What does it take, in the middle of the pandemic, to get something done in Premier Doug Ford’s Ontario?

Hire a lobbyist. Preferably one with deep conservative connections.

A July 15 Toronto Star investigation dives into Ontario’s lobbying registry, and comes to the conclusion that Ford’s government made decisions based not on best protecting people, but best serving corporate interests.

The author of the series, Richard Warnica, writes, “At crucial points large and small since Ontario first declared a state of emergency in March of 2020 the government has made decisions that align with the interests of lobbyists — many of whom have close ties to the premier, his party or both — and the businesses they represent. Those decisions have often favoured certain sectors over others and have, at key moments in the pandemic, gone against public health advice, delaying or fracturing lockdowns.”

None of the decisions were more infuriating, or devastating, than the ones regarding long-term care (LTC) homes.

While COVID-19 was running rampant throughout long-term care homes, turning buildings into nightmarish dens of despair, disease and death, these lobbyists were pushing to make their clients richer.

And, the Star found, they absolutely succeeded: “As a result of that lobbying, critics charge, long-term-care companies have largely been able to dodge responsibility for the death and suffering that took place in their homes. They’ve also been able, some industry analysts believe, to set themselves up—with enthusiastic government support—for decades of future profits thanks to generous new long-term-care bed allocations.”

The LTC profiteers chose their lobbyists well, recruiting a horde of former Progressive Conservative and Ford loyalists to do their work. They were able to secure consistent funding for homes regardless of if beds were full or empty, even though they had an increasing number of vacant beds because their residents were dying from COVID-19. These lobbyists managed to do this despite widespread, righteous, outrage at the treatment of those essentially left to die in largely for-profit homes.

The Star’s investigation adds to an already long list of people who are culpable for the COVID-19 death toll. While it’s doubtful they will feel shame or remorse for what they’ve done, they too need to face consequences, and changes need to be made.

This must include: punishing those responsible; ending the for-profit long-term care home system; changing lobbying rules.

Punishing Those Responsible

The executives, board members and managers at long-term care homes that set the course for them to become COVID-19 death houses should face consequences.

In a remotely just society, we’d find out exactly what happened, who is responsible and then hand out consequences, ensuring they’re removed from their positions of power, at the very least. Some executives should face actual charges for making massive cuts to staffing and services that then lead to mass death. The victims of the pandemic, and the families they have left behind, deserve real justice.

There is a long-term-care commission taking place in Ontario right now, ostensibly intended to find out how things went so horribly wrong, and who is responsible. Yet the Ford government has moved ahead with its own plan for the future of LTCs despite the fact that the commission is still in the process of gathering evidence and putting its report together.

The Star writes: “The issue, to critics, is that the Ford government rushed into their plan, at the urging of lobbyists, before even learning what went wrong in the first wave of the pandemic, let alone the second. In the process, they locked in a system many see as being structurally responsible for at least some of the carnage in long-term care. They also planned and executed their long-term-care strategy — one that was in full alignment with the for-profit long-term-care lobby — before their own long-term-care commission had a chance to weigh in.”

And so, once the report is released, it will likely be ignored, just as so many others in Canada have been.

Lobbyists also deserve to be held accountable, and there is a way, in the short term, for the public to do so for a couple of them.

Lobbyist Melissa Lantsman, a former member of Ford’s campaign team, is running for the federal Conservatives in the Thornhill riding outside Toronto in the upcoming election. Lantsman lobbied on behalf of Extendicare, which saw at least 605 deaths in its homes nationwide, according to figures compiled by Passage columnist Nora Loreto. One Extendicare home, Tendercare Living Centre in Scarborough, has had 81 deaths, making it among the 10 deadliest Canadian facilities.

Lobbyist Stella Ambler, meanwhile, is running for the Progressive Conservative nomination in the Simcoe-Grey provincial riding. Ambler was one of several lobbyists who worked on behalf of Southbridge, a company that the Star writes “was launched with the explicit goal of scooping up older homes, saving money on operations and eventually getting a government contract to renovate or rebuild the properties.” At least 199 people have died in Southbridge managed homes across the country.

Lantsman and Ambler advocated on behalf of companies that let society’s most vulnerable die so they could make a profit. The gall of them running for office is just too much. They don’t deserve to come to power.

No More For-Profit Homes

Going forward, long-term care must no longer be in the realm of profit.

Working conditions and wages in the LTC sector were bad to begin with. According to a June 2020 Royal Society of Canada report, personal support workers (PSWs) in long-term care — the people doing most of the hands-on work with residents — are typically paid between $12 and $24 per hour.

The report finds that, “[PSWs] receive the lowest wages in the healthcare sector, are given variable and minimal formal training in LTC, and are rarely part of decision-making about care for residents.” It adds, “Studies have shown that they often have insufficient time to complete essential care and are at high risk for burnout and injury.”

