PANDEMIC #4 - Ontario Reaps its Dividends
Hosted By
Arshy Mann
COMMONS
PANDEMIC #4 – Ontario Reaps its Dividends
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning?
Hosted by Arshy Mann
May 13, 2020
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 - “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I've sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it's predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn't do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There's a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can't afford it, you know... Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry's findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we've seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can't afford it... You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can't believe they're asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my-- Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It's gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I've added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn't do that. You know, they had all kinds of excuses as to why they couldn't do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out--after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they're very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that's not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He's the premier. He has the right to order these things. I don't understand why he's waiting. I don't understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” ...  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.  
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42
Live From U of Ottawa: Refugees Welcome, But Bad News About the Job Market…
When Canadian University grads work at Starbucks and immigrant doctors drive taxis, how will refugees get on their feet?
February 29, 2016
43
Rogue Senators
Senator Diane Bellemare quit the Conservative caucus, saying pressure to toe the party line is getting in the way of Senators doing their jobs.
March 14, 2016
44
Canada’s Arms Deals: Beyond Saudi Arabia
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
March 21, 2016
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March 30, 2016
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Tom Mulcair: Hot Prosecutor or Wet Napkin?
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April 4, 2016
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Should This Old Indian Guy Lead the Conservatives?
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April 11, 2016
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Parliament Needs More Women’s Bathrooms
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April 19, 2016
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Can a Conservative Be a Feminist?
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April 25, 2016
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Debating Same-Sex Marriage and Other Ways to Stay Irrelevant
The Conservative Party is getting ready to debate same-sex marriage more than a decade after it became law. BC's Premier is getting rich off party funds. An economist on why Newfounland and Labrador are shutting down more than half their libraries. Desmond says goodbye.
May 2, 2016
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How to Make Poor People Disappear (Census Edition)
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May 11, 2016
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Are Libertarians Conservatives?
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May 16, 2016
Celebrating Defeat: Dispatches from the Conservative Convention
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June 1, 2016
This Is Not Canada: Living as a Migrant Farm Worker
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June 6, 2016
Cheri DiNovo on How to Fix the NDP
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Naming a Genocide
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June 21, 2016
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Buy Gold and Raisin Bran: The Brexit and Canada
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July 5, 2016
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When CSIS Comes Knocking
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July 12, 2016
Canadian Police Are Racist Too
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July 26, 2016
MMIW: What Justice Means for a Family Member
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August 9, 2016
When CSIS Comes Knocking pt. 2
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August 23, 2016
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September 6, 2016
Conservative Leadership Showdown Part 1: Michael Chong & Brad Trost
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A Hat Trick Of Deceit: First Nations And The LNG Project
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October 11, 2016
A Message About the Future of COMMONS
We have news.
October 18, 2016
COMMONS returns!
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
February 13, 2017
68
Strong Hearts To The Front
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
February 21, 2017
69
“I’m Ashamed Of Myself For Being Afraid”
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
March 7, 2017
70
You Have No Rights At The Border
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
March 21, 2017
71
Being Icky Is The Job
The Liberals, according to Conservative MP Scott Reid, are trying to "ram through whatever the f**** they want." In other, vaguely sexually-themed Conservative news, Brad Trost isn't down with the "the whole gay thing," while k.d. lang asks if Jason Kenney might be secretly fond of it. Kellie Leitch and Senator Lynn Beyak? Just crapping on Muslims and Indigenous peoples again, respectively. Nothing sexy there.
April 4, 2017
72
Commons Gets High
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
April 18, 2017
73
That’s Why We Live In A Democracy
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
May 2, 2017
74
Cultural Appropriation Is An Inherently Political Act
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
May 16, 2017
75
Drink Like A Conservative
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
May 30, 2017
76
Amy Goodman/The Constitutional Clusterf**k
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
June 13, 2017
77
The Rise Of The Right
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
July 4, 2017
78
Guy Caron, Guaranteed Income And Climate Refugees
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
September 12, 2017
79
Ashton, Angus & Singh – Oh My!
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
September 26, 2017
80
Why We Need Higher Taxes, A Canadian Mt. Rushmore And A Population Of 100 Million
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
October 10, 2017
81
Niqabs & Nafta
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
October 24, 2017
82
As If They Were Pets: The Sixties Scoop
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
November 6, 2017
No Protest is Genteel: On Antifa
Live from Vancouver: We speak with organizers Garth Mullins and Annie Ohana to unpack what it means to resist fascism in BC. Featuring Hadiya Roderique and guest host Sandy Garossino.
November 21, 2017
Invisible Victims: How Police Botched the Robert Pickton Case
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
December 5, 2017
Invisible Victims: The Quest for Police Accountability
"It was bad enough that I had lost my daughter. But the interaction with the police was even worse." A miniseries on policing.
December 19, 2017
Throwing Shade at 2017: A Political Awards Show
We look back on some notably weird political moments of 2017 and collectively cringe.
January 8, 2018
Unknown Road: Inside Immigration Detention
Each year, thousands of people are indefinitely jailed in prisons without any criminal charges. Babou was one of them.  
January 22, 2018
Our Mis(education): the Erasure of Blackness in Canadian Schools
"Only a few decades after slavery was abolished, you already had, in textbooks in Ontario, the removal of references of history of slavery in Canada, but still many examples of realities of slavery in the United States. This idea of identifying racism as an American phenomenon is an important part of how Canadian racism articulates itself."
