Evidence of meeting #8 for Status of Women in the 43rd Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was caregivers.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Saskia Sivananthan  Chief Research and Knowledge Translation and Exchange Officer, Alzheimer Society of Canada
Vicky Smallman  National Director, Human Rights, Canadian Labour Congress
Diana Sarosi  Director, Policy and Campaigns, Oxfam Canada

December 3rd, 2020 / 12:05 p.m.

Conservative

The Chair Conservative Marilyn Gladu

I'd like to welcome everybody to meeting number eight of the House of Commons Standing Committee on the Status of Women. We're starting our first panel on women's unpaid work. For those of you who are joining us as witnesses, thank you for being here.

We're meeting in this hybrid format pursuant to the House order of September 23, 2020. The proceedings will be made available through the House of Commons website. The webcast will always show the person speaking, rather than the entirety of the committee.

To ensure an orderly meeting, here are a few rules.

Members and witnesses may speak in the official language of their choice. Interpretation services are available at the bottom of your screen. Pick either floor, English or French.

For members participating in person, proceed as you usually would when the committee is meeting. Masks are required unless seated and when physical distancing is not possible.

Before speaking, please wait until I recognize you by name. If you're on the video conference, please click on the microphone icon to unmute yourself. For those in the room, your microphone will be controlled as normal. I'll remind you that all comments by members and witnesses must be addressed through the chair, and when you're not speaking, your mike should be on mute.

I would like to introduce our witnesses. From the Alzheimer Society of Canada, we have Dr. Saskia Sivananthan, chief research and knowledge, translation and exchange officer. From the Canadian Labour Congress, we have Vicky Smallman, who is the national director of human rights. From Oxfam Canada, we have Diana Sarosi, director of policy and campaigns.

Each of you will have five minutes to make your remarks before we go into our round of questions.

With that, Doctor Sivananthan, we'll begin with you for five minutes.

12:05 p.m.

Dr. Saskia Sivananthan Chief Research and Knowledge Translation and Exchange Officer, Alzheimer Society of Canada

Thank you, Madam Chair, and good afternoon to members of the Standing Committee on the Status of Women.

The Alzheimer Society of Canada appreciates the opportunity to contribute to the committee's important study on unpaid work. Today I will address how the critical role of unpaid caregiving, specifically as it relates to dementia care, is almost entirely invisible in our society.

Our key point to this panel is this: Caregiving is essential to our social fabric. The work of caregiving falls primarily to women, with direct negative consequences to them as individuals, and society at large. We urge the committee to shape and drive policy changes to reflect a core reality: This is not just a women's issue. This is a crisis, with harsh consequences for all Canadians.

I will discuss this through three key points: measurement, acknowledgement and compensation.

There are well over half a million Canadians living with dementia right now. It has a range of symptoms that, over time, destroy a person's ability to function and perform everyday tasks that we take for granted. This leads to the need for 24-hour personal care, and there are no survivors of dementia.

In fact, one in two Canadians is touched by dementia. Women make up two-thirds of all people diagnosed, and more than 60% of caregivers are women. By those numbers, six members of this standing committee could become caregivers.

The impact of this is multi generational. Wives are more likely to become caregivers for their husbands than vice-versa, and daughters make up more than one-third of all dementia caregivers. Without adequate home and community care support for people living with dementia, this care falls overwhelmingly on women.

What is the impact?

Lisa Raitt, a former MP, is the full-time caregiver for her husband who was diagnosed with dementia five years ago at the age of 56. Like many women, Lisa is balancing multiple responsibilities: motherhood, her work and supporting her husband. She's unable to do other work until her husband is asleep, or unless she has a paid caregiver to support her. In Lisa's words:

...the amount of pressure that is at play on the caregiver...[needs to be talked about and] so few people talk about it meaningfully in society.... I'm the nurse that's charting all of the reactions and the treatments...I'm out of my league.... a lot of people...die because of caregiving.... They're stress-killed....

In terms of measurement, around 20% of women are forced to give up work entirely to become a full-time caregiver. This is a multi-faceted strike against the economy. What happens to the local and federal taxes when thousands of women step away from the workforce? What happens to the investments made in a woman's education by the state, or by an organization's investment in her career? In a two-income household, what happens when one of these is lost?

Caregiving is not just a women's issue.

In terms of acknowledgement, dementia itself is already burdened by the stigma associated with the disease, but this stigma also carries to the family caregivers. Study after study demonstrates that caregiving has a serious and long-lasting impact on the mental and physical health of those carrying this responsibility. Combining this with the added social stigma not only increases the negative health impacts on them personally, but on the health system at large.

