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NUPGE calls on federal government to bring residential care facilities under Canada Health Act

"I am calling on your government to extend the provisions of the Canada Health Act to include Canada’s residential care facilities. By doing so you would ensure that they must meet the 5 principles of the CHA: public administration, accessibility, comprehensiveness, universality and portability." — Larry Brown, NUPGE President

Ottawa (17 April 2020) — Today, the National Union of Public and General Employees (NUPGE) sent a letter to the Prime Minister of Canada demanding that residential care facilities across the country be covered under the Canada Health Act (CHA). The call comes as more and more reports show that residential care facilities are among the hardest hit locations for COVID-19. This is doubly sad as it is those Canadians who made a lifelong contribution to improving this country, and those who care for them, who are among those facing the greatest risks in this pandemic.

Crisis in residential care facilities in Canada

"Our hearts go out to the families and friends of those who have become sick, and who have died, as a result of COVID-19," said Larry Brown, NUPGE President. "We think of the workers, risking their own health, and that of their families, to care for others."

"We grieve with you during this crisis, but we know these words of solidarity are not enough. What will bring comfort to many is to ensure that more concrete action is taken to stop the spread of this virus and avoid further tragedies."

NUPGE demands urgent action to protect vulnerable seniors in residential care facilities

That is why, in his letter to the Prime Minister, Brown called for the federal government to step in to end the travesty that is private for-profit residential care in Canada.

"I am calling on your government to extend the provisions of the Canada Health Act to include Canada’s residential care facilities. By doing so, you would ensure that they must meet the 5 principles of the CHA: public administration, accessibility, comprehensiveness, universality and portability," wrote Brown. Adhering to these guidelines would be a concrete step to ensuring that the privatization of residential care facilities does not come at the expense of residents and staff. 

"What is infuriating is that, in many of these instances, these tragedies could have been avoided," Brown stated. "The broken system of long-term care and seniors care in this country is contributing to these disasters. It appears that a disproportionate number of the tragedies all took place in privately owned and operated facilities. Sadly, if that proves to be the case, that will not be a surprise for our members working in private residential care facilities."

Private for-profit care underperforms compared to public care

Residential care refers to a wide range of supported living and nursing care arrangements for seniors, and others, in Canada. These go by a variety of names across the country, which are generally referred to as residential care or long-term care facilities or residences. These facilities employ a spectrum of highly trained staff who provide medical and social supports to their clients.

NUPGE has long advocated for residential care services to remain publicly provided and administered. But governments have allowed for-profit, private ownership to take root across communities — despite decades of evidence showing that for-profit residential care facilities have seriously underperformed that of the publicly owned and operated ones.

Through NUPGE's work at the provincial level on the expansion of privatized services, it has learned that:

  • Maintaining their profits is priority, so private residential care facilities must pay their workers the least amount of money they can get away with. These workers, in turn, must work at multiple locations to earn enough to survive.
  • Training is often seen as an added expense; thus, training is kept to the minimum.
  • Providing personal protective equipment (PPE) for staff in the privately operated facilities is seen by the owners as an added expense to be minimized.
  • Following provincial guidelines is seen as adding costs, and only the bare minimum should be done to adhere to them.

Brown's letter also cites a study entitled “Observational Evidence of For-Profit Delivery and Inferior Nursing Home Care: When Is There Enough Evidence for Policy Change?,” published in 2016 in the journal PLOS Medicine, the authors argue that “When [long-term care is] provided by the for-profit sector, the evidence suggests there is a greater likelihood of inferior care. Even 4 years ago, the authors were saying, "it is time to re-align policy with evidence."

"Now, with the death toll in residential care facilities is rising, the time for further research and discussion has passed. During this crisis, governments must take immediate and strong action to protect our nation’s seniors," urged Brown.

Increased funding required to protect residents and workers

Brown notes, "My union, the National Union of Public and General Employees (NUPGE), represents a large number of workers in residential care facilities across Canada. We have members currently working on the front lines of this crisis. We also have past members, family and friends, who are living in these residences. Furthermore, we also feel a moral obligation to speak out on behalf of all those workers, unionized and non-unionized, and all those who require care, to demand that their needs not be ignored or forgotten."

"Your government should take all the necessary steps to adequately fund the critical support that workers and residents in residential care in this country desperately need. This funding needs to continue to ensure that a quality public health care system exists in Canada," wrote Brown.

"And as your government acts to ensure the livelihoods of those who are currently struggling to make a living, please take some time to consider all those who have contributed in the past. This is a situation that must be addressed now to help both current and future generations of seniors and those that require residential care.”

More information: 

Letter to Prime Minister on residential care facilities under the CHA