To make things worse, private equity investors are increasingly putting money into LTCs, seeing it as a new way to extract profit, by repeatedly cutting the amount of service to keep costs at an absolute minimum and juice profits.

This is bad enough when it happens to Sears or your local newspaper. A store turning into a dilapidated relic, and a local newspaper barely being able to cover your city, certainly isn’t good. But when it happens at an LTC, the consequences are deadly.

The daughter of one LTC resident who was killed by COVID-19 told the Star about how things went for her mother once Southbridge Capital, a private equity investor, took over her residence: “I started to notice things like incredible numbers of staff changes. You never knew on the bulletin board who was going to be the new manager for that week or that month.”

This was in part because an increasing number of permanent staff were replaced with temporary workers, a trend in the industry that made the pandemic so deadly in LTC homes throughout Ontario.

During the second wave, the worst hit facility in the province was the Tendercare home run by Extendicare. There, public health officials gave repeated suggestions to isolate COVID-positive patients on a floor, and other recommendations to limit spread. Instead, according to documents acquired by Global News, the Extendicare home ignored those suggestions until Toronto Public Health and a local hospital took over the running of the home for the company.

Homes kept their workers from being able to earn sufficiently at one location, so they ended up working at multiple locations to string together enough hours and money to live. This turned the least-paid workers into vectors of infection as they went room to room, and home to home, as the pandemic amplified.

If we had a proper public system, with investments including good wages for PSWs and others, we wouldn’t suffer these problems. If the point of running LTCs was to provide care, rather than extract profit and line the pockets of the premier’s friends, we’d be in a much better place.

Public homes in Canada performed much better than the for-profit homes did during the pandemic. In Ontario, the difference is particularly stark.

As of July 19, 3,401 people in Ontario had died from COVID-19 at for-profit LTCs, while 345 died in public LTCs. Private for-profit LTCs make up 57 per cent of homes in Ontario, but account for 63 per cent of the more than 5,300 deaths. Public homes, meanwhile, account for 6 per cent of deaths, while making up 16 per cent of all LTCs in the province, according to data from the Canadian Institute for Health Information.

A proper system in Ontario wouldn’t have private for-profit homes making up the majority. It would take those homes out of the hands of LTC companies, and run them in a public system. This would, of course, require new taxes.

Higher taxes are something Canadian politicians tend to balk at. But, consider how much the average care home costs in Canada.

According to National Bank, it can cost about $1,900 per month for a long-term stay at a “basic” level of care. That shoots up to about $2,700 per month for a private room. There are government subsidies available that are dependent on income, but those max out at the basic fee, and can’t be used for semi-private or private rooms. Essentially, unless you retire with a significant amount of money, you won’t even be granted the dignity of a private room.

Instead of taxing people, we’re just pulling that money out of the pockets of the elderly and giving it directly to the corporations that are doing a terrible job at caring for them.

Better options are available, and we should take them.

Change Lobbying Rules

If lobbying must exist, it’s going to need a massive change.

The system as it exists now allows lobbyists to work in what is a functional secrecy, even if some details are public. The Star stories are a case in point, as months of work, including assembling their own database, were required to pull together some basic answers about how the Ford government was making decisions. (The website is designed in such a way that it’s impossible to link to individual results.)

Right now, if you’re registered to lobby in the province, you have to fill out a form describing what you’re doing, and why. The Star notes that most of these lobbying registrations are “broad, vague or both,” and points out a lobbyist who was “unusually explicit” because they laid out exactly what policy changes they were lobbying for.

Here, for example, is part of Lantsman’s submission, on behalf of Extendicare, which purports to outline the lobbying goals “in detail” but is incredibly vague: “Ongoing government engagement activities related to any future legislative changes impacting long-term care. including policies impacting the sector, government funding, and policy changes. Advocating for investments necessary to ensure continued care for residents.”

Because of this lack of detail, a spokesperson for Extendicare was able to tell the Star their company didn’t lobby for an indemnity protecting them from lawsuits, and that only company employees, not lobbyists, talked to the government about bed allocation and licences. But there’s no proof, and we’re expected to take their word for it.

At the very least, every meeting between the government and a lobbyist should have a detailed public record. Meeting minutes would be a good start — a detailed list of who was in the room, the topics discussed and what was agreed to — but we should eventually get access to full audio recordings of every meeting.

If what you’re speaking about is so commercially sensitive or embarrassing that the public can’t know, then perhaps you shouldn’t go talking to the public’s representatives about it, looking for public money.

The Star stories are a reminder of the forces at work in this country that made the pandemic so much worse than it needed to be. Although we’re slowing moving out of the worst of the pandemic, thanks to our ability to purchase oceans worth of vaccines, more than 9,200 people in Ontario, at least 3,800 in long-term care, did not make it to this point, due in part to these forces.

This tells us all we need to know about the people that run LTCs in the province. There should be no room in our society for them or their lobbyist lackeys.

Throughout all of this, they’ve asked not to be forgiven, but to be paid. Let’s not forget it, and hold them accountable.