‘Logic of profit’ vs ‘logic of care’

These days, the death tolls in Ontario long-term care are released quietly. Sometimes, the information comes from grieving families. No big headlines. Perhaps we’ve all been numbed by news of so much death.

But with more and more residents dying in privately owned, for-profit seniors’ homes, perhaps it is time to ask whether privatization is the problem rather than the solution.

Take Ottawa. At the time of writing (the figures are higher now), 29 people had died at Sienna Living’s Madonna Care Community in Orléans. The situation is so dire there, some want a provincial takeover. Another 28 had died at Revera’s Carlingview Manor, 19 at the company’s Montfort Long-Term Care and six more at its Stoneridge Manor in Carleton Place. At Extendicare Laurier Manor, one of the embattled homes that received assistance from special hospital teams, 13 had died. Six had lost their lives at Orléans’ Manoir Marochel, operated by Southbridge

Care Homes. The Promenade Retirement Home in Orléans, run by Alavida Lifestyles, had seen four deaths. At the privately owned Almonte Country Haven, 25 people had died.

No deaths had been reported at city-run homes, despite some outbreaks. But at time of writing, there had been five deaths at the non-profit Perley and Rideau Veterans Health Centre.

The virus, which has killed more than 1,000 seniors, has taken lives elsewhere in the province in both non-profit and municipal homes. At the Toronto city-owned Seven Oaks Long-Term Care 37 have died, as have 11 at Lakeshore Lodge and another 11 at Kipling Acres. The non-profit Mong Sheong Home for the Aged in Toronto has seen 29 deaths. And 30 have died at the Salvation Army-run Isabel and Arthur Meighen Manor in Toronto.

By the raw numbers, COVID-19 has killed many more in for-profit homes, which have faced significant community backlash and lawsuits.

Some key examples: More than 60 have died in four homes run by Chartwell Retirement Homes, a big industry chain. Rykka Care Centres runs Toronto’s Eatonville Care Centre, where 39 have died; Anson Place Care Centre in Hagersville, with 24 dead; and North York’s Hawthorne Place Centre, with 21 dead.

Sienna Living operates Altamont Care Community in Scarborough, where 46 have died. At Pickering’s Orchard Villa, operated by Southbridge Care Homes, 54 have died. In Kitchener, 35 have died at Revera’s Forest Heights Long-Term Care Home. The privately owned Pinecrest Nursing Home in Bobcaygeon lost 29 lives.

A common complaint throughout the crisis has been staff shortages, lack of protective gear and poor infection control. The Ontario Nurses’ Association had to get a court order to compel four for-profit homes to provide adequate gear to caregivers. And the Ontario government had to call in Canadian forces and mobilize special health teams to help some troubled homes.

Hugh Armstrong, professor emeritus at Carleton University, and one of the authors of a recent report for the Canadian Centre for Policy Alternatives that called for the elimination of privatization in long-term care, says outbreaks can occur in any home, private or non-profit. But what matters is the business philosophy of the homes. If you have one eye on the bottom line, your response to an outbreak may be different.

“We have seen municipal homes that have serious problems with deaths, but we are seeing the most severe mortality rates in the for-profits, generally speaking,” he says. “That is not to say every for-profit home is bad. But if you look at the measures of care and the overall tendencies, the for-profits are not doing as well as the non-profits. The logic of profit is not the same as the logic of care.”

Ontario has 626 homes, 58 per cent of which are privately owned. Another 24 per cent are non-profit and 16 per cent, municipal. Privately owned homes range from individual or family-run companies, to large multinationals or chains that dominate the market.

So, the question to ask in this crisis is, what happened to the notion that the private sector is more efficient? Why did taxpayers have to step in and fix problems in homes owned by companies that make huge profits and pay dividends to their shareholders? What’s the answer? Mohammed Adam is an Ottawa journalist and commentator.