Debates of March 22nd, 2021

Opposition Motion—Long-Term Care

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, I appreciate that the member opposite spoke passionately about a way to support seniors.

We all know there have been tragic stories coming out of the private, public and not-for-profit homes. All providers need to be accountable for protecting those in long-term care. However, our focus is in getting seniors the care they need no matter where they live. That is why we all want a national standard, but in the right way.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, the hon. colleague talked about the government's role. I am a little alarmed that the government has become an expert at deflection, shirking and buck-passing. For example, the sexism occurring in the military was not its responsibility. The vaccination delays are the fault of the premiers. We have no pharmacare because the provinces are stalling.

Sometimes the government can not make up its mind. Just today I asked the government to take the profit out of long-term care. The minister lectured me that this was a provincial responsibility, but then proceeded to outline the Liberal commitment to national standards, training and wages in long-term care. Which is it?

Does my hon. colleague believe that the federal government can play a role in taking profit out of long-term care or does she think it is the responsibility of someone else?

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, the member for Vancouver Kingsway and I work together on the health committee. I want to thank him for his passion.

Regardless of where seniors live, those living in long-term care deserve quality care and to be treated with dignity. I agree with that. We heard how the for-profit homes failed seniors from families and advocacy groups. All for-profit providers need to be accountable for protecting those in long-term care. I hear about vaccinated residents not able to see their loved ones still—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Questions and comments, the hon. member for Rimouski-Neigette—Témiscouata—Les Basques.

[Maxime Blanchette-Joncas, Bloc, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Madam Speaker, I listened carefully to my colleague's speech, but it made me very confused.

During question period this afternoon, the Minister of Health said that it was the right and responsibility of Quebec and the provinces to deliver health care. If health care is Quebec's responsibility, how can this government now tell us that it wants to set national standards? The government cannot simply take that right; it has to do so through legislation.

I remind my colleague that sections 91 and 92 of the Constitution Act, 1867, state that health care is the jurisdiction of Quebec and the provinces. I would like to know what the federal government can do that Quebec is not capable of doing. After all, the federal government does not run any hospitals and has no experience in delivering health care.

[Sonia Sidhu, Liberal, Brampton South, ON]

Madam Speaker, we have worked with Quebec and the provinces and territories since 2015. Our government has made a historical investment to support health care for Canadians, including new target funding for provinces and territories. In 2020, our government provided almost $41.9 billion cash support to the provinces and territories through the Canada health transfer. Over the next five years, the Canada health transfer funding to the provinces and territories is expected to total approximately $235 billion.

I thank the member for his passion and agree that we need to do a lot, but we need to do it in the right way.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, in politics, it is imperative to speak truth to power. This is especially the case when matters of life and death are involved.

Today, I rise to speak this truth. Canada has utterly failed to protect vulnerable long-term care residents and workers throughout the COVID-19 pandemic, and this failure has cost the lives of thousands of Canadians.

According to the National Institute on Aging, 2,611 long-term care facilities and retirement homes across Canada have been ravaged by COVID-19 outbreaks. This has led to the deaths of 14,802 residents and 27 workers, representing 67% of all COVID-19 deaths in Canada to date. This is the worst record of any nation in the OECD. Worse, successive governments allowed this to happen with eyes wide open. Despite repeated warnings, we did not act in time to prevent or meaningfully abate this humanitarian disaster.

During the first wave of this pandemic, more than 840 outbreaks were reported in long-term care facilities and retirement homes across Canada, accounting for more than 80% of all COVID-19 deaths in the country in the first six months. Again, this represented the worst record among all comparable nations and double the OECD average.

The situation was so dire that the Canadian Armed Forces had to be called in, and what they found was appalling. Residents were discovered underfed, abandoned and afraid. In some cases, they had been left to die alone in bed covered in their own urine and feces. These stories shocked our conscience and challenged our self-image as a compassionate and humane society. However, the shock quickly turned to outrage as Canadians learned that for-profit operators were paying out millions of dollars in dividends to their shareholders, while accepting public subsidies and neglecting the residents under their care.

Last fall, as Canada sat on the crest of a second wave of COVID-19, the federal government pledged to “work with the provinces and territories to set new, national standards for long-term care.” It also pledged to bring in “Criminal Code amendments to explicitly penalize those who neglect seniors under their care.”

