CUPE-sponsored report calls for higher public investment in long-term care

Herald file photo

A report funded by CUPE and written by researchers out of Ottawa’s Carleton University accuses the government of not adequately funding long-term care home infrastructure or staffing levels.

Titled Crumbling Away: Saskatchewan’s Long-Term Residential Care Policy and its Consequences was written by Susan Braedley, Tara McWhinney, Asia Barclay and Kiersten Jensen.

“Our analysis shows that over the last decade, despite demographic trends that predict needs for more capacity, Saskatchewan long-term care policies have both reduced the number of beds available and eroded service provision by removing staffing requirements that allow for dedicated care hours per resident,” Braedley said in a press release.

“Failures to plan for and dedicate sufficient funding to replacing, renovating, repairing and maintaining the physical infrastructure of publicly-owned and operated Special Care Homes have left the sector in disrepair, and literally crumbling away.”

The report cites an estimate that the province’s ageing population will require an additional 4,648 long term care beds by 2035. Still, the number of long-term care beds in the province has fallen from 9,240 to 8,517 over the past year, the CUPE-funded report says.

The report also found that long-term residential care, when properly funded, is correlated with the highest level of care. It accuses the province’s practice of promoting personal care homes offering higher levels of care equal to “developing a private pay alternative of questionable quality.

“there is significantly high-quality evidence that ‘for-profit provision of long-term care leads to lower-quality care, lower staffing ratios, higher rates of hospitalization and mortality, escalating costs and lower accountability and financial transparency,” Braedley wrote.

The report frames what it says is the problem by opening with the closure of 94 beds at Regina’s Pioneer Village that had been identified as requiring urgent repairs in 2014, the second time beds had been closed. It also mentions the closure of a 32-bed special care home in August 2018 due to similar infrastructure problems.

Months later, in February 2019, the province put out three requests for proposals for long-term care beds in Grenfell and Regina, calling for an “innovative approach” to community-based care delivery.

In the introduction of the report released Tuesday, the authors write: “Consistent with the Saskatchewan Party’s decision to open publicly funded health care to for-profit providers, these requests aim to transfer publicly owned and operated long-term care beds to private, and very likely for-profit, corporations. Yet research evidence shows that private, for-profit long-term care is of lower quality and less cost-effective than publicly provided long-term care.”

The report accuses government policy shifts of undermining publicly-operated care homes and opening doors to the private sector.

The report cites a reduction in staffing requirements it says occurred “the exact moment that resident needs are becoming more acute.” It also cites a 1990s policy decision that saw a formula provided for consistent, predictable capital funding for special care homes dropped.

“Since then special care homes must apply and compete for capital funding to maintain their infrastructure, and often get either nothing or a fraction of their needs,” the report found.

“Problems with mould, mildew, plumbing, electrical, and more have been reported repeatedly in special care homes across the province.”

The report says that in 2013, the health minister directed health regions to inspect and report on their special care home facilities, revealing major problems, but with minimal funding following.

To the report authors, this is intentional.

“The government decision to look for private providers in 2019 reveals the connection between the neglected building infrastructure and privatization policies,” they wrote.

“According to these and other government reports, many public special care homes across the province require urgent repairs, renovations and replacements. The situation remains critical. These buildings and the land on which they sit are publicly owned. These are public assets that are being allowed to deteriorate, in what appears to be a deliberate move to make space for private for-profit providers.”

The report goes on to accuse the provincial government of making “a series of policy shifts’ that prepare for long-term residential care “divestments and privatization,” while shoring up privately-owned, private-pay alternatives.

“an unarticulated policy plan aims to marketize and privatize the sector despite significant, high-quality research evidence that shows private for-profit provision is associated with lower staffing, lower quality of care, and problems with accountability, financial transparency, and costs,” they wrote.

They concluded that staffing levels and mix need to be addressed across the public sector to increase the quality of care. They also called for the ratio of beds-to-seniors in Saskatchewan to grown, and for proper investments to be made in public infrastructure.

“Given the weight and quality of the evidence against private for-profit long-term care provision, which shows overall lower quality, lower staffing, inadequate accountability, and lack of financial transparency, privatizing long-term care makes sense only to those who will profit from the new business opportunities,” they wrote.

“From the perspective of most residents of Saskatchewan, who aim to ensure that quality long-term care is available when needed for their family members, their neighbours, and themselves, investments in publicly owned and operated long-term residential care is the best way forward.”

The Herald put these concerns and several questions to the Ministry of Health.

A response was not received by deadline.

The Provincial NDP did bring up the report in question period, and received a brief response from Warren Kaeding, the Minister of Rural and Remote Health and the Minister Responsible for Seniors.

“Long term care is definitely a key priority for this government,” he said.

“We have the second-highest number of beds per ageing population across the country. We are going to continue to work hard to meet the needs of our senior residents as they age across the province.”

Kaeding said he was in a long-term care home as early as this past weekend, and that residents said the care and concern that was provided to them “second to none.”

He added that the Saskatchewan Party had added over 700 more front-line staff members since 2007 and increased annual funding for long-term care by 45 per cent.

He added that the most recent resident and family services surveys showed that 85 per cent of residents and a similar percentage of family members have been pleased with the level of care they received in long-term care homes.