February 12, 2018
Finding A Fix: Our Opioid Overdose Crisis
“I tried to count up the amount of people that I knew who had died from overdose. I got to fifty, and I just had to stop. You get used to it. It’s like it becomes normal.”
February 27, 2018
Unconstitutional Solitude
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning? COMMONS: Pandemic is currently focusing on how COVID-19 is affecting long-term care in Canada. Featured in this episode: Sharleen Stewart (SEIU Healthcare), Natalie Mehra (Ontario Health Coalition) To learn more: “Party of Profits: Ontario Tories and the profit motive in long-term care” by Zaid Noorsumar in Rank and File “For-profit nursing homes have four times as many COVID-19 deaths as city-run homes, Star analysis finds” by Marco Chown Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey in The Toronto Star “40 Ontario nursing homes with the highest rates of reported abuse” by Valérie Ouellet, Dexter Brown in CBC Marketplace This episode is sponsored by WealthBar This show was brought to you by our patrons. Please consider becoming a monthly supporter.  Additional music: I dunno by grapes (c) copyright 2008 Licensed under a Creative Commons Attribution (3.0) license. Ft: J Lang, Morusque “Clean Soul” by Kevin Macleod, adapted.    TRANSCRIPT:    EPISODE 4 – “ONTARIO REAPS ITS DIVIDENDS”   COLD OPEN [ARSHY MANN] Sharleen Stewart has been angry for a long time.   [SHARLEEN STEWART] I am outraged. I myself personally, have been fighting for improvements in long term care for over two decades now. I’ve sat in front of government officials and said “There is a tsunami coming.”   [ARSHY] Stewart is the president of SEIU Healthcare, the union that represents Ontario’s personal support workers. PSWs are the people who do the heavy lifting, often literally, in long-term care homes. They bathe and feed residents, take them to the bathroom and provide the bulk of actual care. When the first coronavirus outbreak hit an Ontario long-term care home, Stewart says she was going to the owners of these homes and asking them for a plan.   [STEWART] We were trying to talk to the front line managers in those homes and we were saying, “OK, it’s predictable that this community of seniors is going to be hard hit. What is your plan, employer, to, first of all, be proactive on this? And they didn’t do that.   [ARSHY] On April 12th, Stewart tweeted out a photo. It was personal support workers wearing garbage bags over their gowns because they didn’t have enough personal protective equipment. They worked at a facility owned by Chartwell, a for-profit company worth almost $2 billion. A few days later, those same workers had a supply of fresh gowns. But they didn’t get it from Chartwell. It came from a private donation.   [STEWART] How could you not be paying to be accessing better equipment than that?  You know, a good quantity of personal protective equipment so that your staff did not have to do that.   [ARSHY] Chartwell maintains that even before the WHO declared COVID-19 a pandemic, they were trying to source PPE from suppliers and that that work is continuing. But long-term care workers encountered even fiercer resistance on other fronts as the pandemic raged. SEIU Healthcare, along with the Ontario Nurses Association, went to court and a labour tribunal to try to force some for-profit companies to provide more PPE and safer working conditions. The for-profit companies fought them every step of the way.   [STEWART] It was disappointing and shocking that they would fight against those types of things. And thank goodness the courts and the, uh, arbitrator and the Ontario Lake Relations Board did rule that those things had to be put in place.   [ARSHY] Ontario’s long-term care system is convoluted to the extreme. But when it comes to the COVID-19 pandemic, one thing has become clear in the last few weeks: Many, many more people are dying at Ontario’s for-profit homes than anywhere else. There are horrifying outbreaks at public and non-profit homes as well, but compared to public homes, if you’re an Ontarian living in a for-profit facility experiencing a COVID-19 outbreak, you are four times more likely to get sick and die. I’m Arshy Mann and from CANADALAND, this is Commons.   PART ONE [ARSHY] That stat you heard earlier is shocking, so I’m going to break it down for you one more time. In Ontario, there are three types of long-term care homes.  There are public ones that are run by local municipalities, there are homes run by non-profit organizations, and then there are for-profit homes. All of them get the same amount of money from the government per resident, but during the COVID-19 pandemic, we’ve seen a pattern. There is no difference between which type of home experiences an outbreak, but when there is an outbreak, Ontario residents in long-term care homes run by for-profit companies have been four times more likely to die than those in public, municipally-run facilities. That’s according to a recent Toronto Star analysis.  Today, around 60 per cent of long-term care beds in Ontario are operated by for-profit companies. So how did such a massive part of this province’s health care system end up being run by private companies? There’s a short answer to this question.   [MIKE HARRIS] We’re going to bring jobs back to Ontario. We’ll cut provincial income taxes 30% over three years, and cut government spending by 20% on everything except health care. Help make Ontario great again. Join the common sense revolution.    [ARSHY] That is Mike Harris, the former Progressive Conservative premier of Ontario. Harris’s “Common Sense Revolution” led to both massive tax cuts and cuts to public spending in the 1990s, and his government laid the groundwork for the system we see today.  They instituted policies that led to an explosion of for-profit companies in Ontario’s long-term care sector. These companies are often multinationals with immense resources and political sway: Extendicare, Revera, Leisureworld, Chartwell. That last one is the company you heard Sharleen Stewart talk about earlier, where personal support workers at one of their facilities were wearing garbage bags over their gowns. And, as it happens, the chairman of the board of Chartwell today is none other than Mike Harris. But Harris can’t solely be blamed for offloading this care onto private companies. To understand how we got this system, you have to go back through the history of long-term care in Ontario. For the first half of the 20th century, there were no long-term care homes in the province. The first public home opened up in Toronto in 1949. It was meant to house poor, elderly people. But the demand for these kinds of homes ballooned and the private sector came in to fill that need. Over the next few decades, for-profit companies were housing more and more elderly people. But these were often terrible places to live, with high death rates, squalid conditions, and almost no oversight.  