Recognition of the Causes of the Long-Term
Care Home Tragedy in Quebec and
Where the Solution Lies
- Pierre Soublière -
Several public inquiries and investigations by unions, individuals
and organizations into what caused the deaths of seniors in Quebec
long-term care homes, the CHSLDs, have reached almost unanimous
conclusions
not only on the causes, but also on what is required to reorganize
health care on a humane basis.
Coroner's Inquest
In the upcoming weeks the inquest conducted by coroner Géhane
Kamel will continue and in January the assistant deputy minister for
Seniors will be called as a witness in the public hearings.
On June 17, 2020, Quebec's chief coroner, Pascale Descary,
ordered that a broad inquest be held on the deaths of seniors and
vulnerable persons in nursing homes during the COVID-19 pandemic. More
specifically, the inquest was to examine deaths which occurred between
March 12 and May 1 at the Herron long-term care home in Dorval
during the first wave, as well as to look into a sampling of deaths
which occurred in other nursing homes during that same period. The
present stage of the inquest which resumed in September 2021 is
entitled "National component of pandemic management in long-term care
homes and recommendations."
In its intervention at the coroner's public hearings, the Federation
of Health and Social Services (FSSS-CSN) states that a tragedy such as
the one experienced by our seniors with the COVID-19 pandemic must
never happen again. It emphasizes that the sorry state of the health
system when the pandemic began, along with the refusal of health
authorities and the government to adequately apply the precautionary
principle, put staff and the seniors in their care at risk.
 What
must change so as to never relive such a tragedy, says the FSSS-CSN, is
that Quebec must ensure a genuine public long-term care system, in
terms of facilities as well as home-based support services. The union
emphasizes the need for increased investment in services, better
planning to attract the needed workforce and better working
conditions for staff, as well as ensuring that all the necessary
supplies and equipment are provided. It points out that the government
refused to listen to and engage with health care workers during the
first wave and to take their proposals into consideration, delaying the
implementation of real solutions.
The Alliance of professional and technical health and social
services personnel (APTS), for its part, stated that we must learn from
the worst of what happened so that such an intolerable situation never
occurs again. It states that the shortage of professionals and
technicians, along with the fact that they were reassigned in a
haphazard manner
and their tasks changed without clear directives or orientation during
the first wave, contributed to the catastrophe, decimating our seniors
and greatly impacting APTS members. It emphasizes how pressing it is to
increase funding for these services and that the government and
facilities must recognize the indispensable role professional and
technical personnel including occupational therapists, physiotherapists
and others play and allow the full contribution of their expertise. It
also recommends increasing prevention and safety at all levels and to
ensure quality services in long-term care homes.
Ombudsperson's Report
On November 23, Quebec Ombudsperson Marie Rinfret published her final report -- COVID-19 in CHSLD's during the first
wave of the pandemic, identifying the causes of the crisis, acting and remembering -- which was filed with the National Assembly. The ombudsperson had published a first progress report on December 10,
2020, entitled Lessons to be learned from the crisis and going into action to respect the rights and dignity of people living in CHSLD's.
In her final report, she reiterates that at the time of the crisis the
health system was significantly weakened by systemic and pre-existing
failings which had long been known. She emphasizes the need for
adequate services so that proper, continuous and humane care is
provided, so that seniors will never again be forced to experience such
dehumanization in these facilities.
Among the failings, she points out the chronic shortage of personnel
which was made even worse by the sudden increase in the number of
patients, older patients who had been sent from hospitals to long-term
care homes, by the level of care needed by patients who were
particularly vulnerable and by the absence of a large number of staff
members who could no longer come to work because they had been
infected. She recommends that the Ministry of Health and Social
Services work out and adopt a plan of action with the aim of
recognizing the complexity of the care and services provided in
long-term care homes and the need for more humane care, increased
services and, among
other things, adequate working conditions, staff stability and ongoing
training.
With regards to the Ombudsman's report, the Interprofessional
Federation of Health in Quebec (FIQ) and FIQ/private sector state that
her recommendations are the same as those that they have put forward on
a number of occasions. They highlight the need to introduce legislation
establishing nurse to patient ratios so as to force the government
and management to provide quality care and services. The acting
president of the FIQ, Nathalie Levesque, observes that the government
was not able to protect the most vulnerable nor offer the care to which
they are entitled. She emphasizes that the situation is still tenuous
in most of the long-term care homes and that a lasting solution
requires
adequate financing and the gradual introduction of ratios. Such
measures would assist in easing the workload, stabilizing teams and
reducing staff turnover, thus ensuring quality health care which is
both safer and more humane.
Relying on Our Own Strength
 In
light of these observations, it is important to note that at the public
hearings of the coroner's inquest members of the Legault government
have testified but refused to take responsibility as they blame
facility directors as well as government's own institutions such as the
Ministry of Civil Safety. They point their fingers at the reforms and
decentralization implemented by the Minister of Health in the previous
Liberal government, Barrette, without ever admitting to the role their
own government has played in stepping up the neo-liberal anti-social
offensive, the main cause of the breakdown of the health system in
Quebec. Members of the Parliamentary opposition, for their part,
are raising that what is at stake is "confidence of the people in
public institutions" and that "confidence must be rebuilt through
transparency."
The confidence that must be strengthened is the confidence of
workers in themselves, relying on their own strength and uniting in
action on the basis of fighting for the solutions they have worked out
to provide a level of health care respectful of the dignity and rights
which are ours by virtue of being human.
This article was published in
December 10, 2021 - No. 118
Article Link:
https://cpcml.ca/WF2021/Articles/WO081182.HTM
Website: www.cpcml.ca
Email: editor@cpcml.ca
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