In terms of compensation, women from black, indigenous and other communities of colour are not just those at greatest risk of developing dementia, they are the predominant caregivers, either paid in long-term care facilities or unpaid within their families and communities, yet the skills and strength they bring are rarely acknowledged, valued or appropriately compensated, even when paid. In fact, unpaid care is important to economic activity and an indispensable contribution to society, much like doctors, teachers and armed forces personnel. All ensure the well-being of our citizens, yet no one would ask any of them—a surgeon, a soldier or a teacher—to provide their services for free.

The 2015 Alzheimer Disease International report measured the global impact of dementia. Overwhelmingly the cost of informal, unpaid care makes up 40% of the overall cost of dementia, which in Canada exceeds $10 billion annually.

Women do the bulk of paid and unpaid caregiving around the globe, and it is systemically undervalued. Not only must this work be compensated, but caregiving must be an economic priority providing stability and adequate education to those who must take on this responsibility, and we must make efforts to erase the stigma attached to it.

12:10 p.m.

Conservative

The Chair Conservative Marilyn Gladu

I'm sorry. That's your time. We look forward to the rest of it during the questions.

We will go to Ms. Smallman, from the Canadian Labour Congress, for five minutes.

12:10 p.m.

Vicky Smallman National Director, Human Rights, Canadian Labour Congress

Thank you for inviting me to be a part of today's discussion. I'm pleased to appear on behalf of the more than three million workers who are part of the Canadian Labour Congress and working across the country in every sector of the economy.

I'm very happy that the committee has decided to further study women's unpaid work, an ongoing systemic challenge that has been exacerbated by the COVID-19 pandemic in ways that were well described by the previous witness.

The brutal reality is that our economy—our society—cannot function without the unpaid labour of women. There's an unstated assumption that women and caregivers will just be there when things need to get done, and this has been aptly illustrated this year.

Gender stereotypes and gender roles are deeply ingrained, and they're systemic. It's not just about individual families and who does the cooking, garbage or laundry; the impact of this unequal burden is also reflected in wage rates, labour market participation, lifetime earnings and career progression.

It's difficult to really tackle the question of the unequal distribution of unpaid work, particularly unpaid care work, without meaningfully considering the issue of paid care work—who does it and what their wages and working conditions are—as well as the question of how the care is delivered and who has access to that care.

That's why the labour movement has called for the establishment of a care economy commission, with a mandate to study, design and implement a care strategy for Canada that would create a broad and inclusive labour market strategy to achieve high-quality, equitable care jobs; examine paid and unpaid care work and develop a road map to meet the increasing demands for care; and reduce and redistribute women's unpaid care work by improving access to public care services for children, the elderly and people living with disabilities.

In 2018, the International Labour Organization released an excellent study on “care work and care jobs”. It said, “No substantive progress can be [achieved] in achieving gender equality in the labour force until [inequities] in unpaid care work are tackled through the effective recognition, reduction and redistribution of unpaid care work between women and men, as well as between families and the state.”

The ILO report sets out a “5R Framework for Decent Care Work” calling for policies to “recognize, reduce and redistribute unpaid care work; reward paid care work, by promoting more and decent work for care workers; and guarantee care workers' representation, social dialogue and collective bargaining”.

Each part of this framework includes a set of policy recommendations. A care economy commission could examine how the 5R framework could be implemented in a Canadian context.

While it's tempting to focus on the unequal distribution of care responsibilities within households, it's not enough to look for ways to encourage men to take on more responsibility. We also need to examine ways to reduce families' overall care burden and ensure the state takes on its fair share of responsibility. Quality public services are essential to the reduction and redistribution of care.

This requires a shift in thinking, with human rights at the core of a new approach. Care is a collective concern, not simply a private family matter. People who need care—children, the elderly, people with disabilities—should have the right to the care they need to support them, and care services should be seen as essential social infrastructure.

We need to act now. The need for care will only increase as our population ages. COVID-19 made this looming crisis even more obvious, revealing all of the gaps and the cracks in our fragmented and precarious system. For too long, austerity-driven fiscal policies have portrayed care as a drain on the fiscal pocketbook rather than as social infrastructure needed to sustain strong communities, reduce inequality and support labour market participation.

Canada's market-based approach to care and the off-loading of many care services to for-profit companies has driven down wages and working conditions for a workforce that is primarily women, many of whom are racialized. This has a direct impact on the quality of care overall, something that was demonstrated in long-term care throughout this pandemic with tragic results. For those who cannot find or afford services, the burden falls often to women caregivers.

