When it comes to the death toll of the COVID-19 pandemic, the comparison between Canada and Australia is shocking. Australia has suffered four deaths per million residents compared to more than 212 in Canada.
Canadians have watched in horror as the COVID-19 death toll climbed in Canada’s long-term care facilities, now more than 6,000, according to a CBC News tally. In Australia, that number is just 29, according to Australian public health data.
Greg Shaw, who runs the International Federation on Aging non-profit, is uniquely positioned to compare the two countries. He lives in Toronto but previously served in senior roles in Australia’s Health Ministry. He points out that Australia’s aged care facilities had a detailed plan to deal with a pandemic, while Canada did not.
“When COVID 19 came to Australia,” he said, “many of the care providers basically locked-down and implemented their pandemic plans for infection control. They stopped families from coming in. They didn’t have staff working from one facility to another facility, and generally that’s not the case in Australia anyway.”
In Canada, the fact that some long-term care workers initially had to find shifts in multiple facilities to make a living was a significant contributor to the spread of COVID-19. Since the outbreak intensified, however, provinces have prohibited staff from working at multiple care homes.
Greg Shaw formerly held senior management positions within the Australian Government in the Department Health and Ageing. (Submitted by Greg Shaw)
Inspection
One of the most striking differences between Canada and Australia lies in the inspection regime for seniors’ facilities. Australia is far more strict, said Graeme Prior, who runs one the largest for-profit aged care providers in Australia.
He owns dozens of homes, and says the inspections of them are rigorous. “If we get a report for the federal authorities in six months’ time from an inspection and it’s a negative one, we’ve got 28 days to fix it,” he said. “There’s no mucking around. There’s no ‘I’ll think about it.’ We’d be sanctioned. We’d be out of business in six months.”
Graham Prior is CEO of Hall & Prior Aged Care Group which operates 25 long-term care homes in Australia. (Submitted by Graham Prior)
Twelve homes were shut down in Australia in 2018, according to figures from Australia’s public health department. Zero were shut down in Ontario that year.
“We don’t seem to have the kind of teeth that they’ve given to their inspectors,” said senior care expert Tamara Daly of York University. “We don’t act as readily to shut a home down. They (Australia) remove accreditation really fast, and as a result of that, I think that they are getting better compliance with their standards.”
Staffing levels
Staffing levels are a key factor in senior care. In Canada, personal support workers may have to care for as many as 36 patients, according to Daly, who finds that unacceptable. “One PSW for 36 residents who themselves are incapable of going to the toilet on their own. If someone needs two people in order to move them and they want to get out of bed, those two people have to be available at the same time. The level of staffing is just so much more limited.”
Tamara Daly is the director of York University’s Centre for Aging Research and Education. (Tamara Daly)
Staffing levels affect care on the most basic level such as bathing. In Australia, Prior said his residents have a bath or shower every day. “That’s the way it works. You’d have your bath at six in the morning or have it at lunch time.” In Ontario homes, only two baths or showers per week are required by law under the long-term care home act.
Many trace the drop in Ontario senior care staffing levels back to the 1990s when Conservative Mike Harris was premier. Harris actually budgeted an extra billion dollars for senior care in Ontario, but his government directed 60 per cent of that money to private “for-profit” providers, and he cut staffing requirements.
“Cutting minimum staffing has had a very negative impact on the sector overall,” said Daly.
The role of Mike Harris
After he left politics, Mike Harris became the chairman of Chartwell Homes, one of Ontario’s largest for-profit senior care providers. Since then, Chartwell has had staffing-level issues.
Government inspection reports show that one Chartwell home in Kingsville, Ont., has been cited dozens of times in recent years for not maintaining adequate staffing. Follow up-inspections often found that the Chartwell operators repeatedly “failed to comply” with regulations but there has been little consequence for them.
“They’re getting away because there aren’t serious consequences,” said Shaw. “Tell me any province in Canada where the government said ‘You’re not meeting the standards now. We’re actually putting in an administrator to bring the care standards in the home, and the service provisions, up to standard before we will allow you to take it over again.’ You’ve got to be able to demonstrate that you’re capable of running the nursing home.”
Only now, as a result of the COVID-19 crisis, the Ontario government has announced it would take over at least nine senior homes.
Mike Harris, seen here in 2018, was premier of Ontario from 1995 to 2002. (Frank Gunn/The Canadian Press )
A crucial tool to find major problems is for inspectors to arrive without warning. In Ontario, they are called Resident Quality Inspections (RQI) and are a counterpart to reactive visits that are required after a complaint or some critical incident in a home, such as a death. RQIs catch facility staff off guard and often reveal hidden problems.
In Ontario, last year there were only nine such unannounced inspections. By contrast, in Australia, recent records show 3,099 unannounced visits in one year, at least one for each home. If Australia’s approach had been applied to Ontario where there are 628 registered LTC facilities, there would have been at least 628 unannounced visits in 2019, not just nine.
For-profit homes
Of the six worst hit seniors’ homes in Ontario where the Canadian army was dispatched to help out, five were for-profit homes.
“We know even before COVID happened that for-profit homes tend to perform worse than public homes and non-profit homes,” said Daly. “We also know that non-profit and public homes pour money in and have higher staffing levels as well as better workplace protections so they have more permanent staff, they have more staff that have benefits. We also know that for-profits tend to rely more heavily on temporary and casual staff.”
In Ontario, a significant amount of money spent for senior care ends up in executive compensation and shareholder dividends for the private providers. The Toronto Star reports that for Mike Harris’s Chartwell Corporation, that figure was $845 million over the last 10 years. At the end of last year, he personally had a seven million dollar stake in the company.