Public pressure forced governments to respond. Municipalities began to build homes with the help of the provincial government, and legislation was passed to regulate private nursing homes. By the 1970s, a strange hybrid system had emerged. There were public homes run by municipal governments, non-profit homes usually run by religious charities, and private nursing homes that nonetheless received their funding from the government. When Bob Rae’s NDP government came into power in the 1990s, everyone expected the system to change. The New Democrats had campaigned on turning the for-profit homes into non-profit ones. But they didn’t follow through and, instead, they increased funding to for-profit providers. They did institute one major reform. All residents were entitled to 2.25 hours of hands-on care each day. But the big changes in the industry came when Mike Harris and the progressive conservatives came to power in 1996.   [NEWS CLIP 1, FEMALE] Good evening. Ontario voters have decided who will lead the province for the next four years, and the province has taken a decidedly right turn away from Bob Rae’s NDP in favour of Mike Harris’s Conservatives.   [ARSHY] Harris went after the public sector with fanatical zeal, and hospitals were at the top of his list.   [NATALIE MEHRA] They closed another 10,000 or so hospital beds, including a very significant proportion of the chronic care hospital beds. And they moved people out into long-term care.   [ARSHY] That’s Natalie Mehra, the head of the Ontario Health Coalition. Harris’s government closed 39 hospitals, including four chronic-care facilities. Almost 9,000 hospital beds were eliminated. This included more than 5,000 that were designated for chronic-care patients.  To keep up with the demand for the remaining beds, hospitals had to discharge patients faster. But those people had to go somewhere, so the Harris government funded the creation of 20,000 new long-term care beds. And that money went mostly to big multinational companies like Extendicare and Leisureworld. Here’s the problem with that: The money the government provides for someone in long-term care is way less than if they were in a hospital. But it’s not like these people were any less sick than before.   [MEHRA] Hospitals have continued to offload their chronic-care patients and sick geriatric care patients into long-term care, which is funded at a third of the rate of chronic-care hospital beds. And so, these much more complex people who require heavier, more intense care have been offloaded in order to save money, and what has ensued has been, you know, major staffing crisis in the homes as staff have left.   [ARSHY] And while they were expanding the number of long-term care beds, the Harris government cut staffing ratios. That meant that long-term care homes could choose how many staff they had working in the home at any time. The consequences of that decision would be felt over the next two decades. As the years went on, issues in long-term care only got worse. An aging population meant that there was a surging demand for more beds and a growing waitlist. And because people were living longer, they had more severe health problems that needed to be cared for.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it, you know… Those people go without   [ARSHY] Throughout the late 90s and into the 2000s, journalistic outlets published deep, disturbing investigations into the conditions at long-term care homes. Those, in turn, led to government reports and inquiries, one after another. In 2008, the Sharkey Report found numerous systemic deficiencies. An Ontario ombudsman investigation in 2010 found “serious systemic problems.” The auditor general has raised numerous concerns about long-term care over the years. And, every time, new regulations would be brought in. But critics argue that this just led to more paperwork and didn’t address the roots of the issue: Not enough staff.  Dalton McGuinty’s Liberals promised to increase the staffing levels so that residents would get at least three-and-a-half hours of care every day. But they didn’t. Instead, the McGuinty years are probably best remembered for when health minister George Smitherman vowed to wear a diaper when confronted with the realities of long-term care. Throughout this time, the for-profit long-term care industry prospered. The companies consolidated and became even bigger, and investors piled in to get a piece of the substantial dividends that these companies provided their shareholders. And every time there was a scandal or an investigation, the government responded with more regulations.  But these regulations mostly meant more paperwork, which just benefited the large operators even more. They didn’t touch the one area of regulation that would’ve made the biggest difference: The number of workers. And even though the system benefitted for-profit companies, they continued to push for laxer regulations, especially when it came to inspections.   [MEHRA] And then, since then, there has been a sort of ongoing struggle that pits on the one side, led by the for-profit chain companies, attempts to deregulate, attempts to reduce inspections, reduce the number of inspections, reduce the depth of the inspections, reduce the enforcement activity of the government in the homes.   [ARSHY] In the 2010s, inspections of homes decreased and the system was overwhelmed with complaints. And when homes were found to be violating the rules, there was little that inspectors or regulators could do. By 2016, the problems continued to pile up on one another with no end in sight. And that is when we all learned about Elizabeth Wettlaufer.   [NEWS CLIP 2, FEMALE] Thank you for joining us tonight. We have special coverage of a multiple-murder investigation like no other in Canadian history. A former nurse is facing eight counts of first-degree murder.   [ARSHY] Wettlaufer was a nurse who worked in long-term care homes and, in September 2016, she told a psychiatrist that over the last decade she had murdered eight people in long-term care with insulin injections. All of her victims lived in for-profit facilities. The news was shocking. After she was convicted, the Liberal government called a public inquiry into how someone could get away with so many murders. The inquiry surfaced many of the same issues that had brought up in previous reports and investigations: Underfunding, understaffing, neglect. And what was most disturbing was that everyone agreed that Elizabeth Wettlaufer would have gotten away with it all if she hadn’t come forward and confessed. The inquiry’s findings were released in 2019, and they barely caused a stir.    