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Proposed Ban on For-Profit Long-Term Care Sinks Otherwise Bold Reform Plan


November 5, 2020 

OTTAWA, ON – The Ontario NDP’s plan to reform long-term care in the province unfairly and misleadingly blames for-profit corporations for the fact that personal support workers (PSWs) “are badly overworked and underpaid,” according to a new analysis by think tank Cardus. As Cardus outlined in a previous report, the poor wages and working conditions of PSWs are not unique to homes owned by for-profit companies. They are the result of several structural challenges to PSW funding, including:

  • A single source of revenue constrained by rising health and other government costs
  • Employers who are unable to exercise any real agency because of the centralized structure of bargaining and funding arrangements
  • Educational barriers to recruitment of PSWs.

“Banning for-profit providers from long-term care is a simplistic, reductive response that fails to solve the underlying, structural issues with LTC and its labour-market challenges,” says Johanna Lewis, a Cardus researcher.

The Cardus analysis also found that two aspects of the Ontario NDP’s plan would lead to significant improvements to LTC:

  • Improving home care and supporting more community-based LTC homes
  • Developing an apprenticeship program for PSWs

Improving home care, partnerships with family and other informal caregivers, protection of couples’ right to live together, and promotion of community-based LTC would all be welcome improvements over the institutional approach that currently dominates LTC.

Developing an apprenticeship program would allow prospective PSWs earn while they learn, helping to make it more affordable to undertake eight months of full-time schooling—the current requirement to earn a PSW certificate. This would also prepare students for the reality of modern LTC work.

Two final aspects of the Ontario NDP’s plan deserve cautious support, according to the Cardus analysis:

  • Better monitoring of LTC homes
  • Improving wages and staffing in LTC

Ensuring accountability and quality of care in LTC are important, but Ontario must be careful not to worsen the heavy and demoralizing paperwork burden PSWs bear. It is best to re-focus inspections on care outcomes, resident and staff experience, systemic safeguards, and practical solutions, which would reduce the current emphasis on compliance and documentation.

Likewise, the need for improved wages in LTC is clear, but relying on government to set wages is a short-term solution at best. Over the long term, Ontario must strive to develop healthy and functioning labour markets, allowing for normal bargaining for wages and working conditions.

“Despite some significant drawbacks, the Ontario NDP has put forward a genuine plan for reforming long-term care that deserves serious attention,” says Lewis. “We encourage Queen’s Park to adopt the best aspects of this proposal, fusing them with the wholesale reform of LTC that the COVID crisis has thrown into stark relief.”

The full Cardus analysis is freely available online.

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