegetables across Canada. I will speak to the impact of COVID-19 as it relates to the continuity and integrity of the fresh produce supply chain and food security in Canada. These areas of impact include consumer sentiment, mental health, food security, food labelling, infrastructure, regulatory modernization, trade, and sustainability including plastic packaging.

To understand how the current pandemic is affecting consumers, and by extension the produce supply chain, I will note what CPMA's polling firm, Abacus Data, found when surveying Canadians just over 12 days ago. No surprise, 76% of Canadians feel anxious and 45% are now feeling lonely. The majority of Canadians feel this pandemic will last beyond three months, putting greater mental stress upon them. Abacus also noted that 47% of Canadians are feeling the impact financially.

CPMA has seen Canadians doing more targeted shopping resulting in larger baskets with a focus on longevity, so more shelf-stable products like canned and frozen. For fresh items, the focus is more on traditional staples such as potatoes, root vegetables and apples.

What we also know is Canadians are focusing on safety. For many this translates into more packaging, on which I will speak later.

Interestingly, the pandemic has also driven more consumers to do more home cooking. The CPMA consumer program Half Your Plate is aligned with Canada's new food guide and, given that 54% of Canadians are now cooking more at home, CPMA has developed tools to support them. This includes a one-page produce storage guide that simplifies the best way to store produce, and information on how to safely and properly handle produce when they get it home from the store. We've increased the amount of information involving children in the kitchen, including easy recipes, tips for parents and links to resources.

While there's a perception that all fruits and vegetables are expensive, the association provides Canadians with shopping tips to get the best value from their basket.

With Canadian buying patterns shifting during the pandemic, we've seen retail sales up 8% for vegetables and 5% for fruit, but consumers are spending less time browsing grocery stores and unique items and the sales of short-term shelf-life products or specialty items are lower.

Given the closure of many food service operations, there has been a dramatic impact on the entire sector, which represents 30% of our market. There has been some rebound with delivery options, but the market is still very fragile.

In a recent industry survey, Canadians say that they look forward to visiting restaurants again but are concerned about personal safety once businesses reopen. While consumer buying patterns have changed, food security has been top of mind during the pandemic.

With many Canadians' employment status changing, there is an increased reliance on food banks. The produce industry is aware of this issue and has significantly increased levels of donation to help. Unfortunately, food banks and other food charities still have gaps. While there is plenty of food to donate, many charities do not have the necessary cooler facilities to handle the volume of fresh produce, resulting in losses of donated products, or the charity declines the offer of product donation. Also, the lack of volunteers who would normally support their services to receive, pack and ship much of the product is still a challenge.

Throughout everything there are positives, including flexibility on labelling. The larger-format items typically destined and labelled for food service establishments are now allowed to be sold through other channels. This is a positive.

We are aware that work is also being done by CFIA to enable some flexibility in consumer package labelling where it does not affect health and safety. This is also supported by CPMA.

I'd like to turn now to recovery. Business continuity will be challenging as we transition into the post-COVID world. The simple decision to reopen for some parts of our supply chain will be the first step, and for many it will not be possible.

Government programs created to support the produce industry must be based on flexibility and longevity to minimize losses to the industry. The complexity and variability of the industry means program adaptability, on both a large and small scale, must be incorporated into any programs moving forward.

To that end, another area of impact to the produce supply chain that influences food production is foreign labour. Access to temporary foreign workers, TFWs, which, early in the pandemic, was the single most significant threat to food production, food security and the integrity of the food supply chain, remains an issue. While the issue of labour has been addressed to a point, there is still a need to revisit the protocols for workers in Canada. TFW protocols vary from municipality to municipality. More work must be done to support an efficient model for managing and streamlining isolation protocols. Audits from multiple levels are also now being implemented, and consistency is essential. The addition of rapid testing for essential farm workers to ensure business continuity and production is also an area of interest.

From the start of the pandemic in Canada, CPMA members worked diligently to perform and implement measures that would protect employees, the public and the food system. In a recent member survey, access to personal protective equipment was the number one area of concern. Public health and public safety guidelines have resulted in member companies' need for much greater access to cleaning, sanitation products and PPE.

A new supply chain for these products is vital. Organizations cannot continue to operate without appropriate cleaning and sanitation in order to ensure food and employee safety. A self-sufficient Canadian PPE supply chain should be one of the government's long-term goals.

We are also supportive of the Public Health Agency of Canada developing guidance regarding the type of PPE required based on the risks associated with various activities and environments found in Canadian businesses.

