- by Eric Coleman
This is the third part of a series on the topic of Long Term Care (LTC) homes in Ontario, following a military report on the state of five LTC homes in which they were deployed to support them. Read the first part here and the second part here .
Ontario has had a great deal of history with deregulating, and privatizing, services. Many times we have gone through the process of relaxing regulations, and many times we are given harsh lessons on the costs that come with that deregulation.
Sadly, it seems, we also fail to learn from those lessons, and go through it again. History doesn’t repeat itself, as Mark Twain said, but it often rhymes. Just this past Victoria Day, the town of Walkerton was set to commemorate the 20th anniversary of a catastrophic E.Coli contamination in its water supply. In the end, thousands were made sick, and seven people died due to the outbreak. The public inquiry following found one of the main, underlying causes for the outbreak was the privatization and deregulation of water testing.
In 1996, shortly after gutting LTC home inspections in Ontario, former Pemier Mike Harris (now Chair of the Board of Chartwell Retirement Residences), slashed water testing as well. Government labs doing testing for municipalities were shuttered, and those tests were shifted to private labs. The Walkerton Inquiry found that those private labs were not required to send adverse test results to the Minster of Environment and the Medical Officer of Health, and did not do so. Reductions in oversight led to situations such as the Walkerton Public Utility Commission (PUC) failing to meet standards of water testing quality and amounts, with only assurances that they would improve their standards, or chlorination levels being based on a ‘guesstimate’ of a meter reading but passed off as actual tested chlorination levels.
A lack of strict regulation and inspection in staffing and training led to the Walkerton PUC ignoring guidelines for hiring standards and ongoing training of that staff. By May 20, the alarm was raised on an E.Coli infection of Walkerton’s water supply. Not, as you might expect, by the PUC workers who were mandated to test well supplies multiple times weekly (and, the infection of the water had been ongoing for over a week at that point), but by the local Health Unit who noticed a sharp increase in school absenteeism, and hospital admissions for gastroenteritis symptoms. In the end, 2300 were made sick from the E.Coli outbreak, and seven people died.
Tangible economic costs of the water crisis were calculated at over $64.5 million and the Ontario government paid out $72 million in direct compensation to victims and their families, with no admission of wrongdoing.
There is a clear and stark parallel of deregulating water testing in Walkerton leading to the outbreak, and deregulating long term care home inspections leading to hundreds of covid19 deaths. Leading up to 1994, a major revamp of long term care was enacted by the provincial NDP government, including things such as a Residents’ Bill of Rights, mandatory Resident Councils in homes, and rigorous annual inspections – inspections that were mandated to be 3-to-7 days long and thorough examinations of all aspects of operation. Following the change in government to Mike Harris's PCs in 1995, regulations and funding were slashed, dropping inspections to 40% of homes. Many LTC homes reported going up to three years between inspections, and those inspections being quick and cursory at best.
Following another change in government in 2003, annual inspections were reinstated, and reconfigured to include resident interviews as part of the process. Legislation was drafted in 2017 to enhance fines and penalties for non-compliant homes, but was abandoned with the 2018 election. From 2018 onward, inspections were dropped, with just half having inspections in 2018 and just nine in 2019. To date, in 2020, no annual inspections have been conducted. This complete lack of regulatory oversight has led to deficiencies in training, staffing, preparedness, and basic care of residents.
This PC government has learned nothing from their predecessor’s failures in deregulation. In 2014, MPP for the Huron-Bruce riding, Lisa Thompson – where, it should be noted, Walkerton is located – spoke on the matter of the E.Coli outbreak and regulations that followed “Municipalities, their expenses are going through the roof because of regulation after regulation that is being introduced … [s]ometimes in the house (legislature), when people are trying to justify regulations, they throw out the name of ‘Walkerton’ as if it is a bad thing. A tragedy did happen but we are moving forward … over and above that I can tell you that we have to take a look at the ridiculousness of regulations”.
To reiterate this, the Conservative Minister (first of Education, now of Government and Consumer Services) believes that regulations – put in place to prevent another crisis of this scale from happening again – is ridiculous.
The final numbers are far from complete, for Covid-19, but to-date there have been over 1000 deaths in Ontario long term care homes , and of those deaths, in Eastern Ontario, 83% of those deaths occurred in privately-run LTC homes. Regulation in government is a lot like the IT department in an office; when everything is working right, you don’t notice them working to keep everything right, and are prone to thinking “what are we even paying them for?” It’s only once you remove them, and something unexpected happens, that it becomes apparent again why we had them in the first place. Regulations may seem “ridiculous”, but time and time again, we see that they save lives.
This is a tragedy 143 times the scale of Walkerton’s E.Coli outbreak, and the root is squarely with Doug Ford’s government and the deregulation of Ontario’s LTC homes.