PART TWO [ARSHY] So why hasn’t the system been reformed, even after all of these recurrent crises? Well, for one, it’s just hugely expensive. Providing long-term care, proper care, cannot be done cheaply. Successive Ontario governments have been unwilling to eat those costs, especially without any kind of federal support. Then there’s the issue of waitlists. The waitlist in Ontario for long-term care beds in 2018 was 36,000 people long. When governments have been faced with the choice of opening new beds or increasing the level of care, they’ve consistently chosen more beds. But the other explanation is one that you’ll hear from unions and advocates for public health care. They argue that the for-profit long term care lobby is closely connected to government and is able to exert its influence. Here’s Natalie Mehra from the Ontario Health Coalition again:   [MEHRA] Around 59 percent of the homes are owned by private for-profit companies. And of those, more than 80 percent are owned by chain companies, large chain companies, most of the multinational chain companies that operate in a number of jurisdictions.  And so over time, what we’ve seen is a much more sophisticated, much more aggressive and effective, lobby on behalf of the for-profit homes. They dominate the lobby of the industry and they are very effective.  [ARSHY] Between 2006 and 2016, long-term care companies and industry groups donated at least $600,000 to the provincial Liberals and Tories. That’s according to reporting from Rank and File. And it’s true that problems in long-term care in Ontario aren’t just in private, for-profit homes. But many studies show that, on average, for-profit homes provide lower levels of care than non-profit or public homes.   A 2015 study of Ontario facilities found residents in for-profit homes are 33% more likely to end up in the hospital within six months and 16 per cent more likely to die. And of the 20 homes with the highest number of abuse allegations in 2018, 75% of them were for-profit operators. Natalie Mehra thinks that the reason for these disparities is obvious.   [MEHRA] You know, a number of those homes have paid out massive dividends to their shareholders at the same time, as, you know, the PSW crisis was happening all across Ontario and, you know, letting their homes run with critical shortages of staff. I think that, you know, it lays bare what is going on in the homes.   [ARSHY] All of the homes get the same amount of money per resident from the Ontario government. But the for-profit homes have to pay out dividends to their shareholders. There’s only a few ways to make up that money. Scale can provide some efficiencies, especially in an industry like long-term care, where you have reams of paperwork to constantly fill out.  Another way is to offload the costs onto families.   [MEHRA] The daily hands-on care is inadequate. Families, if they can afford it, have to hire in extra caregivers to provide care for their loved ones in the homes. Families who are not there or can’t afford it… You know, those people go without.   [ARSHY] But critics and unions have maintained for years that the for-profit providers find most of their “efficiencies” by paying workers poorly and keeping staffing levels low. After all, labour is by far the biggest cost when it comes to long-term care. Here’s Sharleen Stewart again.   [STEWART] But I say that that falls directly on the laps of these multinational for-profit corporations where they are neglecting the residents by not putting the proper staffing levels in place in those homes.   [ARSHY] In 2016, the NDP introduced a bill in the legislature that would have mandated more funding for long-term care. And crucially, it would have ensured that residents were entitled to at least four hours of care a day. The bill was praised by members of all parties and passed second reading without a single vote against it. But the bill died in committee and was never brought up for a final vote.  In 2018, Ontarians went to the polls. But even in the wake of the Wettlaufer murders, long-term care wasn’t much of an issue.  That’s despite NDP leader Andrea Horwath’s efforts to make long-term care one of her party’s biggest priorities.   [ANDREA HORWATH]  We have to ask the hard questions about funding levels and staffing levels. Because if you ask any family member with a loved one in a nursing home, they will almost always tell you that our nursing homes are understaffed.    [ARSHY] But at the end of the day, Doug Ford’s Progressive Conservatives won.  The PCs promised more long-term care beds, but few changes to the overall system, and earlier this year, Sharleen Stewart met with the Ford government to go over the recommendations from the Wettlaufer inquiry.    [STEWART] And again, when they said, “What are some of your ideas?” I can’t believe they’re asking this again. “What are some of your recommendations to improve long term care?” And my response was, “Dust off the last three that I was on and gave you up to 20 recommendations on one of my– Dust those off. Take a look at them and just add to those numbers, because it has not changed over the last 20 years.” It’s gotten worse.  But the fixes are still all the same. You have to look at the staffing levels and the hours of care, and I’ve added on that the government has got to take a look at how much profit these homes can really take out of this service.   [ARSHY] But those fixes weren’t implemented. So when the novel coronavirus came to Ontario, long-term care homes were still especially vulnerable. And there’s a reason that Ontario has been hit worse than any province other than Quebec. It’s the same problem we’ve seen in the system for decades: Staffing. Because they’re low-paid, many PSWs have to work in multiple institutions. And that means if one home has a COVID-19 outbreak, workers can unwittingly spread it to other homes. If there’s not enough staff, residents with dementia will wander into other rooms, again unwittingly transmitting the virus. And these are problems at all long-term care homes. But we can see from the death rates that for-profit homes are more greatly affected. Sharleen Stewart and SEIU Healthcare have been begging the Ford government to take over the homes where they allege companies haven’t been taking the proper precautions.   [STEWART] And we had asked the government to take over those three homes and manage them because of the horrific things that we were hearing from the front lines going on in those homes. And weeks ago, the numbers of deaths and infections were likely half of what they are now, if not less. And the government didn’t do that. You know, they had all kinds of excuses as to why they couldn’t do that, yet it was crystal clear inside the Long-Term Care Act that they did have the ability and the authority to do that.   [ARSHY] Instead, they brought in new rules that would allow long-term care facilities to no longer require training for staff, allow them to use volunteers and not have to report many complaints to the government.  It was exactly what the for-profit long-term care companies had been asking for.  That was over a month ago and the crisis in Ontario’s long-term care homes is still ongoing. The British Columbian government took a different approach. Early on in the pandemic, they provincialized all long-term care workers, making them essentially employees of the government. And they significantly increased their wages and made sure they were only working in one facility at a time. And because of that, because of their choices, the deaths in BC’s long-term care homes are nowhere near the levels of Ontario’s. Throughout this pandemic, Doug Ford has gotten rave reviews from journalists and the public for his straight talk and his empathetic demeanour.    [DOUG FORD] And when they look back on this, when the history books are written, we’ll be judged on how we looked out for each other, but even more importantly, we’ll be judged on who we looked out–after, and who could not look after themselves.    [ARSHY] But Stewart says that much of the blame for what’s happening today in long-term care lies with the Ford government.   [STEWART] The premier and his ministers come on and they’re very compassionate, you know, and he speaks to the public as if they’re his neighbors. He, himself, is like a “Tale of Two Doug Fords,” because he says that on the, uh, presses every day. But yet that’s not the reality in long-term care.   [ARSHY] But Sharleen Stewart is still livid. She’s angry at the for-profit companies that have fought against more staffing for years. She’s angry that they fought her workers in court when they were demanding safer work conditions. And she thinks criminal charges may have to be brought.   [STEWART] I want everybody and everything looked into: The companies, the homes, the government, the ministries. Everybody needs to be investigated.   [OUTRO] [ARSHY] We’ll never know what would have happened in Ontario if the government had listened to the workers instead of the companies. Right now, the Ford government is refusing to promise to hold a public inquiry after all of this.   [STEWART] And he stands up there and he says, “Yes, I agree. The system’s broken. We need to do better.” He’s the premier. He has the right to order these things. I don’t understand why he’s waiting. I don’t understand that. The for-profit long-term care industry says it’s way too early to come to conclusions about their pandemic response. The Ontario Long Term Care Association told the Star that “To proceed down a path of loose interpretation of incomplete data at this point would not be responsible.” But the COVID-19 pandemic has put the industry in the most precarious position it’s been in, in decades. Politicians are openly calling for nationalization. Lawsuits are being filed on a weekly basis.  But at the end of the day, whatever system we have, the problem remains the same: money. We’re simply not willing to pay enough to provide proper care for people in these facilities. “Non-profit,” “for-profit,” “public” …  these are distinctions that matter.  But what matters more is if we’re finally willing to learn. Are we willing to learn from this pandemic, from this history, and give the most vulnerable amongst us the resources and the care that they deserve? Because, up until now, the answer has been no.   [END CREDITS] That’s your episode of Commons for the week. This episode relied on reporting and research done by Zaid Noorsumar at Rank and File, Jack Hauen at QP Briefing, Moira Welsh, Marco Oved, Brendan Kennedy, Kenyon Wallace, Ed Tubb and Andrew Bailey at the Toronto Star, CTV News Toronto, CBC Marketplace, Nora Loreto, Tamara Daly, Pat Armstrong and many, many others.  If you want to get in touch with us you can tweet us at @COMMONSpod You can email me at arshy@canadalandshow.com This episode was produced by myself and Jordan Cornish. Our managing editor is Andréa Schmidt. And our music is by Nathan Burley.  If you like what we do, please help us make this show. You can support us and get ad-free podcasts by going to Patreon.com/CANADALAND.   I think you should be getting our newsletterGet a weekly note about our top stories.This is a good thing that we do. You'll like this.johnsmith@example.comSign UpForm is being submitted, please wait a bit.Please fill out all required fields.
March 12, 2018
Stories From Solitude
Two stories take us inside solitary confinement cells across Canada.
March 27, 2018
92
Canadian History X
As a teen, Elisa Hategan joined Canada's most notorious and well-organized white supremacist group, the Heritage Front. What can we learn from the past about how white supremacists operate today? And what do we do about all these Nazis?
April 9, 2018
93
The All-White Jury In Canada
There's a simple legal mechanism that allows lawyers to whitewash juries. A new bill proposes getting rid of it, but some lawyers are saying that will make things worse. We look back to how we got here.
April 24, 2018
Life In Canada Without Clean Water
Canada has 20 per cent of the world's freshwater and yet some Indigenous communities across the country have not had clean drinking water for decades.
May 7, 2018
What Do Peacekeepers Actually Do?
The Liberal government announced that it would be sending around 200 troops to assist in a UN peacekeeping mission in Mali. But what does "peacekeeping" look like today and what do peacekeepers actually do?
May 22, 2018
Canada Is Not Racist… According To The Stats
If you look at the stats, Canada has a low incidence of hate crimes, but the numbers that we rely on to tell us if we're racist or not are wrong.
June 5, 2018
What The Hell Is A Fairness Letter?
We speak to someone who might not be let into Canada for trying to bring democracy to Syria.
June 19, 2018
CORRUPTION #1 – The Most Crime-Ridden Neighbourhood In Canada
This season, Commons will be focusing on stories at the intersection of money, influence and politics in Canada. In this episode, we take you to what may be Canada’s most criminal neighbourhood — Toronto’s financial district.
