The Need for Working People to Control the Aim
in Long-Term Care Homes and the
Broad Health Care Sector

The disastrous situation in long-term care homes during the pandemic has been well documented. An exposure in The Toronto Star article entitled "‘Devastating to watch': Private long-term-care homes have seen some of Ontario's worst death rates -- but Doug Ford's new funding set them up for decades of profits" details the close connection between some of the private interests in Ontario's long-term care sector and the provincial government.[1]

Many staff and residents and their families have greatly suffered. Instead of viewing the human beings providing and receiving long-term care as one humanity involved in a crucial necessary service, those in control see the health care institutions and their staff and residents as objects and subjects to be exploited for private gain. Control and ownership of social enterprise and services as private property dominates the thinking and outlook of the system of party rule and is the reference point in contradiction with the socialized conditions and needs of the people.

The construction of health care facilities and their operation, the supplies including pharmaceuticals, the procuring of investment funds, the workers providing the care, the manner in which the produced value is realized and importantly the aim of why long-term care homes and health care generally exist in the first place are all targets of global private interests in the service of their own narrow interests.

The private aim of the ruling elite which controls the purse strings clashes with the socialized conditions of the economy and society and the necessary attendant modern aim and outlook to look after one another as members belonging to our socialized collective of one humanity.

The people work in the socialized economy; they depend on it for their livelihoods and to meet their needs and that of society. They have no other choice but to work and live within the given socialized conditions into which they are born. They have legitimate claims on the economy and society to guarantee their rights and well-being from birth to passing away. Those modern conditions call on us to work and live with one another both as productive workers and when necessary as dependents.

The Marxist-Leninist Party of Canada addresses the problem in its program as the necessity to bring the economic, political and social relations and forms into conformity with the objective social conditions facing humanity.

The call in the health care sector is to rid it of any aspect of paying the rich, to increase funding of social programs and to change the political process so that an empowered people are not blocked from solving problems but encouraged to institute change and bring in the New.

The MLPC calls on the people to bring into being a modern Canada that defends the rights of all! Let us together forge a New Direction for the Economy; Stop Paying the Rich; Increase Funding for Social Programs! Humanize the social and natural environment!

All Out for Democratic Renewal!

Note

1. For the complete text of the article by Richard Warnica, Business Feature Writer from The Star, July 15, 2021, click here.

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.

(To access articles individually click on the black headline.)

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The Need for Working People to Control the Aim in Long-Term Care Homes and the Broad Health Care Sector