Unfortunately, it has failed to make any meaningful progress on these commitments to date. As a result, the second wave of the COVID-19 pandemic has proven to be even deadlier than the first for long-term care and retirement home residents. In total, 7,470 residents succumbed to COVID-19 throughout the recent resurgence compared to 7,022 deaths during the first wave.

As Canada's Chief Public Health Officer, Dr. Theresa Tam, recently noted:

I think the tragedy and the massive lesson learned for everyone in Canada is that we were at every level, not able to protec our seniors, particularly those in long-term care homes. Even worse is that in that second wave, as we [were] warned of the resurgence, there was a repeat of the huge impact on that population.

There is simply no excuse for our country's repeated failure to act. This carnage was entirely foreseeable and avoidable. We must ensure this never happens again. If we cannot come together now to address the systemic deficiencies in Canada's long-term care system, when will we ever? COVID-19 has laid bare a fragmented and under-resourced long-term care system across Canada that is heavily reliant on for-profit—

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Madam Speaker, I rise on a point of order. I apologize to my hon. colleague, but I believe he failed to mention he will be splitting his time with the member for South Okanagan—West Kootenay and I would like to provide him with the opportunity to do so.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I should have said that at the beginning. Yes, I will be splitting my time accordingly.

Several studies conducted throughout the pandemic have found that outbreaks at for-profit facilities have been more extensive and have led to more resident deaths. Indeed, decades of research have demonstrated that long-term care facilities run on a for-profit basis tend to have lower staffing levels, more verified complaints, more transfers of residents to hospitals and higher morbidity rates. This should come as no surprise since for-profit management practices are designed to generate returns for investors rather than provide high-quality care. These include paying the lowest wages possible and hiring part-time casual workers and those defined as self-employed in order to avoid paying benefits or providing other protections.

These workers often cannot afford to stay home when they are sick and can carry infections from facility to facility, as we learned was so deadly. For-profit models incentivize and reward cost-cutting. Indeed, we have heard countless stories of for-profit operators locking up personal protective equipment, leaving staff exposed, and rationing vital items like soil pads for incontinent seniors.

A recent review of the contracted long-term care sector in British Columbia, titled “A Billion Reasons to Care”, found that while receiving, on average, the same level of public funding, there is a pattern in the contracted long-term care sector for-profit operators paying lower wages, with care aides in for-profit facilities being paid up to 28% or $6.63 less per hour than the industry standard. Not-for-profit care homes spend $10,000 or 24% more per year on care for each resident compared with for-profit facilities, and for-profit care homes failed to deliver 207,000 funded direct care hours per year, whereas not-for-profit care homes deliver 80,000 hours of direct care beyond what they were publicly funded to deliver.

New Democrats believe that every dollar that flows to long-term care should be spent on residents, not siphoned off for corporate profits and shareholder dividends. We know that health care is best delivered through a non-profit model, both on health and access grounds. Research clearly demonstrates a systemic pattern of lower-quality care in for-profit care homes, while there is little, if any, evidence demonstrating benefits from providing public funding to for-profit facilities.

That is why the NDP motion before the House today calls on the federal government to implement national standards for long-term care that fully removes profit from the sector. New Democrats know that this will not be accomplished overnight. However, with federal leadership, we believe it will be possible to transition all for-profit facilities in Canada to not-for-profit management by 2030.

As a first step, New Democrats are calling on the federal government to work with the provinces and territories to freeze licensing of new for-profit facilities and to ensure that measures are in place to keep all existing beds open during the transition. After decades of underfunding and cuts in Canada's long-term care sector, this strategy must be backed up by significant new federal funding tied to binding national standards of care and the principles enshrined in the Canada Health Act.

The Conference Board of Canada estimates that an additional 200,000 long-term care beds will be needed across Canada by 2035, requiring $64 billion in capital spending and $130 billion in operating spending. However, the Conference Board's cost-benefit analysis found that the benefits of these new beds would be greater than the costs, even without considering the improved health outcomes. In fact, these investments are projected to have a positive impact on the economy, contributing a net $235 billion to real GDP and supporting 120,000 jobs every year. Similarly, the demand for nurses to provide continuing care for seniors would create an increase of nearly 80,000 full-time jobs.

