Government must invest in long-term care, including rigorous inspections

Posted: December 18, 2020

(December 17, 2020)

By: Keith Leslie, The Hamilton Spectator

The Ontario government should be ashamed that the second wave of COVID-19 has been even more devastating than the first in long-term-care homes, especially after Premier Doug Ford promised an “iron ring of protection” for 70,000 vulnerable citizens. So far, 2,400 long-term-care residents and eight staff in Ontario LTC homes have died from COVID-19.

Outbreaks of the virus have spread to 137 of the province’s 626 LTC homes, up from just 16 homes on Sept. 1, an obvious consequence of government failure to better prepare the sector for the long-predicted second wave.

The Ontario Health Coalition found the number and size of large COVID-19 outbreaks in LTC homes increased significantly over the first wave, and expanded geographically to areas that had few, if any, cases last spring.

Government oversight, or the lack of it, is why LTC homes were so ill-prepared for the pandemic, why so few staff were trained in infection prevention and control protocols, why so few had access to personal protective equipment and why some very frail residents were living in disgustingly deplorable conditions.

The government’s hand-picked long-term-care commission, which reported in October that LTC homes were pretty much “forgotten” in the first wave of pandemic planning, issued a second report this month calling for the “urgent” return of in-depth Resident Quality Inspections.

Ontario drastically reduced direct LTC oversight in 2018 — the year the Progressive Conservatives were elected — by phasing out annual RQIs in favour of a complaints-based system. The RQIs, which could take days or even weeks, were done in only half the province’s LTC homes in 2018, and in just 27 homes in 2019.

The commission said virtually eliminating RQIs left the government “with an incomplete picture of the state of infection prevention and control and emergency preparedness” in LTC homes for COVID-19.

Disputing facts she promised to make “crystal clear,” Long Term Care Minister Dr. Merrilee Fullerton confused the situation by claiming her office conducted 2,800 inspections in 2019, and insisting “every single LTC home in Ontario gets inspected at least once a year.”

The commission dismissed the government attempts to equate its complaints-based system as “reactive inspections” that are no replacement for “proactive” RQIs, which were designed to identify systemic issues in LTC homes.

“By their nature, a complaint about day-to-day issues in a home is very unlikely to identify problems with equipment and processes that would be used in an emergency.”

Sometimes government needs to be hit in the face with the facts, but only the dangerously dumb ones stick to their talking points in the face of a deadly reality. The Ford government must bring back full RQIs annually for every long-term-care home, in addition to investigating complaints and critical incidents.

Ontario’s Financial Accountability Office reported the government was sitting on $12 billion in unspent pandemic relief funds at the end of November, up from $9.3 billion in August. The government said 80 per cent of the money is committed and will be spent by the fiscal year-end next March, but why wasn’t some used last summer to reduce the impact of the second wave we all knew was coming?

It’s clear the PCs kept billions of dollars in contingency funds while long-term-care homes struggled to better prepare for the second wave, and some of that money needs to flow now to hire the inspectors that will be needed for the comprehensive annual inspections of all LTC homes. We owe our vulnerable loved ones nothing less.

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