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Systemic changes likely needed for support sector

The province this week extended the temporary wage increase that provides the likes of personal support workers with an extra $3 per hour. It’s the third time the program has been extended, this stint running until October 31.

The increase applies to 158,000 workers who deliver publicly funded personal support services or direct support services in hospitals, long-term care, home and community care and social services. The government has earmarked $169 million for the latest extension, bringing the total to more than $1 billion.

It’s a stopgap measure due to the pandemic, though many in the industry are calling for the increase to be made permanent. The current crisis has underscored numerous problems in the sector, particularly long-term care homes, but the issues long predate the pandemic.

The immediate goal of the program was to help weather the storm, as long-term care residents accounted for the majority of coranvirus-related deaths. There were and are large stresses in the industry.

The crisis has put into sharp relief the longstanding issues with the long-term care system, particularly where staffing is concerned. Long before the current pandemic, there were concerns about low staff numbers, training, turnover and the resultant risks. At the root are costs and the associated accessibility to care for the elderly among us, a growing segment of the population.

Many studies have looked into the shortages of frontline employees, particularly personal support workers (PSWs), in long-term care facilities. Such workers are the ones providing hands-on care to some 80,000 long-term care residents in Ontario. Long-term care homes reported that they are working with shortages on almost all shifts, every day. Weekends are worse. Rural areas are even harder hit. The shortages mean that there are not enough PSWs to staff existing beds let alone the 15,000 planned new beds the province announced to ease the long waiting lists.

Groups such as the Ontario Health Coalition speak regularly of what is called the PSW crisis in Ontario’s long-term care homes. Workloads were described as too heavy, with staff leaving for jobs with less workload, including taking other jobs such as housekeeping in long-term care homes. Part-time staff, a report notes, were working two jobs because they are not guaranteed hours, making scheduling more difficult. Vacations were denied because of staffing shortages. Recruitment has been continuous and not always fruitful.

There was total consensus that PSW shortages across Ontario in long-term care are epidemic and severe. Long-term care homes are short-staffed every day; in fact virtually every shift, and in every area of Ontario. The consequences for care and safety are serious, the group reports.

Some of those same issues were addressed in the Public Inquiry into the Safety and Security of Residents in the Long-Term Care Homes System, launched in 2017 in the wake of the offences committed by Elizabeth Wettlaufer, and published in 2019.

These are only two of the most recent looks at deficiencies in the industry.

What remains to be seen is what more the upcoming commission will recommend to counter the longstanding problems. Money will be at the heart of the matter – as with all precarious work, low wages, poor benefits and insecure hours lead to vacancies, low morale and staff turnover. Reversing those conditions will be costly, ultimately leading to higher costs to residents and their families, in all likelihood … if the industry goes down that road.

Included in the mix will be the division between for-profit and non-profit homes, with many fingers already pointing to the discrepancies in the number of cases and fatalities in for-profit facilities. In the end, the issue will be politicized.

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