RTOERO Advocacy Issues
The Privatization of Ontario’s Health Care — Marie Dellavedova
Ontario is ramping up its embrace of private health care.
More than half of Ontario’s long-term care homes belong to private corporations. That has proven disastrous in the years leading up to the pandemic and even more so throughout the last two years. Ontario has basically entrusted the delivery of care of our most vulnerable to real estate companies focused on reaping profits for their shareholders. Millions of dollars were paid out to shareholders of private long-term care companies as thousands of long-term care residents died from Covid-19. Most of those deaths occurred in for-profit long-term care homes.
Now, despite numerous calls for real reform of the system, Ontario is giving away more than 18,000 long-term care beds in 30-year licenses to private corporations. Many are the same for-profit chains responsible for thousands of long-term care infections and deaths, and who have fought against regulations that would allow more inspections, more accountability and more protections for residents.
In July 2020, while the public was preoccupied with the pandemic, the Ford government passed Bill 175. , setting up the structure for privatizing the last remaining public parts of home care. Health care advocates such as the Ontario Nurses Association (ONA), the Ontario Health Coalition, ARCH Disability Law Centre, the National Association of Federal Retirees and others maintain that the changes are misguided and flawed. Competitive bidding, which was discontinued in the interests of ensuring higher quality care, is again being considered. The ONA maintains that Bill 175 “fails those who work in and rely on home and community care.”
During the pandemic the Ontario government expanded the private sector’s role in COVID testing, allowing private companies to charge patients for needed tests, sometimes up to $400 a test. Vaccinations too have been contracted to private companies.
On February 1, 2022, Health Minister Christine Elliott announced plans to allow private clinics, usually called Independent Health facilities, to operate private hospitals in Ontario. “We’re opening up pediatric surgeries, cancer screenings, making sure that we can let independent health facilities operate, private hospitals, all of those things are possible because we do have the capacity.” Private hospitals would mean the introduction of U.S. style for-profit hospitals, something which has been banned under Ontario law since 1973.
Privatization is not the answer to health care concerns. Two tier medicine, where profit is valued over patient health, where those who are able can buy health care at the expense of those who can’t, and where financial and human resources are drained from the public system, has been rejected by Canada in its embrace of a health care system rooted in equity and compassion. The public health care system is not perfect. Some say that is by government design. In Ontario especially, hospitals have been drastically downsized and grossly underfunded. Ontario has the fewest hospital beds per capita of any province in Canada. We have the fewest nurses. We have the second fewest long-term care beds. Ontario funds its hospitals at the lowest rate. Shifting funding and scarce health care staff from our public system to for-profit companies would only increase our health care problems. Increasing health care funding and increasing public, non-profit health care capacity would allow our public system to to handle the backlog of diagnostics and surgeries.
Those who favour privatization of public services including health care may say that the state of the economy necessitates privatization. However, the economy is in a far better state than anticipated. In early February the Financial Accountability Office (FAO) reported a revenue increase nearly 10% higher than expected and a budget deficit far lower than anticipated. If revenues go to tax cuts rather than an investment in public services, most of us will not enjoy the benefits of an improved economy. In 2019, the FAO estimated that Ontario’s program spending was just over $2,000 less per person than the average of the other provinces. Per capita spending has not gone up since 2019, leaving us much in need of increased funding for those services upon which we all depend. Perhaps at the top of that list is healthcare.
If Ontario is in dire economic straits, one wonders how eliminating license plate fees at a cost of 1 billion dollars in lost revenue can possibly help the situation. That money could have gone towards bolstering public services such as health care. During the last fiscal year the FAO reported that Ontario actually spent $10.3 billion less than planned, including $1 billion less in health care.
Privatization of public health care services has been shown to create a lucrative revenue stream for private owners and operators at the expense of accessible, high-quality care for the rest of us, particularly the sick and vulnerable. The looming threat of increased privatization, particularly that of our hospitals should alarm us.
A Staffing Catastrophe – Marie Dellavedova
Two years from the initial onslaught of the pandemic we are in a debilitating sixth wave of another variant of Covid-19. During the first two waves of the pandemic 4,000 long-term care residents in Ontario died needlessly. Now, the very transmissible Omicron variant has led us to a far worse place than we were last year at this time.
Infection rates and hospitalization numbers are increasing at an alarming rate. In addition, there is now a health care staffing crisis. Hospital care, long-term care and home care services are crumbling due to severe staff shortages.