Mr. Harris declined our request for an interview. In a statement, Chartwell said: “Mr. Harris’s government added much needed additional capacity to the long-term care system and helped ensure a significant portion of buildings were able to be redeveloped to modern standards.”
Daly, however, said there is, “quite a bit of profit-taking in the sector … so we need to ask really, really clear questions about how we want public dollars used, and what we need to demand.”
The political calculation
A few weeks ago, Prime Minister Justin Trudeau speculated aloud about how the federal government should get more involved in senior care. He was quickly shot down by Quebec Premier François Legault, who basically suggested the federal government should mind its own business and stay in its own jurisdiction.
The politics of this situation may have pushed Trudeau to stay out of the sector for now, perhaps because at the moment the senior care homes are seen as a terrible problem that tarnishes any politician responsible for the mess there.
There is some question as to whether the COVID-19 disaster in long-term care facilities will change that political calculation, because the public might demand change. Australia’s federal control and funding of senior care stands as an example.
VANCOUVER – Contract negotiations resume today in Vancouver in a labour dispute that has paralyzed container cargo shipping at British Columbia’s ports since Monday.
The BC Maritime Employers Association and International Longshore and Warehouse Union Local 514 are scheduled to meet for the next three days in mediated talks to try to break a deadlock in negotiations.
The union, which represents more than 700 longshore supervisors at ports, including Vancouver, Prince Rupert and Nanaimo, has been without a contract since March last year.
The latest talks come after employers locked out workers in response to what it said was “strike activity” by union members.
The start of the lockout was then followed by several days of no engagement between the two parties, prompting federal Labour Minister Steven MacKinnon to speak with leaders on both sides, asking them to restart talks.
MacKinnon had said that the talks were “progressing at an insufficient pace, indicating a concerning absence of urgency from the parties involved” — a sentiment echoed by several business groups across Canada.
In a joint letter, more than 100 organizations, including the Canadian Chamber of Commerce, Business Council of Canada and associations representing industries from automotive and fertilizer to retail and mining, urged the government to do whatever it takes to end the work stoppage.
“While we acknowledge efforts to continue with mediation, parties have not been able to come to a negotiated agreement,” the letter says. “So, the federal government must take decisive action, using every tool at its disposal to resolve this dispute and limit the damage caused by this disruption.
“We simply cannot afford to once again put Canadian businesses at risk, which in turn puts Canadian livelihoods at risk.”
In the meantime, the union says it has filed a complaint to the Canada Industrial Relations Board against the employers, alleging the association threatened to pull existing conditions out of the last contract in direct contact with its members.
“The BCMEA is trying to undermine the union by attempting to turn members against its democratically elected leadership and bargaining committee — despite the fact that the BCMEA knows full well we received a 96 per cent mandate to take job action if needed,” union president Frank Morena said in a statement.
The employers have responded by calling the complaint “another meritless claim,” adding the final offer to the union that includes a 19.2 per cent wage increase over a four-year term remains on the table.
“The final offer has been on the table for over a week and represents a fair and balanced proposal for employees, and if accepted would end this dispute,” the employers’ statement says. “The offer does not require any concessions from the union.”
The union says the offer does not address the key issue of staffing requirement at the terminals as the port introduces more automation to cargo loading and unloading, which could potentially require fewer workers to operate than older systems.
The Port of Vancouver is the largest in Canada and has seen a number of labour disruptions, including two instances involving the rail and grain storage sectors earlier this year.
A 13-day strike by another group of workers at the port last year resulted in the disruption of a significant amount of shipping and trade.
This report by The Canadian Press was first published Nov. 9, 2024.
The Royal Canadian Legion says a new partnership with e-commerce giant Amazon is helping boost its veterans’ fund, and will hopefully expand its donor base in the digital world.
Since the Oct. 25 launch of its Amazon.ca storefront, the legion says it has received nearly 10,000 orders for poppies.
Online shoppers can order lapel poppies on Amazon in exchange for donations or buy items such as “We Remember” lawn signs, Remembrance Day pins and other accessories, with all proceeds going to the legion’s Poppy Trust Fund for Canadian veterans and their families.
Nujma Bond, the legion’s national spokesperson, said the organization sees this move as keeping up with modern purchasing habits.
“As the world around us evolves we have been looking at different ways to distribute poppies and to make it easier for people to access them,” she said in an interview.
“This is definitely a way to reach a wider number of Canadians of all ages. And certainly younger Canadians are much more active on the web, on social media in general, so we’re also engaging in that way.”
Al Plume, a member of a legion branch in Trenton, Ont., said the online store can also help with outreach to veterans who are far from home.
“For veterans that are overseas and are away, (or) can’t get to a store they can order them online, it’s Amazon.” Plume said.
Plume spent 35 years in the military with the Royal Engineers, and retired eight years ago. He said making sure veterans are looked after is his passion.
“I’ve seen the struggles that our veterans have had with Veterans Affairs … and that’s why I got involved, with making sure that the people get to them and help the veterans with their paperwork.”
But the message about the Amazon storefront didn’t appear to reach all of the legion’s locations, with volunteers at Branch 179 on Vancouver’s Commercial Drive saying they hadn’t heard about the online push.
Holly Paddon, the branch’s poppy campaign co-ordinator and bartender, said the Amazon partnership never came up in meetings with other legion volunteers and officials.
“I work at the legion, I work with the Vancouver poppy office and I go to the meetings for the Vancouver poppy campaign — which includes all the legions in Vancouver — and not once has this been mentioned,” she said.
Paddon said the initiative is a great idea, but she would like to have known more about it.
The legion also sells a larger collection of items at poppystore.ca.
This report by The Canadian Press was first published Nov. 9, 2024.