Testing of employees for the COVID-19 virus or symptoms of infections should be available to employers within our sector, which is designated an essential service. Once sufficient and affordable testing equipment is available, the Public Health Agency of Canada should create guidance to support businesses implementing point-of-care tests.

Earlier I noted plastics as packaging. CPMA is deeply engaged in addressing problematic single-use plastics in our sector. These are important tools that minimize contact between consumers and commodities or food items.

Since the COVID outbreak, consumers have demonstrated a desire for plastic packaging by increasing their purchases of these items. We do not know how this will change post-COVID, but we need to recognize this shift today and the need for systems to address collection and recycling of these products.

I urge the government not to add plastics to the Canadian Environmental Protection Act list of toxic substances. More review is necessary. We suggest a focus on working with industry to identify and eliminate problematic single-use packaging while improving recycling and recovery of plastics across Canada, which will provide the best possible outcomes.

During this pandemic, we also have realized our reliance on global trade. To ensure the ongoing viability of the food system, we need a strong domestic and global strategy. Market access is critically important to the Canadian produce sector. For successful access to key markets, the supply chain linkages of transportation, border access and ports of entry and exit must be maintained. In addition, international trade agreements, phytosanitary rules and co-operation between governments must continue to be harmonized. The supply chain is multinational, so a failure in one area has consequences along the entire supply chain.

CPMA encourages the government to undertake a pandemic post-mortem in partnership with industry to help understand how this crisis affected Canadians and Canadian industry so that we can better prepare for the next occurrence. Overall, we have all gone through a tremendous challenge in a hyper timeline.

The new business environment has added costs to our entire supply chain that will be difficult to quantify and to bear. In the end, we do know one thing: Food will cost more.

In closing, I want to recognize the extraordinary efforts of government, both elected and public servants, throughout these unprecedented times.

Thank you for your time. I'd be happy to answer any questions that you may have.

[The Chair, Liberal, Marcus Powlowski]

Thank you, Mr. Lemaire.

We go now to the Canadian Union of Public Employees.

Ms. Vyce, please go ahead. You have 10 minutes.

[Amanda Vyce, Senior Research Officer, Canadian Union of Public Employees]

Thank you very much, Mr. Chair.

The COVID-19 pandemic is not affecting all Canadians equally, as evidenced by the horrifying number of deaths of individuals living in long-term care homes across the country. Lou Black and I would therefore like to thank all members of the committee for inviting us to appear before you to talk about the realities of long-term care and the reforms needed to improve quality of care in facilities across the country.

The Canadian Union of Public Employees is Canada's largest union, with 700,000 members across the country. Sixty-five thousand of our 158,000 health care members work in long-term care homes across all provinces, with another 50,000 represented by the hospital employees union, HEU, the health care division of CUPE in B.C. Within long-term care, HEU represents care aides, food service workers, cleaners and clerical staff.

Residents of long-term care and other seniors' homes now account for 79% of all 3,854 COVID-19-related deaths in Canada. Long-term care staff have had to work without access to a ready supply of adequate personal protective equipment. Restricting family members from visiting long-term care homes is a necessary measure to help prevent the spread of COVID-19, but family members can check in to advocate for residents and ensure they're well cared for. They also can't be with their loved one to offer comfort when they're dying. The residents are facing their last days alone.

Over the past month, people have repeatedly asked us why long-term care homes have been so hard hit by COVID-19 and how we could let this happen. COVID-19 didn't create the deadly crisis we're facing in long-term care. The systemic issues that facilitated this heartbreaking situation existed long before this moment. What the pandemic is doing is shining a spotlight on those problems and making them worse. The situation is totally unacceptable.

[Lou Black, Research Director, Hospital Employees Union, Canadian Union of Public Employees]

For the past decade, CUPE and HEU have repeatedly pleaded with our governments to make improvements to long-term care, including having national care standards, increased funding, better working conditions and construction of new public facilities. Unfortunately, from most levels of governments, we've met with more resistance than a willingness to reform the system's state of disrepair.

Many Canadians are longing for life to get back to normal. However, when it comes to long-term care, we must not go back to the way things were. Long-term care homes house people who require care 24 hours a day, seven days a week. Most residents are frail seniors living with chronic medical conditions and physical and cognitive impairments. Unlike hospital and doctor visits, long-term care is not a core publicly insured service under the Canada Health Act. Instead, this sector is governed by a patchwork system of provincial and territorial legislation and regulations. There is little consistency across Canada in the level or type of care provided or in how facilities are governed. Where you live will affect the type and amount of care you will receive and how much you'll pay for it.