Simply put, our parents and grandparents built this country. They sheltered and nurtured us when we were young and vulnerable. In turn, we have a duty to take care of them as they age, but COVID-19 has revealed a bitter truth: We have abandoned this responsibility as a country. Let no one claim that we do not understand the consequences of this collective neglect. It is time to make this right. I ask every colleague in the House to join New Democrats today to start the work to do so.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, our New Democrat colleagues have been asked throughout the day whether any consultation or buy-in exists from the provinces. As we know, legislation like this would have a massive impact on provincial jurisdiction, so when we bring forward stuff like this, we really need to make sure that a buy-in is there.

Every time the question has been asked, New Democrats just come back and answer it by saying that they know we can do things without the provinces, because the provinces will come onboard. We just have to give them the time. We have to bring this forward and then they will come onboard.

However, New Democrats are neglecting to answer the question. The question is this: Has there been any consultation with the provinces and have they provided any feedback on this particular motion the New Democrats have brought to the House today? Can the member answer with a “yes” or “no” as to whether consultation was done with the provinces, and what is their feedback?

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, as my hon. colleague well knows, this is a motion brought before the House that calls on the Liberals to commit to a principle. The principle we are asking the Liberals to determine today is whether they do or do not believe that we should be making profits off the care of our seniors. That is the question before the House today.

Once we know the government is committed to that, then we need national leadership backed up by $5 billion in funding tied to the provinces and territories agreeing to meet national standards. This member well knows that his government committed to national standards six months ago, but has yet to do a single thing about it. This motion is calling for a clear commitment to move this file forward and the first—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Questions and comments, the hon. member for Trois-Rivières.

[Louise Charbonneau, Bloc, Trois-Rivières, QC]

Madam Speaker, I would like to thank my hon. colleague from Vancouver Kingsway for his speech.

As I understand it, the NDP motion targets primarily private centres to ensure that they do not have an unfair advantage. However, health being a provincial matter, does my colleague not think that problems at long-term care homes are caused mostly by the health transfer imbalance?

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, the member is right that it really is a multi-faceted problem. We need more resources, both financially and otherwise, and an improvement in standards. When we talk about national standards, we are talking about things like making sure there is a minimum number of care hours per day per resident and that there is a minimum ratio of care aides to patients. We would tie the federal funds to provinces that agree to meet those standards while finding their own local solutions and recognizing that there may be many pathways to meeting those standards.

There is a wide diversity in care, and surely we can make sure that every senior in this country has access to minimum standards of care backed up by the federal government. That is what we are asking the Liberal government to do today.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Madam Speaker, we have heard again and again that women have been disproportionately impacted by the pandemic. Women perform some of the major roles within long-term care. They are those care providers.

Could the member talk about the fact that women are often underpaid in these roles? What would removing for-profit care within long-term care do to help women in this sector?

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, this gives me a chance to thank the member for London—Fanshawe for her tenacious advocacy on behalf of women in this country. There is an incredible gender aspect to this issue today. It is a heavily gendered workforce. It is a heavily racialized workforce. Most care is provided by women and women of colour. Of course, most of the seniors are women.

We have a government that constantly claims to be a feminist government, but when we call on it to act by taking concrete measures that would actually be of tangible benefit to improving the lives of women, it balks. I was shocked at the comments by the hon. colleague from Brampton South, who talked about the need to preserve profits, as opposed to our passing this motion that would make tangible improvements for women and seniors everywhere across this country. It is time to put them first, not the—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Resuming debate, the hon. member for South Okanagan—West Kootenay.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, I would first like to thank the member for Vancouver Kingsway not only for sharing his time with me today, but also for spearheading this very important NDP motion on why it is essential that we take the profit out of Canada's long-term care sector.

I want to pay my respects to the thousands of Canadians who have died in the last year in long-term care, the most vulnerable victims of the COVID-19 pandemic.

Moreover, I would like to say a heartfelt thanks to all of the workers in long-term care in Canada. These caregivers, cleaners and other staff have worked in very difficult conditions for the past year. They have been at the front of the front lines. Many have come down with COVID themselves and, tragically, some have lost their lives. This is hard work. It is stressful work and it is done by people who truly care for the people they work for. I want to make it crystal clear from the start that these workers are not the problem in the long-term care crisis. They are working as hard as they can to make the best of what is an almost impossible situation.

