Dec 17, 2020

By Jane Brown

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by Bill VanGorder, Chief Policy Officer, C.A.R.P.

Ontario is the only province in Canada with a Ministry of Long-term Care. On paper, this sounds commendable. And you’d think they would be doing a stellar job. After all, they have a very tight focus and mandate, and a lot of high-powered management. The Deputy Minister makes over two hundred thousand dollars a year, as does at least one Assistant Deputy Minister. And numerous department heads make over a hundred and fifty thousand.

But the performance, as we know, has been a disaster.

That is why, for the first time in its 36-year history, C.A.R.P. (founded as The Canadian Association of Retired Persons), has publicly called for the firing of a cabinet minister, and named that minister: Merrilee Fullerton, Minister of Long-term Care.

With over 325,000 members, C.A.R.P. is the largest and most influential organization advocating for the rights and interests of Canadians as we age, and has always been strictly non-partisan in political matters. C.A.R.P. enjoys productive relationships with both federal and provincial leaders and bureaucrats, and has submitted countless policy briefs, white papers, and recommendations covering everything from health care to financial security to ageism and elder abuse. We’ve always concentrated on the policies, not the people.

But we’re so fed up by the mismanagement and inaction of this Ministry, we’ve taken the drastic step of urging Premier Ford – loudly and publicly – to fire Merrilee Fullerton.

And make no mistake about “loudly and publicly.” An online petition on the C.A.R.P. website, carp.ca, had produced over 3,000 signatures as of December 9. And David Cravit, C.A.R.P.’s Chief Marketing Officer has personally voiced a tough and frank series of radio commercials, explaining C.A.R.P.’s demand and urging listeners to join in.

The uncomfortable truth is that the Ministry of Long-term Care desperately needs a wake-up call. They have fumbled every aspect of the COVID crisis – and that’s on top of fumbling virtually every aspect of long-term care, going back to the Kathleen Wynne government.

Clearly, something fundamental is not working over there. Shock treatment is needed.

The litany of mismanagement is long, consistent and outrageous.

Even before COVID, there was chronic understaffing, inadequate and inconsistent inspections, and a hazy – at best – vision for the future.

And we all know what happened when COVID hit. Conditions were so bad, and death rates in some nursing homes were so severe, that the province was required to call in the military for help. Their subsequent report on five facilities in the Toronto area was a horror story, detailing improper use of equipment between COVID patients and those who had not tested positive, improper use of PPE, grossly inadequate infection prevention and control, the presence of cockroaches and ants, and patients waiting hours for a response to urgent calls for help.

Premier Ford, to his credit, was blunt and honest in his reaction. “It was the worst report, most heart-wrenching report I have ever read in my entire life,” he said, and in July created a commission of inquiry under associate chief justice of the Superior Court Frank Marrocco.

The commission was supposed to report its findings by April, 2021, but was so shocked by what it was hearing right off the bat, that it filed an interim report at the end of October and a second interim report earlier this month. Both reports identified serious shortcomings, from inadequate leadership to poor infection prevention and control to confusion within long-term care homes as to who was responsible for quality of care to a lack of data on the quality of care received. In both reports, urgent measures were recommended.

We can give kudos to the Premier for his candour on what was wrong and his determination to fix. We only wish the same urgency was in evidence within the Ministry itself.

Sadly, it is not.

While some impressive announcements have been made around issues of funding and quality of care standards, the execution and implementation lie well into the future. For example, the guarantee that each patient will receive a minimum of four hours’ care per day will not fully kick in until 2025.

What about right now?

The second wave is upon us, and while the mortality rates have thankfully declined, the staffing levels are still inadequate and we still hear stories – many of them in the form of emails or phone calls to C.A.R.P. – that there is still not enough equipment. As well, the Ministry has been all over the map on its regulations regarding visitors, changing the rules frequently (and with very unclear communication) and only adding to the stress levels of both patients and their loved ones.

We believe it is entirely fair to call the Ministry, and its management, to account for their inadequate performance. Why shouldn’t we demand better for the money we are paying?

In the end, it is the Minister who must bear responsibility for this hot mess. It’s perfectly fair to note that the problems in the Ministry were not all of Merrilee Fullerton’s making – the legacy of mismanagement goes back deep into the previous administration under Kathleen Wynne. But Minister Fullerton has the responsibility today, and under the accepted norms of Cabinet responsibility in our system of government, she has to step up and face the issue, either on her own or by the Premier’s dictate.

C.A.R.P. makes no apology for being so blunt and outspoken. Someone has to wake the Ministry up. It has become literally a matter of life and death.

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