Our collective challenge is to find ways to relieve the short-term pressures of the pandemic while ushering in long-term integrated shifts that will build robust care systems to help us weather future crises. While it's tricky to walk and chew gum at the same time, I'm confident we can do it.

Let's make the right care a reality in Canada starting with a care economy commission to develop our 5R road map.

Thank you.

12:15 p.m.

Conservative

The Chair Conservative Marilyn Gladu

Very good, thank you.

Now I'll go to Ms. Sarosi for five minutes.

12:15 p.m.

Diana Sarosi Director, Policy and Campaigns, Oxfam Canada

Thank you so much.

Dear committee members, thank you for inviting Oxfam Canada to present on the important issue of women's unpaid work.

At Oxfam Canada, we put women's rights and gender justice at the heart of everything we do, both here in Canada and in our work with some of the most disadvantaged communities around the world. As a global confederation, Oxfam has been raising the alarm bells on rising inequality over the past decade.

In 2019, the world's billionaires had more wealth than 4.6 billion people combined. This great divide is the product of an exploitative and sexist economic system that values the wealth of the privileged few, mostly men, over the billions of hours of hard and essential work that women and girls do every day.

As COVID-19 has shown us, much of this work of caring for children, elderly people and those with physical and mental illnesses or disabilities and domestic work to keep households running is essential to our communities, our societies and our economies, but it is nearly all unpaid and invisible.

Make no mistake, our economies are built on the backs of women, especially women of colour who provide 12 billion hours of unpaid and underpaid care work each day. The monetary value of unpaid care work globally for women aged 15 and over is at least $10.8 trillion annually, three times the size of the world's tech industry.

In Canada, women spend 50% more time on unpaid care work than men. Despite increases in women's participation in paid work and changing social norms around the male breadwinner model, men's participation in unpaid care work has not increased in any substantial way. Instead, women have taken on a double burden of paid work and unpaid care duties, increasing their total working hours and reducing their ability to rest.

The double burden of paid and unpaid work has been significantly exacerbated by the COVID-19 pandemic. In a study conducted by Oxfam in June on the impacts of the pandemic on unpaid care work in Canada, four in 10 Canadians stated that, as a result of the pandemic and social distancing measures, their household's amount of domestic and care work had increased, with the bulk of the work falling to women. Over 70% of women surveyed reported feeling more anxious, depressed, isolated, overworked or ill because of having to shoulder even more unpaid care work as a result of the pandemic.

Unpaid work is one of the biggest determinants of women's economic security. Globally, 42% of women cannot get jobs because they are responsible for all of the caregiving compared to just 6% of men. In Canada, too many women are stuck in part-time and contract work due to care responsibilities.

The pandemic has severely increased women's economic insecurity. Take the example of Asha, a 32-year-old communications professional who had been steadily promoted in her company over the past few years. She was on maternity leave with her first child until April of this year. Then she went back to working full-time without daycare options and no extended family to help her. With her partner working in an essential occupation, she was routinely staying up until 2 a.m. to 3 a.m. to meet work deadlines while caring for her new baby. In October Asha quit her job.

Women living in poverty and ethnic and racial minorities suffer more acutely from the social and economic fallouts of the pandemic. In the same Oxfam study referenced earlier, indigenous women and black women reported greater challenges due to increased house and care work due to COVID-19 than their white peers. Indigenous women were three times more likely as white respondents to say they have had to give up looking for paid work. Women make up 70% of all pandemic-related job losses in Canada, and women's labour force participation has fallen to 50%, the lowest in over 30 years.

The best investment Canada can make right now to address the widespread social and economic fallout of the pandemic-induced recession—now termed the “she-cession”—and get women back to work is to invest in child care. After decades of dragging their feet and leaving care to market forces, government inaction has resulted in the near collapse of the sector during the pandemic, leaving more families without essential care.

A recent survey of licensed child care centres in Canada found that 70% laid off all or part of their workforce, and more than one-third of the centres across Canada are uncertain about reopening.

The government's commitment to a significant, long-term sustained investment to create a Canada-wide early learning and child care system announced in the throne speech, and underscored in the fall economic update, comes at a critical time. Canada needs a public child care system and federal leadership is needed to realize it.

12:20 p.m.

Conservative

The Chair Conservative Marilyn Gladu

I'm sorry, that's your time. We'll have to get the rest of it during the questions.

We're going to start into our first round of questions with Ms. Wong for six minutes.

12:20 p.m.

Conservative

Alice Wong Conservative Richmond Centre, BC

Thank you, Madame Chair, and thank you, witnesses.

