Alternative federal budget 2026: Seniors’ and long-term care

Introduction

The title of the 2025 speech from the throne was “Building Canada Strong: A bold, ambitious plan for our future.”¹Government of Canada, Building Canada Strong: A bold, ambitious plan for our future, (Speech from the Throne, Canadian Parliament, Ottawa, Ontario, May 27, 2025), https://www.canada.ca/en/privy-council/campaigns/speech-throne/2025/building-canada-strong.html. This contrasted sharply with “Fairness for every generation,”²Government of Canada, Budget 2024: Fairness for every generation, 2024, https://budget.canada.ca/2024/home-accueil-en.html. the title of the 2024 federal budget.

Even though budget 2024’s subsequent policies and practices fell decidedly short of its stated goal, at least there was a notion that a strong Canada is about fairness and equity. It is hard to see such a commitment in the 2025 federal plan, especially when it comes to seniors and their care. There is virtually nothing about care at all, even though Canada’s universal health care has long provided a critical basis for Canadian identity and for making Canada strong—both economically as well as in terms of equity.

The previous government did introduce, after long promises, pharmacare and dental care programs.³Government of Canada, Dental Care Plan: Coverage Overview, modified June 2025, https://www.canada.ca/en/services/benefits/dental/dental-care-plan/coverage.html. Both are critical to seniors—especially to the most vulnerable older populations. However, these essential programs were far from the universal principles of the Canada Health Act,which created a vital basis for fairness and Canadian solidarity (see the Health care chapter).

The previous government also funded the development of national standards for the physical structure of and services in long-term care, but it failed to make funding for provinces and territories conditional on implementing these standards. It consulted widely on the promised Safe Long-term Care Act, outlining promising practices for transforming the system, but the legislation was not introduced.

This pattern of new money, new initiatives, and new promises has been repeated in other areas, such as support for paid and unpaid care providers and workforce planning. However, there has been little indication that provinces and territories have been held to account for promised programs. It has been hard to find out about the impact of federal or provincial/territorial programs that have been introduced, even though many had tracking their impact as a requirement. The COVID-19 pandemic revealed the need for fundamental systemic change in seniors’ care, prompting new programs, but instead we have seen piecemeal strategies and lots of money spent without clear evidence that fairness is a result.

Clearly, these are new times and we have a new government with new priorities. We know little about its intentions for either health care overall or seniors’ care in particular. The Throne Speech only promised to “protect the programs that are already saving families thousands of dollars every year,” explicitly naming pharmacare and dental care.⁴Government of Canada, Building Canada Strong: A bold, ambitious plan for our future, (Speech from the Throne, Canadian Parliament, Ottawa, Ontario, May 27, 2025), https://www.canada.ca/en/privy-council/campaigns/speech-throne/2025/building-canada-strong.html. There was also some attention to housing, employment, and the cost of living—all of which have a critical impact on seniors’ care. At the same time, promises to increase NATO funding have been accompanied by warnings that this will mean spending cuts in other areas.⁵Alex Ballingall, “Carney Warns of Cuts amid Defence Spending,” Toronto Star, June 26, 2025, https://www.pressreader.com/canada/toronto-star/20250626/281500757237127. Finally, there was a promise to stay “true to Canadian values.”⁶Government of Canada, Building Canada Strong: A bold, ambitious plan for our future, (Speech from the Throne, Canadian Parliament, Ottawa, Ontario, May 27, 2025), https://www.canada.ca/en/privy-council/campaigns/speech-throne/2025/building-canada-strong.html. There can be little doubt that universal access to care is central to Canadian values.

We cannot continue to put off the necessary work to secure the health and social care services that seniors need today and in the future.

Overview

The devastating impact of the COVID-19 pandemic on seniors exposed the fundamental weaknesses in an uncoordinated, underfunded care landscape. It prompted demands from families, experts, and advocates for a bold transformation of care—one that would be based on the human rights to access quality care and to provide quality care work.

There is a clear evidence base with multiple international examples of promising practices that could be adapted to our varied Canadian contexts and populations to create an integrated, accessible care system. Doing so would mean articulating in policies and practices a shared vision of the right to care for seniors and all those providing that care. It would require a commitment to putting the well-being of seniors and care providers ahead of both profits and partisan politics.

This vision of care is based on principles rather than uniformity; principles that allow adaptation to geography, populations, and cultures. Care like this is only possible if it is prioritized within federal budgets—with dedicated funds, defined actions, principles, standards, and accountability. This requires much more than protecting existing programs. It means recognizing that universal care systems can be not only the most equitable, but also the most economically beneficial.

Over the last decade, there have been significant budget allocations, federal programs, bilateral agreements, and proposed legislation. Although many have been beneficial, the various parts do not add up to a system. There are major gaps, a lack of co-ordination, and limited enforcement of standards in many areas. All of this makes it difficult to not only access and provide care, but also to track the most effective strategies for providing it.

Some of the pieces have included funding, both short- and long-term, to provinces and territories for the following:

• Services in home and community care, and in long-term care, and for a safe restart after the pandemic.
• Protective equipment and improvements in long-term care quality and safety
• Implementing new standards for the design and operation of nursing homes as well as for care within them.⁷The author served on the technical committee developing these standards for the Health Standards Organization.
• Staff for personal support workers and related professions, for those practicing in remote areas.