[The Chair, Liberal, Marcus Powlowski]

Pardon me, Ms. Black. The interpreters are having trouble. Could you make sure your mike is near your mouth? You are speaking very clearly but they're just having trouble.

[Lou Black]

Sorry.

Amanda, over to you.

[Amanda Vyce]

Thank you, Mr. Chair.

Medical and personal care are delivered to residents by a facility's care aides and registered and licensed practical nurses. Most care aides are women and many are racialized and immigrant workers. Care aides perform the most labour-intensive, hands-on care to residents yet they are very low-paid. Starting wages are as little as $12 an hour in New Brunswick and there are large wage variations within provinces. The median wage in Canada is just over $20 an hour but it can take a care aide 10 years to reach that scale.

Care aides perform upwards of 90% of direct care to residents. Their work is complex and requires a high skill level. In Ontario, care aides have six minutes to get a resident up and ready for the day. Within six minutes, they must help transfer the resident out of bed, assist with toileting or change incontinence products, help the resident get dressed, perform oral hygiene and other personal care, and assist the resident to the dining room for breakfast.

Staffing levels in long-term care are typically measured as the number of hours of direct care a resident receives daily. A landmark study conducted in the United States established that the minimum staffing level required to prevent a deterioration in a long-term care resident's health and to ensure good quality of care that is timely and consistent is 4.1 hours of directly worked, hands-on care per resident per day. No province or territory in Canada is currently meeting this minimum standard of care.

[Lou Black]

Privatization and contracting out also have a negative impact on working conditions and the conditions of care. Research on for-profit ownership of long-term care homes shows that for-profit homes are more prone to closure, are focused on profit rather than quality care and have lower staffing levels, more verified complaints, more transfers to hospitals and higher rates of pressure ulcers and morbidity.

The first COVID outbreak in long-term care in Canada occurred in the Lynn Valley Care Centre in British Columbia. Twelve years ago, staff at this facility were members of our union. Staff had decent working conditions, pay and benefits, but in 2002, changes to the province's labour code opened the door to privatization and eliminated union successorship rights. As the service was contracted out—

[The Chair, Liberal, Marcus Powlowski]

Ms. Black, the translators are having difficulty again. I'm not quite sure what the problem is.

Let's suspend for a couple of minutes while we get this sorted out.

The meeting is now suspended.

[The Chair, Liberal, Marcus Powlowski]

The meeting has now resumed. We will carry on with Ms. Vyce, with apologies to Ms. Black.

[Amanda Vyce]

I'll just back up a bit to where Lou left off.

Lou mentioned that the first COVID-19 outbreak in long-term care in Canada occurred in the Lynn Valley Care Centre in B.C. Twelve years ago, staff at this facility were members of our union. Staff had decent working conditions, pay and benefits. However, in 2002, changes to the province's labour code opened the door to privatization and eliminated union successorship rights. If a service was contracted out or home ownership changed hands, workers' collective agreements no longer formed part of the deal. Thirty years of positive wage and other gains were totally gutted. Workers were terminated en masse and others were forced to reapply for jobs at half their former wages, with fewer benefits and far fewer sick days. Recruiting and training staff has been an uphill battle for Lynn Valley.

The casualization of the long-term care workforce is predominant and growing across Canada, especially as the number of for-profit, long-term care homes increases. Because they're paid low wages, care aides across Canada work multiple jobs in order to cobble enough hours together to pay the bills. The pandemic has drawn attention to this issue since long-term care staff who work in multiple homes have unwittingly spread the virus between facilities as they've moved from job to job to job. Several provinces have issued orders restricting staff to employment at a single work site as a temporary measure intended to protect residents.

Another serious problem that staff in long-term care face is injury, both from musculoskeletal injuries which result from heavy lifting and repetitive strain, as well as from workplace violence. In B.C., injury rates for the long-term care sector are four times higher than the average provincial injury rate. Workplace violence is also a serious everyday health and safety issue for long-term care workers. A poll conducted in Ontario showed that 90% of care aides and registered practical nurses have experienced physical violence in long-term care settings.

Because the system is characterized by low wages, precarious jobs and high levels of injury and violence, it's extremely difficult to recruit and retain workers. As a result, long-term care homes have been dangerously understaffed or short-staffed for over a decade. When staff call in sick, they're often not replaced by another worker, and the remaining staff on shift must add more work to their already heavy workload. When this occurs, staff rush from resident to resident to perform care. For residents, this means they may not receive their baths, their call bell may go unanswered or they may sit or lie in a soiled diaper for hours. When workers don't have adequate time to perform necessary tasks, the quality of resident care suffers.