October 2, 2018
CORRUPTION #2 – How Vancouver Became a Money Laundering Paradise
For years, people could walk into Vancouver-area casinos with tens of thousands of dollars of suspicious cash and walk out with clean money, no questions asked. That money may be fuelling the city's housing crisis and opiate epidemic.
October 16, 2018
CORRUPTION #3 – The Trouble With Paradise: How Canadians Built The Offshore World
The Panama Papers revealed to the world just how deeply enmeshed tax havens are in the global economy. And for 100 years, Canadian banks, businessmen and politicians have worked to build that offshore system, alongside crooks, fraudsters and corrupt officials.
October 30, 2018
CORRUPTION #4 – Papa Pump and the Small Town Shakedown
In the eleven years that Marolyn Morrison was the mayor of Caledon, Ontario, she faced down deep-pocketed developers, mafia enforcers and corrupt federal officials. When millions of dollars are at stake, things get heated.
November 13, 2018
CORRUPTION #5 – The King of Cabbagetown
For two decades, he's controlled public institutions and bragged about his connections to organized crime. So who exactly is the King of Cabbagetown?
November 27, 2018
CORRUPTION #6 – Charlottetown’s Web
It might be small, but it when it comes to graft, Prince Edward Island plays in the big leagues. Inside PEI’s long, strange attempt to become Canada’s online gambling hub.
December 11, 2018
CORRUPTION #7 – The Only Canadian Imprisoned For Insider Trading
One of Canada's most notorious white-collar criminals speaks about his crimes.
January 8, 2019
CORRUPTION #8 – Hockey’s Hall of Shame
Canada is hockey crazy. But at the heart of the sport is a system of unpaid labour that scars some boys for life. And the teams and leagues are doing whatever it takes to make sure things stay exactly the way they are.
January 22, 2019
CORRUPTION #9 – Victoria’s Secrets
Tens of thousands of dollars in suits, luggage, magazines and mustard. An epic booze heist from the legislature. An undercover legislator exposing corruption. And a wood-splitter that’s transfixed a province.
February 5, 2019
CORRUPTION #10 – The Canadian Company Accused of Using Slaves Today
Canadian companies have committed all kinds of wrongdoing abroad. But this is on a different level. One Vancouver-based company has been accused by the United Nations and Human Rights Watch of using slaves to build a mine with one of the world’s most oppressive governments.
February 19, 2019
Introducing Our New Season: CRUDE
Canada was built on oil.
March 28, 2019
CRUDE #1 – Smell This Town
If you don’t understand oil, you can’t understand Canada. We take you to a place unlike anywhere else in the world, where the booms and busts all began. And find out why just a short distance away, children grow up afraid of the very air they breathe.
April 2, 2019
CRUDE #2 – Bombs, Blood & the Battle of Trickle Creek
A family poisoned in their homes. Bombs going off in the night. Shots fired and inside jobs. The story of Wiebo Ludwig is There Will Be Blood come to life. So was he a man of faith facing down the full might of Big Oil? Or a terrorist with blood on his hands?
April 16, 2019
CRUDE #3 – Let the Bastards Freeze in the Dark
The Alberta oil sands. It’s a cold patch of land (which we once almost nuked into oblivion) that’s become Canada’s economic engine. Governments have fought over it for decades. And now it’s one of the most controversial places on the planet. Will it finally tear our politics apart?
April 30, 2019
CRUDE #4 – Orphan Wells: Citizen Con
What happens when the oil wells run dry? Environmental damage, government bailouts and a scheme that some are comparing to the subprime mortgage crisis. And all of this is just the beginning.
May 14, 2019
CRUDE #5 – A Town, Annihilated
The Lac-Mégantic rail disaster was a calamity like we’ve never seen before. The families of the victims never got justice. But the conditions that made it possible have barely changed. And the next time could be far worse.
May 28, 2019
CRUDE #6 – The Devil in the Deep Blue Sea
An unspeakable tragedy occurs off the coast of Newfoundland. But this isn’t just a story about a nautical disaster. It’s about what happens when a poor province finds immense riches just within reach. And how the promise of oil wealth can twist history around itself.
June 11, 2019
CRUDE #7 – The Billionaire Plot to Destroy Alberta’s Economy is Totally Real!
Has Canada been a casualty of a nefarious campaign by foreign-funded radicals to landlock our country’s energy resources? Is Big Oil the victim of a vast international conspiracy? Naaaah. But there is, of course, another conspiracy afoot.
June 25, 2019
Introducing Wag The Doug
Over the past few weeks, Ontario Premier Doug Ford was booed at the Raptors' victory parade, demoted a bunch of star members of his Cabinet amid sagging poll numbers and lost his Chief of Staff, who got caught up in a nepotism scandal.  Are we witnessing the downfall of a government, or is this just another month in Ontario? 
July 8, 2019
CRUDE #8 – Spies, Lies and Private Eyes
Ever get the feeling someone is watching you? If you’ve been to an environmental protest recently, you might be right. Private intelligence firms, the RCMP and even Canada’s spies have all been caught collecting information on everyday Canadians speaking out against the oil industry.
July 23, 2019
CRUDE #9 – Tar Teck: The Final Frontier
Teck Resources just got approval to build the largest tar sands operation ever. The Frontier mine would have serious and permanent consequences for the local environment, Indigenous peoples and the global climate. So why haven’t you ever heard about it?