For decades, many long -term care homes have been operating at critically low staffing levels. Now, due to the very transmissible Omicron variant, a growing number of front-line health-care workers are sick, isolating, burnt out or have left the profession. Staffing levels at long-term care homes in Ontario, including those in Sault Ste. Marie, are even lower than before the pandemic. Low staffing levels result in inadequate resident care. In many long-term care homes, the staff work beyond their 12-hour shifts, work double shifts, and go without vacations. The situation is so dire that several for-profit chains have issued emergency requests for family members to volunteer to provide care for residents other than their own family members. And this far into the pandemic, not all long-term care workers have been provided N95 masks. Some are not required to wear them. Those that are, do not always receive adequate training on how to use them.
As of January 13, 2022, approximately 75,000 long-term care residents were in lockdown for a month. More and more residents are sick with Covid. Those who are not sick are also confined to their rooms. Residents are in decline from lack of personal care such as bathing, from dehydration and inadequate feeding, from bed sores, from isolation. Mental health issues are skyrocketing. Residents are spending day after day in their rooms without any interaction with other residents.
Health care advocates are proposing measures to address the severe staffing shortages.
Short term measures could include the immediate deployment of military teams to those facilities in crisis and the creation of rapid response teams composed of volunteer health care professionals from across the health care system. They could be deployed into those long-term care homes, hospitals, retirement homes and home care locations in need of crisis services. Doctors and nurses could be freed up from vaccination centres and replaced with other injection-qualified health-care professionals. The use of proper fit-tested PPE, enforced in all health care settings, would help control the spread of the virus and reduce staffing shortages. The accreditation of internationally trained and retired health care professionals could be fast-tracked and licensing fees waived.
In the longer term, advocates insist that critical staffing shortages that have existed for decades in long-term care, hospitals and home care must be addressed. According to the Ontario Health Coalition, “In long-term care alone, Ontario needs 21,500 full time equivalent PSWs and 15,500 RN/RPNs by 2025 to get care levels up to safety and open the scheduled new/redeveloped beds. There are currently 22,000 vacant RN positions in Ontario.” As well as increasing the number of staff and the compensation they receive for their crucial work, training is important. Every patient deserves appropriate and compassionate care. Transparency from government and health care leaders would help the public to understand and respond appropriately to important health care issues as they arise. And as our population ages, we need health care capacity that will meet population needs.
Solving the staffing crisis will require a huge investment of resources, people and ideas. Stable long-term funding is expensive but necessary. Valuable insight can come from front-line workers and from patients and their families who have been impacted.
For too long governments have allowed the situation to deteriorate. Now the stability and very existence of a quality health care system depends on immediate concrete action to address unprecedented, catastrophic staffing shortages.
RTOERO’s 3 Advocacy Issues
RTOERO has identified three advocacy issues this year
The three issues are: A National Seniors Strategy, Environmental Stewardship, and Geriatric Healthcare.
A coordinated seniors strategy is necessary to remove barriers to seniors’ independence and to the essential role seniors play in vibrant, healthy communities and economies. There is a need for a national seniors strategy that will tackle the gaps that exist in health care and social policies. That will require dedicated funding and accountable goals to meet the changing needs of seniors who are Canada’s fastest growing demographic. Challenges include income security, universal public pharmacare, social isolation and aging at home.
It is important for us to maintain the viability of our ecosystems for ourselves and for future generations. We must improve in all areas that are critical to a sustainable future. That includes a responsible use of resources, conservation and protecting our air and water. Everyone has a part to play in environmental stewardship-individuals, companies, industrial groups and governments. Challenges include a ban on single-use plastics, common recycling standards, environmentally-sustainable transportation and safeguarding the water supply and drinking water.
Geriatric Healthcare: Physical and Mental Health for Older Adults
Canada’s population is aging. In 2020 more than one in six Canadians is now a senior. By 2030 it will be nearly one in four. Our health care system, which has tended to address acute care needs, has had less focus on home care and community care. The rising needs of the growing senior population means that our health care system and social systems need to develop ways to address the new reality in order to meet those needs.
Challenges include geriatric training, healthy aging, long-term care and elder abuse.
If you would like more information about RTOERO’s advocacy issues please go to the website: www.vibrantvoices.ca.
There you can also add your voice to the voices of fellow RTOERO members in urging government to improve the tragic conditions that presently exist in long-term care.
Click the Summary Sheets, below, to view/download.
Below are the complete booklets for each Advocacy Issue.
Click to view/download.