Certainly this is a topic very close to my heart. For the Alzheimer Society of Canada, I've worked with your organization before and definitely have already heard about all of the challenges, especially for caregivers, whether paid or unpaid.

You hit the nail right on the head. There are so many important issues related to family care, an unpaid job mostly done by women. My question is what about support from employers because very often women who have caring responsibilities will have to take time off and will also have to give up promotion opportunities because they want to spend more time. At the same time, their co-workers, who will probably pick up the rest of the responsibilities they've left behind will say, how come this colleague of mine is always absent and how come I'm always doing her job?

Of course, the pandemic has already created more challenges in the house, but what about the workplace in general? Can I ask Saskia to comment on that please.

12:20 p.m.

Chief Research and Knowledge Translation and Exchange Officer, Alzheimer Society of Canada

Dr. Saskia Sivananthan

Yes, I can. Thank you for bringing that up.

I think you make a very good point. There are two pieces to it. The first is, you're absolutely right from a workplace perspective, caregiving—informal and formal—has a significant impact on women, but the question for me comes back again to how we economically frame caregiving. Because informal caregiving is seen as unpaid work and not adding value, from a workplace perspective then it can be viewed the same way.

This is why it's essential that we recognize what caregiving is, what the value is that we bring and we compensate it as such, because then it would not be a competing responsibility. It is valuing the caregivers who are providing essential services to the economy. That would be the approach I think would help us to recognize and move forward the agenda on caregiving.

12:20 p.m.

Conservative

Alice Wong Conservative Richmond Centre, BC

You're exactly right.

On the other hand, sometimes the caregivers themselves are only friends. There are seniors and other people with challenges who do not have family at all and so their friends actually would have to pick up that kind of responsibility.

Now, I'm coming back to caring for the carers. What about them? Just now we heard from all three of you that these caregivers are unpaid, and suffering stress and anxiety, especially during the pandemic times. What kind of support do we actually.... For some, we could just give them a day off, if someone could take the responsibility for just one day. It's like a one-day day care for their seniors or those with Alzheimer's. Of course, with the pandemic it's very challenging to do that.

My question to you, again for the Alzheimer Society, is this. On the one hand, we value their work and on the other hand, we do have to care about them. For example, in England they have the National Care Association, which recommends policies to the British government and what kind of support they have to do. I was able to visit with them when I was the minister. Can you shed some light on this?

12:25 p.m.

Chief Research and Knowledge Translation and Exchange Officer, Alzheimer Society of Canada

Dr. Saskia Sivananthan

Yes, absolutely. Thank you so much for bringing that up.

I think Canada has the opportunity to be a leader, from a policy and legislative perspective, when it comes to caregiving and really driving change. In my previous role—I was with the World Health Organization on the global dementia team—this was one of the issues we looked at. Globally, when you look at countries, what have they done from a legislative and policy perspective to support caregivers by recognizing them and compensating them? Sadly, it's very limited. Ireland, for example, in 2017 did recognize caregivers and extended financial allowances for caregivers, so this is one of the policy tools that could be leveraged, but outside of that, there are very few. I think this goes back to your previous point about extending work hours, extending allowances just as we would for women who have just given birth, recognizing that caregiver responsibility and financially compensating for it, and doing so through appropriate policy and legislative changes.

12:25 p.m.

Conservative

Alice Wong Conservative Richmond Centre, BC

How about mental wellness? Right now we talk about the challenges for mental wellness. These unpaid caregivers need that very crucial point to keep them going and also to let them know that they're not alone. What would you suggest?

12:25 p.m.

Conservative

The Chair Conservative Marilyn Gladu

Unfortunately that's your time.

We're going to go to Ms. Sidhu for six minutes.

12:25 p.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you, Madam Chair.

Thank you to all the witnesses for being here and giving us this valuable information.

My first question is for Dr. Sivananthan. You make an excellent point about caring for the caregivers. That is why our government recognized this with the Canada caregiver benefit, because we know it is very important for families.

Without a doubt, one of the most devastating outcomes of the pandemic has been on long-term care homes. It is a fundamental responsibility of all of us to ensure that our seniors are safe and well cared for. Just this week, our government announced $1 billion for the safe long-term care fund. In partnership with the provinces and territories, we will establish a national standard for long-term care facilities. We also made the largest investment in home and community care in Canadian history.

Doctor, other than these investments, what can the federal government do to help seniors age in the comfort of their homes? Additionally, what can the government do to ensure the safety and well-being of the family members who want to be involved in their care?

12:25 p.m.

