The long-term care (LTC) sector in Manitoba is facing serious challenges. Manitoba, like the rest of Canada, is faced with an aging population, increasing the demands on the LTC system and the need for funding. According to Statistics Canada, over the past ten years the number of Manitobans aged 65+ has grown from 156,420 in 2001, to 172,450 in 2011. While in 2011 seniors made up 14% of Manitoba’s population, seniors could account for 22.5% of Manitoba by 2036. The result of this increasing pressure on the system is decreased quality of care for LTC residents, and worsening working conditions for the caregivers who look after them.
A summer of labour unrest in the LTC sector in Manitoba has exposed some gaping holes in the way personal care homes, both private and public, are staffed and funded. These issues must be addressed before the increasing demand for care overwhelms resources and staffing. In July of 2013, employees at Maples Personal Care Home (PCH) in Winnipeg, represented by CUPE Local 2719, were on the verge of a strike, calling on their employer to ensure adequate staffing levels. In an effort to save money the employer was not covering staff who called in sick. This failure to replace absent staff reduced the quality of care for residents, and placed mounting levels of stress on the staff who were forced to take on additional duties.
Given the danger to residents and the stress placed on workers, staff decided to engage in a picketing campaign to draw attention to the situation. The result of high-profile pickets outside of the home was an agreement between the union and the employer to ensure full staffing levels at all times. Similar pickets were held outside Lions Housing Personal Care Home throughout August, where that local recently received a 99% strike mandate from the membership. The threat of a strike at Lions has been averted with an agreement ratified by members on Monday, October 28th.
But it shouldn’t take picketing and strikes to ensure proper care for Manitoba’s elders.
The issue of “working short” was profiled in research published by Sheila Novek at the University of Manitoba’s Department of Community Health Science in 2011. Novek found that while the provincial government planned to increase staffing levels in PHCs to 3.6 care hours per resident per day, most facilities were unable (or unwilling) to hire additional staff. Ultimately, Novek’s research, as well as that taking place in other jurisdictions across North America, points to the fact that even 3.6 hours per resident is insufficient to provide the level and quality of care residents need. The most thorough research done on the issue of long-term patient care, commissioned by the U.S. Congress and conducted by the Centre for Medicaid and Medicare Services, found that a minimum of 4.1 hours of care per resident per day is required to avoid jeopardizing the health and care of residents in LTC homes.
Working short doesn’t only affect residents’ health; it also has a major impact on the well-being of health-care workers. In 2006 the Manitoba Nurses Union released a report highlighting the effect that working short has on the health of staff, notably stress related and physical injuries. A 2002 study by Debra Morgan on rural nursing home staff found that nursing staff in LTC homes reported high rates of job stress which can result in coronary heart disease, impaired performance, decreased productivity, increased absenteeism and burnout. Picketing health care aides at Maples PCH and Lions Housing PCH attested to this – working short not only threatened residents’ wellbeing, it was harming the workers’ physical and mental health.
In addition to the serious concerns raised about inadequate staffing levels in Manitoba LTC facilities, workers at Vista Park Lodge have initiated full strike action to demand fair compensation for the important work that they do. Novek’s research highlighted the fact that a large number of support staff in personal care homes are women and recent immigrants who are faced with precarious and low-paid work. In addition to the high demands of ensuring resident health and safety, these employees are stigmatized as the bottom of the health care “hierarchy”: overworked, underpaid, and ignored. Striking workers at Vista Park Lodge, represented by UFCW Local 832, and CUPE Locals 3729 and 2719 brought to the brink of strike at Lions Housing PCH and Maples PCH, are all demanding wage parity with other facilities. These workers are being paid wages that are the “lowest of the low”; a first step in improving their conditions would be to bring their pay to the same level as that of other workers in the sector. But that would just be a start; the entire sector needs reform to ensure that our seniors receive the care they deserve.
The provincial government must address the issue of care in Manitoba’s LTC facilities for the sake of Manitoba’s most vulnerable people and the people who care for them. To do this, increased hours of care must be implemented and enforced. Additionally, the Manitoba Ombudsman should implement a review of Manitoba’s LTC facilities to ensure that funding to both public and private facilities is allocated to ensuring that staffing levels are safe for both residents and employees.
The crux of the issue ultimately falls on the federal government. The federal Conservatives are making dramatic changes to the way in which health care is funded nation-wide. A refusal to renew the Health Accord, the federal-provincial agreement on health care funding, will result in substantially less health care funding (as much as $36 billion over ten years), a push for privatization, and an elimination of national standards. All of this compromises wages and quality of care at the local level by further stretching the province’s already limited resources.
However, the provincial government must find ways to ensure long-term care support staff are compensated fairly for the work they do. These workers provide a safe, healthy, and clean environment for the growing number of Manitobans in care, providing services that are essential to the well-being of our province. They deserve to be treated with dignity and respect. With Manitoba’s population aging as it is, we cannot afford to put off these necessary investments in long term care.
Matt McLean is a National Representative with the Canadian Union of Public Employees