Justice Committee on May 10th, 2023

[Sameer Zuberi, Liberal, Pierrefonds—Dollard, QC]

I'd like to thank the witnesses for being here today, and for your years of work to promote the good health of everyone in our society, including seniors. I think your testimony is extremely valuable in highlighting that we need to look at some of the definitions, potentially expand the scope in some ways and ensure that we're not capturing those who are not managers in other ways.

I would also like to say that, during the pandemic, the reality of long-term care facilities in Quebec and Ontario was different from that in the rest of Canada.

In Quebec, there was an investigation into how seniors were treated in those facilities, and it was discovered that 4,000 people lost their lives there.

This was an important finding, and it was mentioned by Mr. Garrison as part of the reason that this legislation has come forth. I think that's the context we're dealing with, but you point out something important in terms of expanding beyond these homes to other spaces where seniors are cared for.

To all of the witnesses, I would assume that you would want us to expand it to other facilities and domains where seniors are cared for. Is that correct?

Give a quick answer, please.

[Terry Lake]

If the bill were to go forward, yes, that would be correct.

[Sameer Zuberi, Liberal, Pierrefonds—Dollard, QC]

I would assume that you feel that this is a gap or an area that we should legislate on, given what happened during the COVID pandemic and what that showed in terms of the care of seniors.

Would you agree that we need to close the gap and to see that seniors are properly cared for through legislation that encompasses not only the people we're talking about—the managers we're talking about in this space, in senior care homes—but in other spaces too? Would you agree to that?

[Terry Lake]

I'm not sure I would agree.

We are reacting to a terrible situation with emotion, which is understandable, but we have to think why this situation occurred. All of the witnesses here today have outlined what those reasons were: the understaffing, the lack of PPE—which is supplied by government, by the way, and it just was not available—the terrifying nature of the virus, the fact that so many people were ill and the fact that they were really working with skeleton crews beforehand because it's been so hard to attract people into the sector, so anything we do that—

[Sameer Zuberi, Liberal, Pierrefonds—Dollard, QC]

Just around that, though, this legislation doesn't target the rank-and-file employee. It targets managers and owners who have a responsibility.

Do you think that this responsibility should fall on their shoulders and that they should be held responsible when there are deaths? Don't you think this gap must be closed?

[Terry Lake]

First of all, I think the definition is so broad that unintended people are captured, so certainly narrowing the definition within the long-term care space—

[Sameer Zuberi, Liberal, Pierrefonds—Dollard, QC]

Let's assume we narrow the definition, as you're suggesting, in one sense, so as not to capture those who aren't managers, and expand it in another sense so as to capture managers and owners in other sectors who do care for seniors.

If we make those adjustments, don't you think this would be a salutary law?

[Terry Lake]

I think it would be much improved over what we have today, yes.

[Sameer Zuberi, Liberal, Pierrefonds—Dollard, QC]

That's really helpful, I think, in helping us to think about amendments, because in this committee we can amend what's on paper, so what we're seeing and what you're talking about is very helpful.

We have about 30 seconds. Would somebody like to speak about seniors who aren't in care homes or in hospitals but are in isolated situations, such as in their own homes or in the community?

[Jodi Hall]

I can jump in quickly just to say that we do support the development of elder abuse legislation in Canada that is multi-faceted and that is attached to the older adult and not to a particular setting.

I do want to very quickly speak to the concept of owner, because this legislation as presented does not provide a definition of what a long-term care owner is, and there are a multitude of definitions for how that looks across the country. We have provincial governments, regional health authorities, municipal governments, indigenous communities, non-profit community boards, faith-based organizations and a range of private corporations that own these homes, so defining “owner” is not simple, and it is not defined within this legislation as presented.

[Sameer Zuberi, Liberal, Pierrefonds—Dollard, QC]

Thank you. That's really helpful.

[The Chair, Liberal, Randeep Sarai]

Thank you, Mr. Zuberi.

We'll go now to our last two-and-a-half-minute rounds, beginning with Ms. Larouche.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Mr. Chair.

I thank the witnesses for joining us today for this study on an extremely important topic, one that is of particular concern to me, as I mentioned, since I worked on the issue of abuse before I was elected.

I have heard some interesting things.

Ms. Silas, you talked about standards. There are already some standard. That was noted in the armed forces report. One of the witnesses also said that, in Quebec, 80% of long-term care facilities are public and fall under the health care system. Standards have been put in place by the Quebec government, which has the jurisdiction to take action on the issue of long-term care facilities. What is missing is financial means.

What falls under federal jurisdiction, however, is the whole issue of supply and personal protective equipment. However, it was recognized that there was a deficiency in that regard during the pandemic, when those elements could have helped prevent much of the transmission of the virus.