We hear a lot about the ravages of the pandemic in care homes in Ontario and Quebec, but the pandemic has hit long-term care facilities across the country. In my riding, McKinney Place Extended Care in Oliver was home to 59 residents. Fifty-five of them contracted the virus, as well as 23 staff members. Seventeen residents died before the outbreak was declared over in mid-January. In the nearby Sunnybank Retirement Centre facility, 27 residents, 10 staff and one essential visitor contracted COVID; and six residents died in that outbreak. Across Canada, 42%, or almost half, of Canada's long-term care homes have experienced COVID outbreaks. Those outbreaks represent about 80% of the deaths from this pandemic in Canada.

The fact is that our most vulnerable citizens found themselves in situations from which they could not escape. They were often being cared for by people who were paid so little and given such minimal shift times that they had to work in two or three care homes to make a living. Despite all of the precautions within the homes, some of these workers inadvertently passed the virus from one facility to another.

A recent article by Paul Webster in The Lancet, the world's most respected medical journal, puts a lot of this into perspective. Webster reports that Canada had the worst record of fatalities in long-term care homes for any wealthy country in the world, a situation that many called a national disgrace. He cited Pat Armstrong, a sociologist at York University in Toronto, who has studied Canada's long-term care facilities for almost 30 years, in saying that this terrible record comes from the historical decision to exclude long-term care facilities from Canada's public health system. Armstrong pointed out that “This has resulted in under-training and poor treatment of workers, substandard and ageing facilities, overcrowding, and poor infection control capabilities.”

Armstrong also found out that there is a lot of evidence to support the contention that privately owned facilities supply lower-quality care in Canada, and that there should be much more government oversight of all facilities. Indeed, researchers from Toronto's Mount Sinai Hospital found that, on average, privately owned care homes in Ontario delivered inferior care and had higher rates of death during the pandemic. These problems existed before the pandemic, and have simply been exacerbated by the ravages of COVID.

In 2013, eight years ago, I met with a family who had lost both their mother and father to substandard care at a privately owned care home in Summerland, British Columbia. After their concerns became public, the province investigated and found that staffing levels at the facility were far too low. Months later, the company that owned the facility, Retirement Concepts, reported that it was trying to hire more staff but was having trouble filling those new positions. As Mike Old of the Hospital Employees' Union has said, Retirement Concepts is known for paying low wages and that has resulted in chronic under staffing at many of its facilities.

Retirement Concepts operates 17 facilities in B.C., two in Alberta and one in Quebec. In 2016, Retirement Concepts was sold to Anbang Insurance Group of China for more than $1 billion. Since then, problems at Retirement Concepts homes seem only to have gotten worse. In the last two years, the operation of its properties in Courtenay, Nanaimo and Victoria was taken over by the provincial health authority, and last year the Summerland facility joined that list, all because care levels were inadequate, mostly due to understaffing.

Retirement Concepts is not alone in understaffing problems. A mother of a good friend of mine moved into a long-term care home in Penticton when she could no longer take care of herself. My friend reported that the staff was hard-working and attentive, but completely overworked. There was always a “now hiring” sign out front. Apparently the home could not afford to pay workers as much as the local hospital, and so it was constantly losing the most experienced staff whenever a job opened up at that hospital.

I remember visiting that facility in 2015, six years ago, and talking to the staff about working conditions. I was shocked to find out that some of the staff had worked there for 20 years but were making less money in 2015 than they were making when they started in 1995. No wonder they were tempted to leave whenever they could.

One last story about care in a for-profit home is about Louise, a constituent of mine. Her brother was living in a care home in Ontario run by Revera, another big company, but one owned by the Public Sector Pension Investment Board, the Crown corporation that manages public service pensions. Louise praises the staff at the care home. Her brother died suddenly last May, apparently not from COVID, and when Louise heard the sad news, she asked the staff if there was anything she needed to do to alert the Revera office about her brother's death and was told no. Imagine her surprise when she was later charged not only for the May rent but also for June and half of July. Being charged for months not used at $5,000 a month is not the news one likes to hear after the death of a loved one, but it is indicative of the profit motive that these privately owned care homes have.

