British Columbia

Sunshine Coast residents angered by public-to-private long-term care switch

Community members say there was no consultation on a plan to replace two publicly-run care centres with one private-for-profit facility on B.C.'s Sunshine Coast.

Vancouver Coastal Health plans to replace 2 public long-term care facilities with 1 private-for-profit centre

The 33-year-old building that houses Shorncliffe Intermediate Care Facility. Both Shorncliffe and Totem Lodge in Sechelt had zero patient complaints in the 2014-2015, the last recorded year. (Vancouver Coastal Health)

Two long-term care homes in Sechelt on B.C.'s Sunshine Coast are to be shut down and replaced by one private-for-profit facility, but many residents are angry about the plan they say they weren't consulted on.

Vancouver Coastal Health (VCH) made the plan public at an open house in May 2016.

Trellis Group is the private company that will operate the new 128-bed facility, which amounts to 20 more beds than are currently available.

VCH says the two existing long-term care facilities are both more than 30 years old and require extensive repairs and upgrades, the cost of which is estimated to be $35 million.

The plan has been met with strong opposition from the community. Hundreds of people attended open houses hosted by VCH and Trellis.

Louise Phillips is one such resident. Her mother, who turns 96 in November, has lived in long-term care with severe dementia in Sechelt for more than three years.

Phillips has never had a problem with the conditions or level of care at Totem Lodge.

The sun room at the Totem Lodge in Sechelt. (Vancouver Coastal Health)

"The staff are unwaveringly patient and kind and concerned for the people in their charge," she said.

This makes Phillips all the more worried about how her mother will fare during the anticipated move to a new facility less than two years from now.

"I hope my mother is not around for this. I really do."

Phillips' concerns are shared among the community, including things like the proposed location for the new building, the transition of residents and the impact on more than 200 employees.

Many say they feel the community was not properly consulted before being told by VCH that this was "a done deal."

200 jobs on the line

Between the two existing facilities — Totem Lodge and Shorncliffe Care Centre — 200 employees will lose their jobs.

Approximately 170 are members of the Hospital Employees' Union. Of those, 150 are employed by VCH and 20 through other services such as food services and cleaning contracts. Another 30 employees are represented through other unions, such as the B.C. Nurses' Union.

"They are going to have to fire their entire workforce. I think we need to understand here, that's a choice they are making," said Jennifer Whiteside, secretary-business manager with the Hospital Employees' Union.

"There's nothing inevitable about [it]."

Jennifer Whiteside, with the Hospital Employees' Union, says hundreds of employees will lose their jobs, only to start at the bottom with Trellis, a private company. (Samantha Garvey/CBC)

VCH has made an agreement with the Trellis Group that the company will consider any employees who want to transfer to the new facility.

Lauren Tindall, VCH's director for the Sunshine Coast, says employees have the choice to stay employed with VCH through their collective bargaining agreement. However, that would require relocation to another city, possibly away from the Sunshine Coast altogether.

"What we would hope to see is that people will apply to Trellis to allow for that continuing relationship with the residents they currently provide and care for," she said.

But employees hired by Trellis will lose any seniority they've acquired at VCH, and it's not clear how their pay will be affected.

"It will be different. It is a privately-owned business," says Mary McDougall, president and CEO of Trellis Group. "It's going to be market-competitive to other privately-owned facilities in similar communities."

The dining room at Shorncliffe Care Facility. VCH says the combined cost to repair and upgrade Shorncliffe and Totem care centres would be $35 million. (Vancouver Coastal Health)

Whiteside says she's not hopeful the pay will be going anywhere but down.

"Our experience over 10 years of considerable privatization in long-term care is that they'll be hired back at lower wages," she said.

Seventy per cent of British Columbians in a long-term centre are cared for by a private company.

Hours of care likely to decrease

The main concern with the move to privatization is that the care will be inferior to what is offered at the publicly-run centres.

VCH insists it won't be, noting that Trellis Group has exemplary standing with Accreditation Canada and will be held to the highest standards of care.

But community and family members aren't convinced.

At a presentation in May of this year, the public was informed that the new facility, called Silverstone Care Centre, would offer 2.86 hours of care per resident, per day.

Right now, Totem offers 3.1 hours and Shorncliffe offers 3.2, according to a report by B.C.'s Seniors Advocate Isobel Mackenzie.

Margaret McGregor, a clinical associate professor with the department of family practice at UBC, says these numbers are crucial.

"Those differences matter. Even if it's minutes of care, it really can make a difference in the lives of residents," she said.

Mary McDougall, Trellis Group CEO, says the new care facility in Sechelt will have more staff than the two existing centres. (Charlie Cho/CBC)

McGregor is the co-author of the study "Observational Evidence of For-Profit Delivery and Inferior Nursing Home Care."

"The vast majority of research [shows] that, in general, private-for-profit facilities provide less good, quality care," she said. "[There are] big differences in staffing [and] things like pressure ulcers, transfers to hospital and hospital admissions."

McGregor said there are several factors that contribute to the quality of care and the type of ownership is one of many.

"Found in the literature is this tradeoff between improving quality and generating profit, and when there's a huge pressure to make profit, quality may be sacrificed," she said.

In addition to the ongoing quality of care, community members are also concerned about the initial transition of residents. But McDougall says her company has experience in transitioning patients to a new building and that the process will be done over time.

The company owns three other facilities in B.C. and has plans for two more. The Simon Fraser Lodge in Prince George had zero complaints in the 2014-2015 year, the most recent available data. Information was not available for the other two facilities.

Residents, local politicians not consulted

It's not just family and other community members who felt left out of the process.

Nicholas Simons, NDP MLA for Powell River-Sunshine Coast, says a move of this magnitude is something he should have been consulted about.

"If government wants to make significant changes to the provision of healthcare services, you'd think they'd be interested in discussing it with the representative," he said.

"It would have been better had [VCH] told me earlier, because I could have probably forewarned them about the reaction from the community."

The publicly-run Totem Lodge in Sechelt is 30 years old and in need of repairs and upgrades. (Vancouver Coastal Health)

Sechelt Mayor Bruce Milne agrees. He too was not informed ahead of the plan being announced, even though the local government will be necessarily involved. The new location will have to be rezoned and permitted through the district.

Milne says he is hearing more and more distress from the community about the move.

This week, he joined members of the Sunshine Coast Regional District in requesting a meeting with Health Minister Terry Lake at this year's Union of B.C. Municipalities conference. The meeting did not take place at the event.

'A done deal,' VCH says

VCH's Lauren Tindall says there is no going back on the plan to build the new Trellis facility in Sechelt.

"This is a done deal," she told CBC Radio One's The Early Edition. "We have a legally binding contract with Trellis."

However, the Hospital Employees' Union has joined other organizations to form a petition to stop the privatization of long-term healthcare in B.C. It is addressed to Mary Ackenhusen, CEO and president of VCH.

A hardcopy version of the petition has 7,000 signatures and another 1,500 have signed an online version, according to the union.

Silverstone Care Facility is slated to begin operating by August 2018. There's no word yet on what will become of the buildings that currently house Totem and Shorncliffe.

With files from CBC Radio One's The Early Edition.


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