There are bound to be calls for formal inquiries after the long-term care horror show discovered in Ontario and Quebec, and quite likely on its way to being discovered in other provinces.
This isn’t actually what Canada or any Canadian province needs, though. We already know what led to the collapse of the seniors-care system as the global coronavirus pandemic swept through Canada.
And too often the purpose of formal inquiries is to delay change, deflect blame, and obfuscate solutions so that, in the end, nothing changes.
COVID-19 was a heavy burden, but you’ll notice it did not break the spine of our public hospitals.
Long-term care collapsed in many locations because of underfunding, both by governments and private-sector owners; a precarious, poorly paid and often badly trained workforce, by intent; and regulatory negligence by governments bent on eliminating “red tape” amounting to a near complete absence of standards.
The result is a deadly catastrophe.
There is plenty of blame to go around: profiteering private-sector long-term care operators, irresponsible politicians yammering about “red tape,” weak labour laws that give health-care workers, especially those not members of regulated professions, little ability to stand up for themselves or their patients.
And there is credit, too. The nightmare was discovered by Canadian Armed Forces troops sent into Ontario and Quebec’s seniors’ lodges to relieve their shell-shocked employees and rescue as many dehydrated and abandoned residents as possible.
This may not be the primary role imagined for the armed services, but it turned out to be one of the noblest missions in the history of Canadian soldiering. And having no particular stake in the way things were, and no reputations or profitable revenue streams to protect, the forces were able to act promptly and speak up bluntly — no doubt to the chagrin of many in power.
It’s ironic that Canadian nurses have been warning about this situation, and the potential for catastrophe, literally for years.
Yet Canadian politicians, who never skip an opportunity to express their supposed respect for the profession and its members, habitually blithely ignore what civilian nurses have to say.
It took the arrival of the armed forces to capture official Canada’s attention.
It was a near thing in Ontario, where the Conservative government apparently ignored the offer of the province’s Registered Nurses’ regulatory college to send in retired nurses, nurse practitioners and student nurses, and called for the army only when things began to fall apart.
I’m sure there are people in that government who wish they had listened to the RNs. If they had, sad to say, civilian nurses would have been easier to blow off when they reported the same things.
Naturally, the temptation is strong for political parties to demand inquiries, and when in power to implement them.
For opposition parties, demanding an inquiry is great political theatre. It gives the impression of a call to action. It may even be intended as such. This is true even of parties that once in power lack the courage to deliver what they know is needed.
For parties already in power, inquiries work as theatre too — although governments are more likely to see their real utility as a gambit to preserve the status quo. After all, by the time a commission of inquiry delivers its report, the sense of urgency has usually passed. If the recommendations are not to the taste of the government of the day, they are all that much easier to ignore.
Naturally, there are powerful people in this country, donors to certain political parties at both the provincial and federal levels, who would very much like nothing to change because, to put it crudely, there’s a lot of money in it for them if they can keep things the way they are now.
We already understand what’s wrong with seniors care in Canada and we know what the solutions are. As with prescription drugs, we need urgently to bring long-term care into the national health care system through either the Canada Health Act or similar legislation. That way, we can set national standards of care, and appropriate training requirements and compensation for health care workers of all types.
In 2015, the Canadian Federation of Nurses Unions published a paper called Before It’s Too Late: A National Plan for Seniors’ Care.
“We need a national plan for safe seniors’ care, with long-term, dedicated funding and effective enforcement mechanisms,” CFNU President Linda Silas wrote in the introduction. “In both home care and long-term care facilities, we need a stable workforce, adequate staffing levels and an appropriate staff mix.”
Of course, by definition it is too late now. A global pandemic is exactly why a plan like this needed to be implemented long ago. This is an emergency piled on top of an emergency and we need to get on with fixing it.
That will require political courage, not more studies, and certainly not an inquiry that would make the solution less likely.
None of this is likely to come from any provincial government, deeply committed to the status quo for reasons of ideology and constitutional rivalry.
There is really only one politician in this country who can make the change we need happen, and we all know who he is. Yes, this is a test.