August 6, 2019
CRUDE #10 – The Apocalypse is Now
Canoe-borne bandits strike an underwater town. A new generation of wealthy lobstermen is minted. An island disappears. And hellfire engulfs a highway jammed with broken heroes on a last chance power drive. Just another normal day amidst Canada’s climate catastrophe. 
August 20, 2019
Our New Season: DYNASTIES
Stories about the rich and powerful families who run Canada.
September 11, 2019
DYNASTIES #1 – The Stronachs
Canada is a country ruled by dynasties — political, commercial and criminal. In the first episode of our new series, we bring you the story of an eccentric, billionaire patriarch; his famous, charismatic daughter; a fire-breathing monument the size of the Statue of Liberty; and the battle over one of Canada’s great business empires.
September 17, 2019
DYNASTIES #2 – The Irvings
For almost a century, the Irving family has run New Brunswick like a personal fiefdom. They own the newspapers, the industry, and, according to some, even the government. So how does a single family come to so thoroughly dominate an entire province? And what happens when that family starts to fracture and split apart at the seams?
October 1, 2019
DYNASTIES #3 – The Fords
They call themselves the Canadian Kennedys. And they’re one of the most famous political dynasties to ever exist in this country. But the rise of the Ford family has been marred by violence and self-destruction at almost every turn. The story of the Fords is tragic — for them, for everyone who falls into their orbit, and for the people of Toronto.
October 15, 2019
COMMONS Needs Your Help
Canada is a big, weird, and complicated place. We want to keep telling you these stories, but we need your help.
October 29, 2019
DYNASTIES #4 – The Rizzutos
The Rizzutos are Canada’s first family of crime. For decades, they dominated Montreal’s underworld with an iron fist. With the help of corrupt politicians and police officers, the Rizzutos built one of the most fearsome and lucrative criminal enterprises this country has ever seen. Their reign was long and bloody. But their fall was even more gruesome.
November 12, 2019
DYNASTIES #5 – The Sahotas
The Sahotas are Vancouver’s most notorious slumlords. For decades they’ve let their buildings rot, leaving their tenants to live in filth and desolation. But the Sahotas are not like any other dynasty you’ve ever heard of. Their story is far stranger, and far darker, than anything you can imagine.
November 27, 2019
DYNASTIES #6 – The Desmarais
The Desmarais family is by far the most influential Canadian dynasty of the last half-century. But if you don’t live in Quebec, chances are you haven’t even heard of them. Paul Desmarais had Prime Ministers and Premiers in his pocket and billions of dollars at his disposal. He wasn’t just a Laurentian elite; he was the Laurentian emperor.
December 11, 2019
DYNASTIES #7 – The Olands
For 150 years, the Olands have been one of Canada’s most prominent brewing dynasties, the makers of Moosehead Beer. But in the last decade, they’ve made the news for much darker reasons. Richard Oland was murdered in 2011. And police and prosecutors believe that he was killed by his only son.
January 8, 2020
DYNASTIES #8 – The Regans
Gerald Regan was the premier of Nova Scotia, the founder of a powerful political dynasty, and one of the most prolific sexual predators in Canadian political history. Even after his death last November, few in the establishment are willing to recognize, let alone reckon with, his crimes.
January 22, 2020
DYNASTIES #9 – The Harts
The Harts are Canada’s first family of professional wrestling and one of the most famous dynasties the country has ever produced. And sure, wrestling is scripted. But what happens when reality begins to invade that fiction? The story of the Harts is one of triumph and tragedy that transcends the world of pro wrestling.
February 5, 2020
Introducing: Cool Mules
A new investigative series about the cocaine smuggling ring inside Vice Media.
March 1, 2020
Our New Season: RADICALS
Our new season is about the people who go to extreme lengths for what they believe in.
March 12, 2020
RADICALS #1 – Nazi Island in the Sun
It’s one of the most audacious plots in North American history. Turn a Caribbean island nation into a criminal state — then use the money to fund Neo-Nazis and Klansmen across Canada, the US and Europe. The scariest part? They almost pulled it off.
March 18, 2020
RADICALS #2 – They Buried Her Heart at Wounded Knee
There have been books and songs and plays written about Anna Mae Aquash. But she was no folk hero — she was flesh and blood. A young Mi'kmaq woman who took up arms against the United States government, Anna Mae was a revolutionary. But when she was found murdered in the South Dakotan countryside, it tore her movement apart. It took thirty years to find out who pulled the trigger. But that’s not the same thing as knowing who’s responsible for her murder.
April 1, 2020
RADICALS #3 – The Last Pandemic
It began as a mysterious disease from a far off place. It turned into the deadliest plague humanity has faced since the Black Death. AIDS has ravaged and reshaped us in so many ways. But in Canada, the battle against AIDS wasn’t just a fight against a virus. It was a fight against a system that didn’t care if some people lived or died.
April 15, 2020
An emergency season: PANDEMIC
A new season of COMMONS
April 27, 2020
PANDEMIC #1 – 33 Dead in Dorval
They were found abandoned in the facility. The conditions were described as “akin to a concentration camp.” Within two weeks, over thirty of them would be dead. The story of the Résidence Herron in Dorval, Quebec is a national shame. And a preview of the carnage still to come.
April 29, 2020
PANDEMIC #2 – When the Plague Came
Why did Commons drop everything and focus in on long-term care? Because the vast majority of deaths are happening in those homes. Because we should have known that was going to be the case, but we let it happen anyways. And because the level of suffering, isolation and trauma happening in long-term care today is almost too much for us to face up to.
