Thanks, Mr. Casey, and members of the committee.
I'm Dr. Samir Sinha, and I'm the director of health policy research at the National Institute on Ageing.
The NIA is a Ryerson-based think tank focused on addressing the realities of Canada's aging population. Additionally, I serve as the director of geriatrics at Sinai Health and the University Health Network. I was recently appointed as a member of the federal government's National Seniors Council and invited to chair the Health Standards Organization technical committee that has been tasked with developing the new national long-term care services standard for Canada.
First of all, I want to take a moment to acknowledge the 23,253 older Canadians, representing 95% of Canada's deaths thus far from COVID-19, as well as their families.
There's a growing public discourse on the role of governments to address the inadequacies of our supports for older Canadians during the pandemic, including the provision of long-term care, and growing calls for the federal government's greater leadership in these areas. While other countries have acted clearly and decisively to develop stronger systems of long-term care for seniors as they've aged, Canada didn't. This inaction cumulatively helped to sow the seeds of this tragedy we've been witnessing, where 62% of Canada's deaths to date from COVID-19 have occurred in LTC settings, the highest rate of any G20 country.
I publicly noted early on that while LTC homes were becoming the epicentres of Canada's pandemic, there was no national mechanism in place to track these outbreaks in a consistent way. Neither PHAC nor CIHI were doing this. Our NIA, thus, took on the task to systematically collect all the data related to resident and staff cases, and deaths at individual home levels across Canada. Had we not done that, the truth of what happened in long-term care might have remained obscured.
Our highly accurate record, developed with CIHI support, has become the basis of many important studies and analyses. However, my point here is that something important like this should not have been left to the goodwill of provinces or a university research centre, but should have been a clearly enabled function of the federal government's pandemic response. Moving forward, clear protocols and systems need to be in place in future to ensure we're never caught off guard like this again.
PHAC was helpful in coming up with some early guidance to help the provinces and territories look at more standard infection prevention and control measures, and the treatment of COVID-19 cases in long-term care settings. However, it's not clear why the agency could not have been enabled or supported to provide much needed guidance to the provinces and territories to navigate other important challenges, such as addressing the effects of social isolation and resident access to family members.
It was our NIA, on our own initiative, that decided to lead on the creation of national LTC guidance. First, the release of our spring 2020 “Iron Ring” guidance continues to serve as the evidence base around how the provinces and territories should respond to COVID-19 in congregate care settings. We've now updated that three times.
In July 2020, we released our “Finding the Right Balance” guidance document to support the reopening of Canadian long-term care homes to family caregivers and visitors. With the majority of LTC residents and staff being now vaccinated, the lack of guidance being issued, as the CDC has done in the United States, is forcing residents and families in homes across too many parts of the country to remain isolated from each other, producing serious physical and mental health consequences.
Again, the NIA is helping to develop new evidence-based guidance to enable our provinces and territories to safely reopen their homes, but it should be the official government bodies, like PHAC, leading this work.
I'm glad that the federal government is now providing much needed leadership with the creation of new national standards for long-term care. Enabling this with $3 billion will also be helpful to ensure the provision of a more consistent and higher standard of care across Canada. In being asked to chair the HSO's technical committee, I am thrilled to see an unprecedented level of public engagement in this work so far.
In the future, with our NIA research showing that at least 430,000 Canadians have current unmet home care needs, while more than 40,000 are on wait-lists for long-term care homes, even before the pandemic, we need to do more to support Canadians to age well and in their own homes for as long as possible. Our research shows that Canada spends 30% less than the average OECD country on the provision of long-term care, and close to 90% of our public LTC dollars are spent on institutionalizing people rather than caring for them in their own homes where they want to be.
Our NIA's “Pandemic Perspectives” report shows that virtually 100% of older Canadians want to do everything possible to remain in their own homes for as long as possible. Our “Bringing Long-Term Care Home” report shows that this could be done well and for lower costs for many people currently in our long-term care settings. Of course, people have the right to pay privately for their own home care services, but this is not an option for the majority of Canadians who don't have the financial resources to do so.
The recent commitment to increase OAS payments for Canadians 75 and older will enable some to better meet the growing costs associated with aging and aging in place, but we need to think bigger, as other countries have, perhaps by enabling the creation of a national long-term care insurance program or further improvements to the guaranteed income supplement program for lower-income older Canadians.
Where do we go from here? While it's good that most political leaders have agreed that long-term care is broken, we need to ensure that we pair our immediate actions with efforts to determine how best to fix and fund the long-term care system that all Canadians should look forward to as they age. In this regard, I am glad that our NIA has been helping to ensure that we can define the issues properly, ask the right questions and find the right answers and ways of implementing them as quickly as possible.
Much of what we need to do has been well known for years. Luckily it isn't rocket science, but it will take political will and a federal, provincial and territorial coordination of efforts. We thus recommend that the federal government fully support the work ahead that will enable the creation of new national long-term care standards and help its provinces and territories in addressing these issues once and for all.
Thank you very much.