Provinces that don't agree to improve long-term care standards risk losing funding, PM hints

Prime Minister Justin Trudeau is hinting that provinces that don't want to work with Ottawa to improve standards in long-term care homes won't get federal funding.

In a year-end interview Wednesday with The Canadian Press, Trudeau said his government will "happily partner" with provinces and territories that want to boost standards in long-term care facilities.

And he said Ottawa will help them cover the costs of those improvements.

But he warned that provinces that don't choose to take the federal government up on that offer will have some explaining to do to their own populations.

"The provinces that don't choose to give their seniors the highest level of standards will be asked questions on that by the folks who are sending their moms and dads into those senior centres," Trudeau said.

"And it will become a difficult answer for them to give."

The COVID-19 pandemic has exposed deplorable conditions in some long-term care homes, particularly in Ontario and Quebec. Reports on conditions in the worst-hit homes have revealed appalling examples of neglect, abuse and unsanitary conditions.

Residents of long-term care facilities account for more than than 80 per cent of the COVID-19 deaths in Canada.

Delivery of health care is a provincial area of responsibility and some premiers, particularly Quebec's Francois Legault, have strenuously objected to idea of the federal government setting national standards for long-term care facilities or setting any conditions on funding provided for health care.

The premiers have unanimously demanded that Ottawa immediately increase its annual, unconditional health transfers to provinces and territories by at least $28 billion a year, money that is sent with no strings attached.

"I don’t see what the federal government knows about nursing homes,” Legault said last week after Trudeau failed to acquiesce to the premiers' demand during a daylong, first ministers' video conference.

“If he wants to help with nursing homes and hospitals, he has to boost recurring funding.”

Legault's views have been echoed by other premiers, including Ontario's Doug Ford and Saskatchewan's Scott Moe. But premiers in the Atlantic provinces been more open to the idea of federal funding specifically tied to improving conditions in long-term care homes.

In the interview Wednesday, Trudeau appeared to signal that his government will negotiate separately with each province and territory that is willing to accept additional, targeted funding for long-term care — much as it did to target funding for mental health and home care a few years ago.

"The approach we have as a federal government is to first start looking at what the best practices are in certain jurisdictions that do have stronger standards than others," he said.

"And work with the jurisdictions who want to, to increase their standards to the best possible level. And the federal government to be there to help them with the extra costs involved in getting up to that level … So we will happily partner and work with the provinces as we have during this pandemic."

Trudeau acknowledged that long-term care is a provincial jurisdiction. But he said: "The dignity of elders, the safety of seniors, doesn't really have much of a jurisdiction. Not when you talk about their lives."

He noted that the federal government sent the military and Canadian Red Cross to help in overwhelmed long-term care facilities in Ontario and Quebec last spring, at the request of those provinces.

"I guess, theoretically we could have said, 'No, it's your area, you deal with it.' No. The federal government is going to be there to look out for every single Canadian and that means, yes, working with the premiers."

Trudeau said standards in long-term care vary across the country and from facility to facility within provinces.

"And I don't think that's right. I think every senior in this country, regardless of where they live, should feel confident that if they go into the long-term care centre that they get accepted in, down the street or across the road or on the other side of town, they don't have to worry that 'Oh, maybe that's one of the bad ones' or 'Maybe I'm lucky enough to have gotten into one of the good ones,''' he said.

"There needs to be a sense that in this country we ensure that every single senior gets to age in dignity and in safety and we're not there."

This report by The Canadian Press was first published Dec. 16, 2020.