Chief Research and Knowledge Translation and Exchange Officer, Alzheimer Society of Canada

Dr. Saskia Sivananthan

I do want first address your earlier point and commend the government on making that investment and committing to bringing forward these national standards that are so essential in long-term care. Within long-term care, where the majority, again, of personal support workers who are providing those daily care duties are women and are women of colour, part of the concern has been that these women are not being appropriately compensated. They're not being given the appropriate benefits that they require. They're not even being given appropriate full-time employment, and so they're trying to make ends meet by taking part-time work at multiple locations. I was speaking to a long-term care director just the other day who talked about the difficulty where many personal support workers are being forced to leave this work and in fact work for their local LCBO, because they—

12:25 p.m.

Conservative

Jag Sahota Conservative Calgary Skyview, AB

Madam Chair, on a point of order, there are six Liberal members on right now.

12:25 p.m.

Conservative

The Chair Conservative Marilyn Gladu

I believe that Mr.—

12:25 p.m.

Liberal

Peter Fragiskatos Liberal London North Centre, ON

On a point of order, I'm here as an associate member, and should Ms. Sidhu have to attend to a family matter then I will step in for her again, as noted at the previous meeting.

12:25 p.m.

Conservative

The Chair Conservative Marilyn Gladu

That's correct. Thank you.

Sorry to interrupt.

12:30 p.m.

Chief Research and Knowledge Translation and Exchange Officer, Alzheimer Society of Canada

Dr. Saskia Sivananthan

It's no problem.

Just to wrap that point up, it was that personal support workers were working at their local LCBOs because they had more stability and better compensation. Even for paid caregivers, such as personal support workers, this is an issue. For home and community care, however, the way the government can take more ownership and really move forward the agenda is by building more robust home and community care supports so that seniors, people living with dementia, and their caregivers have the appropriate supports to be able to age at home and in their communities.

12:30 p.m.

Liberal

Sonia Sidhu Liberal Brampton South, ON

Thank you.

For the other two witnesses, anybody can answer that. Our government recognizes the extraordinary toll that the pandemic has taken on women—you talked about women of colour and indigenous women—but we are moving forward with our plan to create a Canada-wide early learning and child care system. Beginning with the federal secretariat to support this work and new investment to support early childhood educators, how do investments in early learning and child care and long-term care help address the challenges and barriers that come along with the non-paid work?

12:30 p.m.

National Director, Human Rights, Canadian Labour Congress

Vicky Smallman

Maybe I'll start.

I think the investments that were announced this week have been very welcome. The establishment of the secretariat is an essential step towards building a comprehensive pan-Canadian system of early learning and child care. What needs to happen next, though—and in short order—is the funding necessary to sustain the creation of a system in the long term. Without that, we will not get closer to the kind of universal access that is required to redistribute that unfair burden that is currently shouldered by women and to enable their participation in the labour force.

Diana, I don't know if you have anything to add.

12:30 p.m.

Director, Policy and Campaigns, Oxfam Canada

Diana Sarosi

What I would like to add is around how this money is spent. Obviously, this is going to provinces and territories through their transfers. At the current time, there just aren't enough measurements and targets put in place to ensure that this money is actually spent in a way that increases affordability, quality and flexibility in child care. That is one thing that I think needs to be strengthened through the multilateral framework that currently exists with the provinces.

One thing that I would like to underscore, also touching a bit on what was previously said, is the fact that there is a bit of a difference between elder care and child care. Child care does really provide sort of a path for women to enter the workforce that wouldn't be possible otherwise because they have children at home. It's not quite like that for elder care, for example. Child care really is sort of a stepping stone for increasing women's participation in the labour force.

12:30 p.m.

Conservative

The Chair Conservative Marilyn Gladu

I'm sorry. That's the time for that question.

We're going to go to Madam Larouche for six minutes.

12:30 p.m.

Bloc

Andréanne Larouche Bloc Shefford, QC

Thank you very much to the witnesses for their testimony, which is touching.

We see that invisible work is much more widespread than we might think and that it affects many more aspects than we think, for volunteers, caregivers or women supporting their families.

That said, perhaps we are missing data. I have many discussions with a major association called Afeas in my home province of Quebec. I would like to ask you some questions based on my discussions with that association.

Since the beginning of the pandemic, what are the statistics on the invisible workload for women and men? Are there any figures on that? Can they be compared with pre-pandemic figures?

We have seen data on the impact on the economy, for example. Why wouldn't there be information on invisible work as well?

I think Statistics Canada should address this issue given that organizations, even well-funded ones, do not have the opportunity or even the capacity to paint a complete picture of invisible labour in Canada.

Why is it important to have a picture that is much more reflective of the reality?