As political leaders from across Ontario begin to set post-pandemic priorities, one of Canada’s top policy critics is asking for elder care to be at the top of the list.
“The pandemic forced the public and public policymakers to look more closely at social issues like poverty, inadequate housing, racism, and the overdose crisis,” said Andre Picard, keynote speaker during the Association of Municipalities Ontario (AMO) conference being held this week.
The AMO conference is held annually and brings together representatives from municipalities across the province for networking, information sessions and minister forums.
“Sometimes we just turn away but the pandemic taught us that we can't afford to,” he continued.
Picard is one of Canada’s top health and public policy observers, authors and commentators. His most recent book is entitled: Neglected No More - The Urgent Need to Improve the Lives of Canada’s Elders in the Wake of a Pandemic.
In his presentation to municipal representatives at AMO on Tuesday afternoon, Picard addressed the impact COVID-19 is expected to have on the health system in Ontario and on health-related political priorities going forward.
“Virtually every problem we have in Canadian healthcare is structural or administrative. The medicine is fine. We have some of the best medical and nursing schools in the world, but it's the way we deliver the care that's flawed,” he said.
He explained that the current healthcare system depends on a lot of workarounds, that it is not connected in the way it should be and that the system makes it much too difficult for healthcare workers.
“It was a system created in the 1950s to deliver acute care. It's not fashioned in a way to deliver chronic care, to deal with an aging population or to deal with pandemics. And COVID-19 demonstrated that in spades,” Picard said.
Reflecting on the initial 18-months of the COVID-19 pandemic, Picard applauded the response of the province’s hospitals, suggesting that the system implemented lessons learned in former pandemic scares such as SARS.
He added that the good news story in hospitals made the inadequacies of other parts of the healthcare system “even more glaringly obvious and tragic”.
“Everything that could possibly go wrong in long-term care (LTC) went wrong,” he said, pointing to a lack of PPE, a lack of training and insufficient staffing levels.
“There were shortages of people. People who do the essential work for our elders like toileting, bathing, and transport. The pandemic also showed us just how weak and crumbling the infrastructure is and how inadequate it is, and that again, made it difficult to do infection control and made this so much worse,” he continued.
“Of the 26,500 deaths we've seen in Canada. So far, more than 17,000 have been elders in institutional care, people living in LTC homes, in nursing homes and retirement homes. Places they went to be safe to live out their lives being cared for and they were failed. They were failed miserably by our system,” he continued.
In a passionate plea, Picard suggested honouring the lives lost in care by working to fix the problems in the system that were highlighted by the pandemic.
He explained that through the pandemic, municipally-run LTC facilities fared better in controlling the virus than that of their for-profit and not-for-profit counterparts.
But why did municipal-run homes do better with their COVID-19 outcomes? Picard suggested it all came down to the personnel.
“People are accountable to the communities they serve, because they're actually connected. Many of you will sit on the boards of your local care homes, and that matters. It's not anonymous,” he said.
In addition, in the municipal-run LTC facilities, Picard said it was more common to see additional staff brought in, movement between other facilities was limited or restricted, inspections were increased and the use of communal rooms reduced.
He urged municipal leaders to demand more money, as the province continues to pour funding into LTC in an attempt to improve the quality of infrastructure and care.
“If we're going to build more LTC homes, which seems to be a priority of the provincial government in Ontario, where the money is invested matters and it matters a lot,” he said. “Municipalities should be demanding a bigger piece of the pie, because they're delivering better care.”
For municipalities, he noted, funding should not be all about building new LTC facilities. He suggested political leaders should look more broadly at how care is provided to elders by investing in home care, supportive housing, and making communities more elder-friendly.
“Municipalities have a key role to play in all these areas, especially the latter. How can we make our cities more adapted to the aging population?" he asked.
“Coming out of the pandemic, there'll be a lot of opportunities, a lot of positive change. And no matter how painful some of it has been, it needs to happen. We can't afford to just return to our old, not so great way, of doing things,” Picard concluded.