In B.C., Retirement Concepts purchased the largest chain of for-profit, long-term care homes in the province in 2017. Since then, public health authorities have taken over the administration of four of these homes. Wages were so low and the workload so impossibly high that it could not recruit or retain staff. In a survey conducted by HEU, staff at one site reported their staffing ratio at night was as low as one care aide for 75 residents. Residents were reported to routinely go without their weekly bath or without being toileted in a timely manner. Health authority staff were redeployed to each site to stabilize the situation.

With high numbers of long-term care workers testing positive for COVID-19 and needing to self-isolate, the difficulties employers have to fully staff homes has been compounded. Provinces across Canada have asked retired health care workers to return to service to help out. Hospital staff have been redeployed to fill in the gaps. With the situation so bad in Ontario and Quebec, the provinces' premiers requested and are receiving assistance from Canadian Armed Forces medical personnel.

It's unacceptable that our governments have allowed the conditions in long-term care to deteriorate to such a great extent. The pandemic has shown Canadians how fragile our long-term care system has become from underfunding, understaffing and a political willingness to allow the profit-making interests of private companies to trump the public interest when it comes to the provision of care for our most vulnerable. It's time for our governments to take meaningful action to improve the conditions of work and the conditions of care in facilities across the country.

CUPE and HEU members offer the following recommendations to the committee.

First, the federal government must work with the provinces and territories to bring long-term care into the Canada Health Act and make it a core, publicly insured health care service that is publicly administered, accessible, universal, comprehensive and portable.

Second, the federal government must provide dedicated and adequate funding to the provinces and territories for long-term care through the Canada health transfer.

Third, the federal government must implement and enforce the national standard of a minimum of 4.1 hours of directly worked, hands-on care per resident day and tie the standard to funding.

Fourth, governments must work collectively to eliminate the private, for-profit ownership of long-term care homes. Private corporations and shareholders should not profit from people's medical needs, and governments should not put their health up for sale.

Fifth, long-term care homes must stop the contracting out of services to for-profit companies, such as front-line care, laundry, housekeeping and food services. All services should be provided by in-house staff to enhance working conditions and quality of care.

Sixth, the wages of workers in long-term care must be standardized and increased to reflect the value of their work and their role in providing an essential service, especially for care aides. Workers should be provided good benefits, including adequate paid sick days.

Seventh, the casualization of the long-term labour force must be eliminated through the creation of full-time regular jobs for workers who want them.

Finally, by 2035, it's expected that Canada will need an additional 199,000 long-term care beds. Hospitals have long operated well over capacity because there aren't enough long-term care beds for individuals who are unable to live independently in their own home. This situation became more alarming when hospitals had to rush to find ways to handle the expected influx of COVID-19 patients.

The pandemic therefore reinforces how urgent it is to increase the number of long-term care beds across Canada in order to alleviate capacity problems in hospitals and to ensure individuals receive the appropriate care they need when they need it. Public funds should be available to build new beds, and the facilities must not be designed or operated as P3s.

Thank you very much. Both Lou and I welcome any questions you may have.

[The Chair, Liberal, Marcus Powlowski]

Thank you, Ms. Vyce.

We'll start our questioning at this point. As is normal, we will have three rounds of questions. We will start the first round with Mr. Doherty, the voice of the Cariboo.

Go ahead, Mr. Doherty, for six minutes.

[Terry Dowdall, Conservative, Simcoe—Grey, ON]

I apologize to our guests for the challenges they're experiencing in delivering their messages.

I want to start off with our guests from CUPE. I want to thank both of you for sharing your stories.

My mother was a long-term care aide and my brother still is a nurse's assistant working in a long-term care facility. On your comment regarding physical damage and violence, that is the reason why my mother had to retire early. She still has steel rods in her back and is mobility challenged because of violence. That also led me to take the steps that my colleague Mr. Davies has taken in previous Parliaments, in putting forth a piece of legislation on violence against our health care workers. Earlier this year, I tabled Bill C-211, which includes the issue of violence against health care workers and first responders, so I thank you for your comments.

Ms. Vyce, in a recent article, your president, Michael Hurley, of CUPE's Ontario Council of Hospital Unions, was quoted as saying that “more than 20% of [their] confirmed cases are health care workers, with 68 testing positive so far” and that “[s]uch high numbers suggest workers don't have adequate PPE”.

He said:

When you look at the numbers of health-care workers who are currently reported as having COVID against the number of cases in the general population, [one] can only conclude that there has been a colossal failure to protect health-care workers and that is all about failures of ordering enough equipment.

Do you stand by your president's comments?