Kicking out for-profit operators won't be enough to fix long-term care, says geriatrician
'I want people to look deeper,' says Dr. Samir Sinha
As advocates call for an end to for-profit long-term care homes in Ontario, geriatrician Samir Sinha says proper funding is a needed first step to stem widespread COVID-19 deaths.
"People have focused in on this piece and said, 'Well, this is the problem,'" said Sinha, a physician for Sinai Health in Toronto.
"I want people to look deeper because if we don't look deeper, we're not going to solve the issues of the fact that, frankly, we, first of all, grossly underfund our system."
Earlier in January, a group of more than 200 doctors and researchers who are part of the Doctors for Justice in Long-Term Care campaign called on the Ontario government to abolish for-profit business in the long-term care sector.
Palliative care physician Naheed Dosani called the deaths of residents in the current system a "humanitarian crisis."
"When you think about for-profit homes, they're by design created to have one thing in mind and that's profits for shareholders. It's not care for our seniors," Dosani told CBC Toronto's Metro Morning on Tuesday.
Of the over 6,000 COVID-19-related deaths in Ontario, more than half are linked to long-term care homes. A report released by the provincial government's COVID-19 Science Advisory Table found that for-profit homes accounted for 78 per cent more COVID-19-related deaths compared to not-for-profit homes, and have outbreaks with twice as many residents infected.
While transitioning long-term care to the public sector may be a worthwhile goal, Sinha says that it's not a straightforward process.
Sixty per cent of long-term care facilities in Ontario are privately owned, but many publicly-owned homes are run by private companies. Some not-for-profit homes also rely on private companies to provide services, including laundry.
With more than 600 total long-term care facilities in the province, Sinha says it would be impossible to fully transition those run by private companies to provincial or municipal control.
"Simply saying, 'Let's just get rid of for profits' — sure, we could look at that, but there's not necessarily any municipalities around, or an entire system, that could be taken over that way just that immediately," Sinha said.
What it comes down to, he argued, is funding for staff and upgrades. Many long-term care homes in Ontario are built to 1972 standards, allowing small rooms with up to four residents — a perfect storm for the spread of COVID-19.
Additionally, the lack of inspections and enforcement of standards for long-term care in Ontario needs to be addressed, he says.
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In a statement, Ontario's Minister of Long-Term Care Merrilee Fullerton told CBC News that it's working "around the clock" to protect the province's most vulnerable and that she is confident measures including testing, masking, pandemic pay and partnerships with hospitals are "stabilizing the sector."
"We absolutely have applied lessons learned from the first wave to inform our current response," she said.
More staff, better benefits
One short-term solution to slow COVID-19 outbreaks in Ontario care homes is to hire 10,000 more workers immediately, and provide better benefits, including sick days, according to Sinha.
The Quebec government committed last year to hiring the same number of new long-term care support workers, and announced in September that 8,000 would be trained and ready to work that month.
B.C.'s provincial government also announced last year that they would hire and train 7,000 new workers for long-term care homes.
"The provinces that have actually fixed their staffing problems ... and done it definitively early on. They are not seeing the massacre, or the carnage, that we're seeing in Ontario," Sinha said.
If people are looking for someone to blame for the problems facing Ontario's long-term care homes and residents, Sinha says the provincial government should take responsibility.
"For profits, municipalities, not for profits, they're all providing care under the rules that the government has actually set," he said.
"But frankly, we have an entire system that's been set up to fail and we can fundamentally fix that."
Produced by Mouhamad Rachini. Written by Jason Vermes.