Some pieces included funding for federal programs, for the following:

• Developing and distributing vaccines.
• Developing standards for the design and delivery of long-term care.
• Recruiting international health care workers.
• Creating and supporting organizations for policy development in unpaid care.⁸For example, Health Workforce Canada, Coalition for Action for Health Workers, and Healthcare Excellence Canada.
• Collecting data in areas such as the health workforce.
• Offering housing supports, through low-interest and/or forgivable loans, or through contributions to help build new affordable housing and renovate and repair existing, affordable, and community housing.⁹Canada Mortgage and Housing Corporation, “Federal Government Supports Homes for Seniors in Saint-Basile,” CMHC News Release, March 20, 2025, https://www.cmhc-schl.gc.ca/media-newsroom/news-releases/2025/federal-government-supports-homes-seniors-saint-basile
• Targeting particularly vulnerable populations, such as $2 billion for Indigenous health.
• Increasing Old Age Security for those over age 75.

Although the list of examples does not include the passing of the Safe Long-term Care Act, as promised by the previous government, it is clear that the federal government provided significant money and introduced multiple initiatives that had some potential to promise fairness for many seniors. However, it is hard to see how many of these promising features were realized in practice. This was in part because the measures were limited in terms of accountability, enforcement, dedicated or earmarked funding, and public assessment of their impact. In some cases, provinces and territories even failed to take up the money offered, or they failed to spend it in the broadly designated areas of bilateral agreements.

Despite the large body of evidence that private, for-profit care is detrimental to seniors and the workers who care for them, the federal government has taken little effective action against the increasing shift of public funding to privatized delivery of seniors’ care. While some attention has been paid to workers’ wages and the need for sick leave—at least during the COVID-19 pandemic—there is no broader plan to address the conditions of work that are the conditions of care. This lack of an overall vision was reflected in the piecemeal, uncoordinated approach to seniors’ care and the very limited, unequal impact made on it.

A bold, ambitious plan is required for seniors’ care. We need a vision based on recognizing the human right to quality care and quality care work, on recognizing our shared responsibility for public services and their benefits, on recognizing the need for integration and continuity through public services, and on recognizing that the conditions of work are the conditions of care.

The argument the federal government makes about defence spending creating infrastructure and jobs also applies to seniors’ care, with the added benefit that such investment reflects and builds on Canadian values of equity and inclusion.

Actions

The following actions focus onputting forward a dedicated, funded, and accountable vision for transforming seniors’ care that supports quality of care, quality of work, and quality of life. Building on a large body of research, funding will be based on enforceable standards, removing profit from care, affordability for seniors, and providing appropriate compensation and conditions for those who do care work.

The AFB will transform housing and living options for seniors. This will be done through funding envelopes for publicly owned, publicly delivered, affordable housing options that integrate care services within them and provide smooth transitions as care needs change.

The AFB will transform how seniors’ care is delivered by funding the development of standards for home care, social housing for seniors, assisted living, and retirement homes. The AFB recognizes that standards do not mean standardization, and that accountabilities should therefore indicate how populations, locations, cultures, language, and other conditions are taken into account.

The AFB will make funding conditional on the demonstrated application of standards that apply to the entire range of services and those who provide care. This means funding for long-term care, home care, and seniors’ assisted living will be conditional on addressing working conditions for senior’s care. This may include setting provincial/territorial wage floors for common classifications, implementing minimum sick leave entitlements, reducing inequities among care workers employed in different sectors of seniors’ care, and other provisions across all health care settings.

The AFB will invest directly in expanding home care and facility-based long-term care to ensure that care can be provided to everyone who needs it, where it is needed most. It will also invest in funding options for seniors’ housing that can provide intermediate care, such as assisted living, retirement homes, and co-operatives.

The AFB will, in keeping with the proposed federal housing strategy, provide funding to provinces and municipalities to build, own, and operate high-quality, public, non-profit seniors’ care facilities.

The AFB will make any funding for long-term care, home care, and seniors’ assisted living conditional on phasing out the use of for-profit staffing agencies, working with provinces and territories to establish a central non-profit agency to supply staff to address temporary shortages, ensuring wages and conditions are harmonized with local employers.

The AFB will make funding for long-term care, home care, and seniors’ assisted living conditional on establishing daily hours of direct care standards that are enforceable and that would ensure minimum requirements for full-time work in every workplace.

As the recommended best practice for care evolves, the AFB will fund more than 115 million additional hours of direct care annually, to a minimum of 4.2 direct care hours per day. This will be met through a commitment of $18.1 billion over three years. It is estimated that direct care hours provided in seniors’ facilities averaged just three hours per day across the country, with the costs of meeting a minimum of four hours per day of direct care assessed at $4.3 billion annually.¹⁰Yves Giroux, “Cost Estimate for Motion 77: Improvements to Long-term Care,” Parliamentary Budget Office, August 04, 2021, https://distribution-a617274656661637473.pbo-dpb.ca/46d6a48451ea460cb2beefb46620819308f298940c57227ea95ae03edd39f61d.

The AFB will double the Health Canada grant to Health Workforce Canada so it can expand the implementation of an in-depth, comprehensive, Canada-wide workforce strategy to address the current recruitment and retention crisis in seniors’ care. To this end, the AFB will commit $9 million annually.

The AFB will increase and make refundable the Canada Caregiver Credit for those providing care for dependents over age 65. This would not impact eligibility for government-funded home care services.