Since taking power in 2019, the United Conservative Party (UCP) has maintained a heavy focus on “reforming” health care in Alberta, introducing measures which it says will help bring costs “under control.”
In practice, this has meant introducing more and more private, for-profit operators into the system. From the plan to eliminate 11,000 health care jobs (announced during the early, shock-and-awe phase of the pandemic), to the plan to address the province’s surgery backlog through private providers, the UCP’s reforms have always been about chipping away at health care as a public service.
The party leadership has justified these waves of privatization by hiring third-party firms to “study” Alberta’s health care institutions and make recommendations for where to find “efficiencies.” Unsurprisingly, those commissioned reports tend to point in the direction that the UCP already wanted to move—towards privatization.
In many ways, 2021’s Continuing Care Review—the report which justified the Continuing Care Act—followed that pattern. It recommended cutting costs by moving seniors away from facility-based continuing care, towards home care. Such a move may lower costs, but it also moves senior’s care away from the more heavily unionized facilities and towards low-wage home-care companies, where it’s much more difficult for isolated workers to get organized and demand better conditions for themselves and patients.
But the Continuing Care Review also listed priorities that, if implemented, would seriously address the crises in continuing care. The report recommended ending the chronic understaffing that forces workers to provide inadequate levels of care to each resident. It recommended that care homes begin to hire more full-time workers, rather than relying on precarious part-time contracts that force workers to take on multiple jobs. It recommended increasing and formalizing some standards of care.
These are all recommendations that workers in continuing care homes have been demanding for many years. They recognize that to improve care conditions for residents, we also need to improve working conditions for staff.
Instead of implementing these much-needed improvements, the Continuing Care Act focuses on a series of bureaucratic and governance changes that will have little impact on the day-to-day lives of residents and workers. Rather than any type of minimum care standards, it creates a single system for licensing continuing care providers.
Home care is, of course, an extremely important part of any continuing care system. It allows seniors to stay in their homes longer, and, when done properly, can help people achieve dignity in their old age.
But it’s also plagued with problems. Workers are often misclassified as freelancers, preventing them from accessing basic workplace protections. In its worst form, home care is treated as an assembly line, with companies forcing workers to provide inadequate care and see the most patients possible in a day. While these problems are fixable, this law does not attempt to do so—either in home care or facility-based care.
Most importantly, but unsurprisingly, the Continuing Care Act fails to address the most pressing problem in continuing care: profit.
Recent research from the University of Alberta’s Parkland Institute shows that publicly owned facilities tend to have higher standards of care for residents than for-profit ones. According to Parkland, there is a “broad consensus” among researchers that for-profit homes provide fewer hours of direct care per resident per day and are more likely to be understaffed.
We might add that the chronic understaffing in for-profit care homes may have something to do with owners’ hostility towards unions, and propensity for low-wage precarious work. The solution to understaffing and labour shortages isn’t complicated—if employers offer good wages, benefits, and working conditions, then workers will come.
Alberta already has existing legislation that mandates care-home providers to provide a minimum of 1.9 care hours per day per patient. This is significantly lower than the agreed-upon number experts recommend, which is 3.9 to 4.8 hours per day. A real reform package to fix Alberta’s continuing care system would need, at an absolute minimum, to increase that number—and provide an enforcement mechanism against providers who lapse in their responsibilities.
None of these things are a part of the UCP’s latest law. Instead, we’ve been given a bureaucratic reorganizing of the chairs on the Titanic—a cosmetic move from a party that desperately wants us to believe that it is fixing the problems that have consumed us for so much of the past two years.
But the UCP will not fix the problems, even when the solutions are clear. That is because the party is guided by an ideology that is bent on dismantling public services and attacking workers, even though that is the exact ideology that got us into this mess in the first place.
Mike Dempsey is an Executive Vice President at the Alberta Union of Provincial Employees (AUPE). Dempsey is Chair of AUPE’s Standing Committee on Political Action, and also serves as a Director on the board of the Parkland Institute.