Ontario's long-term care commission is set to deliver its final report to the government, the culmination of more than 150 interviews over seven months and the review of tens of thousands of documents.
The commission has released two interim reports and thousands of pages of interview transcripts, providing a detailed picture of the conditions that led to the deaths of nearly 4,000 long-term care residents and the suffering of others who have lived for more than a year, isolated in understaffed homes.
That interim work sheds light on the issues that have concerned the commission, led by retired associate chief justice Frank Marrocco, along with former Ontario Public Service executive Angela Coke, and former hospital CEO Dr. Jack Kitts.
That includes the government's lack of preparedness for a pandemic, with no applicable emergency plan and its stockpile of personal protective equipment expired and discarded. The commissioners have also shown concern about the structure of the government's pandemic response, resulting in mixed messaging, slow decision-making and the failure to heed scientific advice. They've heard testimony that the government failed to perceive the threat to long-term care quickly enough and initially seemed to leave the sector out of its pandemic planning.
They've studied the issue of how homes' outdated infrastructure contributed to wide spread of disease and recommended that the government take action to move residents out of homes when necessary, but that was not acted on to any significant extent. Likewise, they've heard heartbreaking testimony about the impact of staffing shortages in both the first and second waves of the pandemic, resulting in resident neglect and staff burnout.
Their work has also uncovered concerns about the province's inspection regime, which were highlighted by the auditor general earlier this week.
The commissioners have spent considerable time studying the differences between for-profit long-term care homes and their municipal and non-profit counterparts, as for-profit homes saw higher rates of deaths during the pandemic. Whatever recommendations they make in this area will be of interest at Queen's Park, as the opposition NDP has vowed to end the for-profit system the government defends.
And perhaps most importantly, the commissioners have heard from residents themselves, using Zoom interviews to hear their thoughts and concerns. Those interviews have included heartbreaking accounts of isolation and fear alongside more mundane complaints about the quality of their homes' food.
On Friday afternoon, Premier Doug Ford said at a press conference he will welcome the report, however hard it will be to read.
"Because what happened in our long-term care homes, it was tragic, and it was terrible," he said. "But most of all, it can never be allowed to happen again. That's why I personally commissioned this report: to get answers to bring the long-standing problems to light, to do everything in my power to make sure that there's justice and answers for family members."
Ford also said he wouldn't make excuses for what happened, while also mentioning that he inherited problems in the system from "30 years of underinvestment from government after government, Liberal and Conservative."
"But none of that matters because I'm your premier today," he said. "And I don't want them to look back 20 years and say that we could have done more. So I will not stand here and try to make excuses or pass the blame. But I will stand here and tell you that I'm doing everything in my power as premier, and I'm sparing no expense to fix the system, to upgrade the homes that had been neglected for decades, to make the biggest single investment in the standard of care for our residents in a generation."
Ford was referring to the government's ongoing work to redevelop older long-term care homes and build new beds, as well as its commitment to increase the average hours of hands-on care residents get to four a day by 2025. While those improvements are welcomed even by the government's critics, they did not come in time to avert the tragedy of the last year.
The premier's comments struck a different tone than those of long-term care Minister Merrilee Fullerton earlier this week, following the release of the Auditor General's report on the COVID-19 crisis in long-term care. She said she was taking responsibility but likened her own role to running into a burning building to try to save people. She pinned the blame on the former Liberal government — and on the NDP that has not been in power in a quarter-century — and said of her own party: "We didn't start the fire."
Neither Fullerton nor Ford spelled out exactly what they're taking responsibility for.
QP Briefing has been reporting on the work of the long-term care commission since it was struck by Fullerton nine months ago, publishing dozens of articles. We broke the news that the commission accused the government of delaying the release of documents, impeding and negatively impacting its work. On that basis, the commission asked for an extension of the unusually short nine-month timeline for its work, but was denied.
The final report is expected to be given to the government late Friday and released to the public shortly thereafter. In the meantime, read our coverage of the commission's interviews with three key architects of the province's pandemic response: the minister of long-term care, the minister of health, and the chief medical officer.
- The work of the commission hit a climax with its interview of Fullerton in March. She made headlines for having noted concerns about the asymptomatic spread of the virus long-term before the province's chief medical officer recognized that reality. She also made some more curious statements, like she doesn't know why the sector has such a high prevalence of part-time work, and it may be that it is the workers' choice. That's despite research from her own ministry that found part-time staff in the sector are seeking full-time work. We focused on that, as understaffing was one of the most severe problems facing the sector in the height of the pandemic, and remains so today. The interview also included a grilling of the minister on for-profit homes.
- The commission's interview with the chief medical officer of health, Dr. David Williams, seemed focused on the commission's concerns that he didn't draw conclusions and act quickly enough to save lives in the fast-moving pandemic, and instead waited for evidence he didn't always see, asymptomatic spread being one key example.
- The interview with Health Minister Christine Elliott focused in large part on the province's lack of preparedness for the pandemic. In her remarks, Elliott took responsibility for the province's failure to replenish its stockpile of emergency supplies after the medical masks and respirators — desperately needed at the beginning of the pandemic — had expired and been disposed of.