May 2, 2020
PANDEMIC #3 – McKenzie Towne
The McKenzie Towne Continuing Care Centre has experienced the deadliest COVID-19 outbreak in Alberta. But some people say that their loved ones were killed by neglect at McKenzie Towne long before the pandemic even began.
May 6, 2020
PANDEMIC #4 – Ontario Reaps its Dividends
Over 1700 Ontarians have already been killed by COVID-19. And the vast majority of them died in long-term care. But if you live in a private, for-profit home, you’re much more likely to die from this virus. The for-profit long-term care industry is politically powerful and deeply entrenched. Is this their moment of reckoning?
May 13, 2020
PANDEMIC #5 – Shirley and Tracy
Tracy Rowley lost her surrogate mother to COVID-19 in a long-term care facility. But she’s determined that Shirley Egerdeen doesn’t become just another statistic. Tracy’s suing the company that runs the home. But one of the strangest things in this story is exactly who owns them.
May 20, 2020
PANDEMIC #6 – Northwood
Over the last two months, Nova Scotians have endured tragedy upon tragedy. The worst mass murder in modern Canadian history. A helicopter crash and the death of a Snowbirds’ pilot. And all the while, COVID-19 ravaged the biggest long-term care home in Atlantic Canada.
May 27, 2020
PANDEMIC #7 – The Frontline
Long-term care workers are in the vanguard in the war against COVID-19. They’re not the kinds of workers who get movies or TV shows made about them. In fact, their stories are rarely told. But not only are they battling heroically against this pandemic. They’re fighting for recognition and respect within a system built to marginalize them.
June 3, 2020
BONUS: The Honest Fakery of Wrestling
Wrestling is very real and Stampede Wrestling helped build World Wrestling Entertainment. Damian Abraham, host and creator of The Wrestlers, explains in this week's bonus COMMONS episode.
June 10, 2020
PANDEMIC #8 – Hunger Strike
Innis Ingram’s mother is his hero. But today, she’s living in one of the worst hit long-term care homes in Ontario. She has a terminal illness. Dozens and dozens of people around her have died, including her friend and roommate. And she’s had minimal human contact for three months. But even though he can’t be there with her, Innis is determined to get her the care she needs.
June 17, 2020
PANDEMIC #9 – Mend the World
After a stroke left him locked in his own body, Rabbi Ronnie Cahana has found ways to lead an incredibly full life. Then the pandemic came. It swept through Quebec, leaving a trail of devastation. Today, Rabbi Cahana is one of the thousands of Quebeckers left stranded in the middle of one of the worst disasters in modern Canadian history.
June 24, 2020
PANDEMIC #10 – Burn It Down
Jonathan Marchand is one of the thousands of young disabled people living in long-term care. But Marchand doesn’t want to fix the system. He doesn’t think it can be reformed. Marchand is an abolitionist. For a century and a half, Canada has hidden away disabled people in institutions where they were neglected and abused. Is long-term care just the latest incarnation of this dark history?
July 8, 2020
PANDEMIC #11 – It Didn’t Have To Be Like This
Four months after the first outbreak in a Canadian nursing home, over 7000 long-term residents have died of COVID-19. But if you look at the news or social media or our political debates, it seems like we’ve already moved on. Maybe that’s because it feels like this kind of tragedy was inevitable during a pandemic. It wasn’t. And we know that because in some places in Canada, politicians and public health officials made decisions that saved hundreds, if not thousands of lives.
July 22, 2020
PANDEMIC #12 – The Most Dangerous Story
In the final episode in our series about the COVID-19 pandemic and the crisis in long-term care, we’re going to tell you a different kind of story. A story of hope. About how the people we treat as disposable, can have lives of joy and dignity. And about one place where they were given exactly that.
August 5, 2020
Introducing our new season…
Stories about the power the police wield in Canada, and about the lengths they’re willing to go to hold on to it.
October 7, 2020
THE POLICE #1 – Julian Fantino
Julian Fantino may be the most famous cop in Canadian history, but during his rise, people critical of the police had a way of finding themselves in the crosshairs.
October 14, 2020
We Need Your Support
We want to keep doing this work. So this week we’re reflecting on the year behind us and talking about our goals for the future.
October 20, 2020
THE POLICE #2 – The Secret History of the RCMP
The RCMP is one of the most famous police forces in the world — the red serge and stetson hat are practically synonymous with Canada. But that image obscures the profound power the Mounties have held throughout Canadian history. And the dark legacy of ethnic cleansing and genocide at their core.
October 28, 2020
THE POLICE #3 – Dirty Tricks
He called himself the General. And he was at the heart of the RCMP's biggest scandal.
November 11, 2020
THE POLICE #4 – Starlight Tours
Thirty years later, we know some of what happened to Neil Stonechild. But we still don’t have justice. 
November 25, 2020
THE POLICE #5 – Toronto’s Finest
A Toronto police officer shoots and kills two Black men and is accused of beating another, all within a five-year span. He’s never found guilty of committing a crime. And he continues to rise through the ranks.   
December 9, 2020
THE POLICE #6 – Who Killed Myles Gray?
Myles Gray was an unarmed man who died after seven Vancouver police officers beat him mercilessly. Half a decade after he died, not only does his family not have justice, they don’t even know the names of the people who killed him.
December 23, 2020
THE POLICE #7 – The G20: Conspiracy
In the first of a two-part series on the G20, two mysterious strangers start volunteering with activist networks in southern Ontario. It’s all part of one of the biggest undercover police operations in Canadian history
January 13, 2021
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