Health minister promises to fix long-term care, but offers no money to actually fix it

Last week’s expert-panel report into the province’s flat-lining long-term care system offered a clarion call for the government to finally fix our ailing long-term care system. But the panel didn’t provide a clear, costed pathway to do that, in part because the government didn’t provide it with enough useful data about the existing problems and in part because the government wrote the panel’s job description precisely to make it difficult for them to talk about the only issue that will ultimately matter: money.

Health Minister Randy Delorey (Global)

This column originally appeared in the Halifax Examiner January 14, 2019.

Health Minister Randy Delorey says his government “will pursue and act upon” the five recommendations and 22 action items in last week’s expert-panel report into the province’s flat-lining long-term care system.

The backdrop: in September, a woman with untreated, infected bedsores died in a long-term care facility. She wasn’t the first. And questionable patient deaths were far from the only crises plaguing the province’s long-term care system.

Delorey responded by appointing the three-member panel, handed them a vaguely generic mandate, gave them three months and told them to come back with suggestions to fix the mess.

The panel did — and it didn’t.

The panel’s chair describes the current state of long-term care as a “crisis,” and the report itself warns the government that staff in those facilities need “immediate support.” Ongoing staff shortages, it declared, “increase staff responsibilities, with more residents to provide care for, resulting in overstressed staff, high rates of injury and sickness, and many unfilled vacancies across the system.”

But the panel didn’t offer a clear, costed pathway to fix the system, in part because the government didn’t provide it with enough useful data about the existing problems and in part because the government wrote the panel’s task description to make it more difficult for them to talk about the only thing that ultimately matters: money.

That said, it is difficult to read the report as anything but a clarion call for the government to finally do something, and to do it now.

Which begs the question. What does Delorey really mean when he says he will “pursue and act upon” the report’s recommendations?

Does he mean his government will put much-needed new funding into a system everyone knows is in desperate need of more funding, more staff, and more hours of care per patient?

Well, no. The minister deliberately didn’t include funding as part of the panel’s mandate, he says, because he “didn’t want that to be the driver” of its discussions.

Fair enough, but does that mean we can now expect — seeing that funding is at the heart of every panel recommendation and action item — the province will put more money in the long-term care pot in the finance minister’s upcoming budget? Delorey can’t — or won’t — answer. That will be up to the finance minister, he says as he step-dances around the question.

As for the finance department, it won’t even dance. When Devin Stevens, a reporter with the subscription-based business website, allnovascotia.com, asked the money question, a department spokesperson “declined to commit to more long-term care funding.”

So let’s review. This is all about money. “It’s that simple,” Janet Hazleton, the president of the Nova Scotia Nurses’ Union, told the CBC way back in October. “What has to happen is [more] money.”

But rather than put more money into the system, the McNeil government — according to NDP leader Gary Burrill — has actually siphoned $5-million out of nursing home operating budgets over the last three years to help it create its vote-friendly fiction of balanced budgets.

When the Liberals were elected in 2013, Burrill also says there was a plan waiting on the health minister’s desk to create 350 already urgently needed new long-term care beds.

Five years later, not one of those new beds exists.

Meanwhile, 20 per cent of the patients now being warehoused in hospitals in Nova Scotia should be in long-term care, but aren’t — because there are no beds for them.

That, of course, puts added strain on strained primary health care facilities, which…

To make matters worse — if that is even possible — Nova Scotia is an already old province that is aging rapidly. The number of Nova Scotians over 65 is expected to double in the next 10 years.

In the face of all of that, Health Minister Delorey blandly declares his concern is with the “quality of care, irrespective of the number of beds within the system.”

Sure, but if the lack of beds is one of the key reasons for the quality-of-care crisis, shouldn’t he…?

Like the issue of the number of beds, the question of hiring enough staff for the patients in the beds that do exist was also — inexplicably — not part of the panel’s mandate.

The government claims it doesn’t even know how many staff vacancies there are in the system today. The panel chair could only estimate it is in the hundreds.

Why are so many jobs going begging in long-term care homes? Money. Again. Still. Always.

When the McNeil government was elected, one of its first orders of business was to freeze the wages of public servants, including lowly paid continuing care workers, whose starting salary was — and is — $16.38 an hour.

“Who would be attracted to this profession?”  asks Nan McFadgen, the president of CUPE, which represents many of those workers.

There used to be a bursary program that at least eased the cost of training for continuing care students in community colleges. The government didn’t renew it.

So, in short, what we have is a government-appointed panel telling us what we already know, and a government that helped create the problem — and the panel — not now doing very much of anything to fix the mess.

And so it goes.

A version of this column originally appeared in the Halifax Examiner.  
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