Ontario has appointed Justice Eileen Gillese to conduct an independent public inquiry into the circumstances and systemic issues that may have allowed former nurse Elizabeth Wettlaufer to kill eight nursing home residents in her care.
Wettlaufer pleaded guilty in a Woodstock, Ont., court last month to 14 charges, including first-degree murder, attempted murder and aggravated assault in connection with the deaths of eight seniors in her care.
She worked at long-term care homes in Woodstock, Paris and London, Ont., often as a nurse overseeing the night shifts.
At her trial, the court heard how Wettlaufer killed eight seniors and attempted to kill six others by administering massive doses of insulin to her victims.
In a release Tuesday, the Ontario government said the judge has been tasked with looking into "the circumstances and system issues which may have contributed to the assault and death of residents" who were under Wettlaufer's care.
Gillese will also examine whether the current checks and balances in the long-term care system live up to the spirit of the law and recommend ways to improve the safety and well-being of long-term care home residents.
Gillese is among Ontario's most respected judges, having served 15 years as a justice with the Ontario Court of Appeal, the province's top court.
'I'm glad that the government acted so quickly on this.' - Jane Meadus, Advocacy Centre for the Elderly
She was born in Edmonton but has strong ties to the region where Wettlaufer committed her crimes. The judge served as dean and professor of law at Western University in London, Ont., for 16 years before becoming a judge in 1999.
More recently, she sat as chancellor of Brescia College at Western University in 2015.
Gillese's appointment took effect Tuesday with a final report by the inquiry expected to be made public on July 31, 2019.
"I'm taking this personal because this is my father," said Susan Horwath on Tuesday. Her father, Arpad Horwath, was murdered by Wettlaufer.
Much of the inquiry will focus on how care-home employees, in particular nurses, are vetted by employers and disciplined when there are workplace problems. Wettlaufer was fired from Caressant Care in 2014 for a "medication error."
She went on to kill one of the victims after her 2014 firing. She was also investigated in 1995 when she was fired from a hospital after stealing Lorazepam from her employer. The medication is commonly used to treat anxiety.
Horwath said she would like the inquiry to delve into how long-term care homes, which are mostly operated by private businesses, conduct their hiring and ensure their staff does a proper job.
"I know it's a business to them, I know they have a profit margin, it's all understood, that's business 101, but I really don't think that the nurses that they're hiring are evaluated the way they should be."
Horwath said nurses who work in long-term care homes should undergo a more rigorous vetting process to ensure they have compassion for seniors and they want to help.
The Registered Nurses Association of Ontario (RNAO) welcomed the probe, which it said should focus on the "systemic factors" in long-term care.
The nurses association also wants to see employers required to share information when a nurse is fired.
"It's good to see that this investigation is going beyond the particulars of this shocking case," said association president Carol Timmings. "It is the only way we can rebuild that trust, and ensure this never happens again."
Organizations that advocate on behalf of patients who live in long-term care homes were also quick to react to the province's announcement.
"I'm glad that the government acted so quickly on this," Jane Meadus, the staff lawyer for the Advocacy Centre for the Elderly, told CBC News Tuesday.
"It is opened up to anything to do with the safety and well-being of residents. We can really have a good look at the system," Meadus said, noting issues such as staffing at long-term care homes and resident violence would likely also be examined by the inquiry.
Meadus said the inquiry would be a multi-pronged approach that would examine many issues within the system from a variety of perspectives, going beyond what the public has heard so far.
She also noted it would offer clarity on issues where the public has heard two different versions of events, such as a recent disciplinary hearing by the College of Nurses of Ontario that formally stripped Wettlaufer of her designation as a registered nurse.
The agency was odds with Caressant Care, Wettlaufer's former employer over how the ex-nurse's firing was handled and Meadus said a full examination by the inquiry would likely bring clarity to a number of unanswered questions.
The government has yet to disclose an estimated budget for the inquiry, but previous inquiries have cost upward of $10 million.
Member of the legislature Bill Walker, the Progressive Conservatives' long-term care critic, questioned why the inquiry will take two years.
"Why will the results of the inquiry not be released until July 2019, well after the June 2018 provincial election? Is this timing merely a political decision designed to avoid public scrutiny? If so, this is unacceptable," he said.With files from Meagan Fitzpatrick and Amanda Margison