It should be obvious by now that if a society wants to keep long-term care for the frail and elderly from turning into a deadly nightmare during pandemics, it must ensure privately run long-term-care centres provide their employees with the same wages, benefits and working conditions as those who work for the public health care system.
If the rules don’t prevent underpaid and marginalized health care workers from having to hold jobs at two, three or more care facilities to earn a living wage, it is axiomatic that the rule-makers are encouraging the spread of the pandemic malady.
But if the pandemic rules do prevent multi-site work but fail to ensure employees get the same pay and benefits for the same work at all sites, then there will be an immediate worker shortage whenever a pandemic hits. This too is axiomatic.
Yesterday, Canada’s Chief Public Health Officer admitted close to half the deaths in Canada from COVID-19 have taken place in long-term care facilities. What’s more, Teresa Tam said during her daily coronavirus update in Ottawa, that’s likely to continue as COVID-19 sweeps across the country.
That such facilities house a frail population particularly vulnerable to infectious illness is no excuse — it means extra precautions are required.
So, what do we do?
British Columbia announced at the start of April it would effectively be taking over as the employer of all long-term care workers in the province in response to the danger posed by COVID-19. B.C. Provincial Medical Officer of Health Bonnie Henry said that every long-term care worker would be hired full time and paid standardized wages for the next six months.
“Many of them work not only across facilities but in acute care and long-term care,” Dr. Henry explained. “The bottom line is, everyone will be employed by the ministry at a specific rate so they will not be penalized.”
It would be fair to describe the B.C. move as both bold and courageous — bold because it needed to be done swiftly and without half measures; courageous because Canadian provincial governments have long used low pay and poor working conditions in private for-profit and not-for-profit long-term care as a mechanism for saving money and suppressing wages across the entire health care system.
But after the clusters of COVID-19 deaths at the Lynn Valley Care Centre in North Vancouver, the McKenzie Towne Long-Term Care Home in Calgary and the Residence Herron in Montreal, it should be obvious that this approach is a recipe for disaster during epidemics.
Yesterday, Alberta Chief Medical Officer of Health Deena Hinshaw dropped hints during her daily COVID-19 briefing that Alberta is considering the same approach as B.C.
Responding to a reporter’s question, Dr. Hinshaw noted that “British Columbia has taken this step ahead of us, and so … we’ve been talking with them to learn from their experience, (to) make sure that we’re applying as many of the lessons that they’ve learned as we can.”
This is why, she explained, “we’ve given a one- to two-week window for making this change happen.
“We are doing our absolute best to do both things — to make sure that all facilities have enough staff to safely care for residents and at the same time minimize the risk of transmission that’s caused when staff move between facilities and between many different facilities,” she said. “All of those details are being sorted out this week and my colleagues and I are working to make sure that both of those objectives are met.”
Dr. Hinshaw certainly understands that this simply can’t be done if for-profit care home operators are permitted to pay low wages, avoid providing comparable benefits and scrimp on supplies for residents and safety equipment for staff.
Those goals of the low-wage economy favoured by market-fundamentalist governments are simply incompatible with providing safe and dignified long-term care — and not just for few months during pandemic emergencies.
That’s why organizations like the Canadian Federation of Nurses Unions have long called for a national strategy for equitable and inclusive safe seniors’ care with adequate staffing levels, a stable workforce, dedicated funding, and effective enforcement.
And that’s why during the coronavirus pandemic, both United Nurses of Alberta and the Alberta Union of Provincial Employees have called for policies like those implemented in British Columbia to ensure safe operation of Alberta long-term-care facilities.
If the continuing coronavirus pandemic has made anything clear, it’s that we need to be prepared for whatever may come, and running a hospital or a care home like a hotel or a fast-food restaurant is a recipe for disaster whenever it happens.
So that doesn’t just mean for six months during emergencies, but always, to ensure safety and fair treatment for residents and staff alike in jobs that will always be essential.
This doesn’t rule out a role for the private sector. But as an essential service, long-term care needs to be operated just as electrical and telephone utilities were before the destructive 40-year march of neoliberalism began — with negotiated profit margins that are fair to the operators and shareholders and strict regulation that ensure safe and affordable essential services for citizens who require them.
Because, face it, dear readers, we might as well get used to the idea that COVID-19 isn’t going to be the last global pandemic we will ever face.
We don’t know when we’ll have to deal with the next one, but we can rest assured we will.