Ms. Silas, you'll be able to comment on that, if you want, but I also have some other questions for you.

Do you think that seniors living in long-term care facilities are necessarily unable to provide for the things they need for their own existence?

Do you think that some seniors who are independent, but in precarious situations and without a family network, may choose to go to a long-term care facility?

What is the demographic reality of people living in these types of facilities?

[Linda Silas]

Your question is a heavy one, Ms. Larouche.

I must start by saying that I do not represent Quebec nurses. The Quebec system is completely different from that in the rest of Canada, that's for sure. I am not qualified to answer those questions.

What we do know, as I mentioned, is that long-term care, care for our seniors, is not a priority in any province or territory. Ms. Hall has made it clear that the responsibility lies with a number of players, whether it is the government, the municipality, indigenous communities or the private sector.

It is important for the federal government to look at standards. In fact, it just announced standards, which are great, but they are not mandatory. The province of Quebec and my province, New Brunswick, are just looking at these fine documents, since the standards are not mandatory and are not linked to funding. But that's what needs to be done: The standards need to be attached to funding. Then, if necessary, amendments to the Criminal Code could be considered.

[The Chair, Liberal, Randeep Sarai]

Thank you, Ms. Silas.

I hope I'm okay with time, Ms. Larouche. My clock was a little off, but I guesstimated that it was about two and a half minutes.

Mr. Garrison, you have two and a half minutes.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Thank you very much, Mr. Chair.

I want to go back to Ms. Silas on the question that Mr. Lake refuted about the difference between public and private facilities, because the studies that I am aware of all showed higher death rates from COVID for workers in long-term care and for residents.

I know you don't have the full statistics at hand, but can you just tell us a bit about what you have heard on those specific studies regarding the differences between private, for-profit and non-profit long-term care homes?

[Linda Silas]

Thank you for the question.

What we're working with is a death rate in for-profit homes that is twice as high as the other nursing homes that we see. I mentioned 17% higher in my presentation. Those are the numbers we're working with.

We're hearing from those working at the base that there's a complete difference between a private, for-profit long-term care compared to a community-based or religious-based nursing home.

We are recommending, when we're talking to provincial governments, that you can have a private nursing home, but the for-profits should never come into effect for the care of either children or elders, similar to our public health care system. That is always where the debate is. When we enter negotiations with a for-profit, it's a different language than it is with our community-based homes.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

I have a question, though the time is really short.

Are you aware of any other wealthy country in the world that had to send its armed forces in to provide assistance in private long-term care homes?

[Linda Silas]

No. It was very difficult for health care workers who had to call on their owners and on their managers for dire help. When the report came out with the military—and I'm sure for Ms. Hall and Mr. Lake it was the same thing—we were all distraught. It was very difficult to read. We all committed as providers, as owners and as policy-makers that we would do better.

What we question today for nurses is if going through the Criminal Code is the best way. That's your decision to make as a committee, but for sure we need clarification on the decision for who is responsible and who is covered with this private member's bill. Right now it can attack any nurse working today in a long-term care facility.

[The Chair, Liberal, Randeep Sarai]

Thank you, Mr. Garrison.

I want to thank all of the witnesses and share a little story. I grew up in an old folks' home. My mother used to work there. I was babysat for about an hour between shifts. I vividly remember from my toddler and elementary years all of the hard work, and the bond that lots of staffers had with their patients in these long-term care facilities. Thank you for all of the great work you do in all of your various sectors.

You're now dismissed. You're more than welcome to watch, as the remaining few minutes or so is also public.

We'll go into committee business for the rest of the meeting.

We have the subcommittee's report. Has everyone seen it?

Are you okay with it? Do we need to repeat it, or are you okay?

[Some hon. members]

Agreed.

[The Chair, Liberal, Randeep Sarai]

Okay. That's approved.

There's the travel to Europe. I think the travel budget was sent around. I think it's slightly higher than last time. It's about $15,000. That's actually to Mr. Garrison's suggestion to make sure there are business arrangements on it. Hopefully that will be okay. We'll give it one last try to see if it goes.

Are we all good with that?

[Some hon. members]

Agreed.

[The Chair, Liberal, Randeep Sarai]

I think that's it.

We have Mr. Garrison.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

I think Mr. Van Popta raised an important issue today about the cancellation of the second panel. We're not having officials appear. I think it's very clear that members of the committee would like to have the officials appear. When a committee is asking for advice from the justice department, I've never seen it treated as an option for officials not to appear.

I'm looking for assurance that even though they didn't appear today, they will appear to give us their advice on this bill.