We must take the profit out of long-term care facilities. Because Revera is owned by a Crown corporation, it could and should be the first step in government action. Yes, we need better national standards for care homes, but that by itself will not fix the situation. Every province has minimum standards, but they are not being met, as the examples I have just gone through have shown, and they are not being met because of the pressure to maintain profits for shareholders.

Canadians want to get the profit out of long-term care. An Abacus poll in May found that 86% of Canadians are in favour of bringing long-term care facilities into the Canada Health Act.

Our parents and grandparents deserve to live in dignity in the last years of their lives. They should not be warehoused in facilities where the number one priority of management is not their mental and physical health but the financial benefit to shareholders.

We can change this. We must create a long-term care system in which both workers and residents are valued, a system that would get rid of the fear that most of us have about moving into a care home in our last years, and the first step to building that new system is to take the profit out of long-term care.

[Mark Gerretsen, Liberal, Kingston and the Islands, ON]

Madam Speaker, I have been listening to the discussion today and I think it is safe to say that all members in this House, or at least those who have spoken, recognize the fact that something has to be done differently. Most are talking about national long-term care standards, and I think it is extremely important that we look towards ways the federal government can work with our provincial partners to do something significant when it comes to taking care of the elderly in Canada.

My problem with the motion before us is that it says, “The House call upon the government to ensure that national standards for long-term care which are currently being developed fully remove profit from the sector”. National standards, at least the way I see them, if I can equate them to something like the building code, are standards that are established and then put forward to be adopted by provinces throughout the country, but the motion is calling for profit to be fully removed. I feel that the motion is not in the right place, because it is asking to fully remove the profit, to put something in there that would not be recommendations given to the provinces.

Can the member explain to me where the language for this motion is coming from when it comes to putting these enforceable measures into something that would just be standards?

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, first of all, as I said in my speech, national standards are important, but by themselves they are not sufficient to build a better system of long-term care. We need to provide the funding to provinces to develop that system, but we are not going to give the funding, $5 billion, without standards. It is like our Canada Health Act. The federal government provides funding to the provinces to create the medical system that we use, but there are standards, and that is where I think we need to work with—

[The Assistant Deputy Speaker (Mrs. Alexandra Mendès), Liberal, Alexandra Mendes]

Questions and comments, the hon. member for Trois-Rivières.

[Louise Charbonneau, Bloc, Trois-Rivières, QC]

Madam Speaker, I thank my hon. colleague for his speech.

Does he feel that, if the Canadian government agrees to our colleagues' demands, that could result in a paternalistic approach? It would not necessarily help retain staff. The only way to limit staff retention is for the government to agree to the premiers' demands to increase health transfers. What does he think of that?

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, I think the Bloc knows full well that the NDP is right behind them in demanding more health transfer money to make sure that our health care system is the best that it can be. It has been falling behind over the past few years under both Conservative and Liberal governments, and we have to increase funding. This would be another example of it. Let us put more funding into long-term care and make sure the standards we all believe in are met so that our senior citizens can live in dignity.

[Scott Simms, Liberal, Coast of Bays—Central—Notre Dame, NL]

Madam Speaker, I have a deep concern about this. I know where the member is coming from when he talks about overarching goals and providing a level of service to seniors. Where I live in central Newfoundland, we have 10 to 15 seniors homes that are level one and level two. They are privately delivered. However, this is not so much about the for-profit part; it is about the for-service part. Some of these places actually provide a substantial service. They are of good quality. They have a long waiting list and they do well by the clients they provide a service for.

I am not going to focus on the provinces so much, but I have a very specific question about the short term. What does the NDP hope to accomplish by taking these private institutions out of the sector altogether? This is going to be a huge thing for the people who are providing a fairly good service. That is what I am concerned about.

[Richard Cannings, NDP, South Okanagan—West Kootenay, BC]

Madam Speaker, I made sure to say “on average”. Some of the for-profit centres are doing good work and people are not being left behind, but on average, many bring down the level of service. The poor service those people are getting is really shocking. That is what we want to take out.

In the short term, we are saying let us do it in the next 10 years. Let us take 10 years and gradually move those—