Here’s why a ‘Commission’ into Ontario’s long-term-care system isn’t good enough

The scale of the disaster is unprecedented, making anything but a full-fledged public inquiry unacceptable

BRUCE CAMPBELL, MARK WINFIELD AND PAT ARMSTRONG

Long-term-care facilities have emerged as the epicentre the COVID-19 pandemic in Canada. Rates of COVID-19 infections have been disproportionately worse than in other developed countries. In Ontario, over 1,400 care facility residents and a number of front-line staff have died. Care-home residents account for more than 80 per cent of the total COVID-19 fatalities. The situation represents an unprecedented catastrophe in the history of the province.

This week, the Ford government seemed to acknowledge the severity of the situation. The government announced its intention to establish a “commission” to examine the long-term-care sector and make recommendations for reform. Details regarding the commission’s composition and mandate have yet to be determined. But the Premier was clear in his remarks on May 19, that it is not to be a judicial inquiry along the lines of those called into the Walkerton drinking water disaster, SARs epidemic, or Wettlaufer nursing home murders.

The government’s proposed commission falls far short of what is being demanded by the families of long-term-care home residents, staff, experts on long-term care, and the legislative opposition. It also falls far short of what is needed in response to the scale of the disaster that has unfolded in the long-term-care sector.

It is already painfully clear that the long-term-care sector was hopelessly unprepared for a pandemic. That was despite earlier experiences with SARS, long-standing warnings of the likelihood of similar global outbreaks and concerns over staffing practices raised by the Wettlaufer inquiry.

COVID-19 situation has made it is clear that a fundamental rethinking of care models for the most vulnerable members of society, including, staffing, funding, oversight and inspection practices and the roles of for-profit operators in the system, is essential.

A formal judicial inquiry is the only appropriate mechanism to investigate a tragedy of the magnitude. Unlike the kind of informal commission apparently being proposed by the government, a formal inquiry established under the Public Inquiries Act and led by a sitting or retired senior member of the judiciary, would have the ability to require access to documents and compel testimony on the part of key actors in the decisions and events surrounding the long-term care sector.

Those tools will be essential to establishing the facts around the COVID-19 situation, and an understanding of the roles, actions and motivations of the individuals and organizations involved. They are also fundamental to ensuring that those who made decisions, and those who were in a position to influence and oversee those decisions, have to explain their actions and choices, on the public record, before victims and survivors.

As was demonstrated in the Walkerton case, the credibility of the inquiry process helps to ensure that governments carried through on the inquiry’s final recommendations. At the same time, the existence of an inquiry does not, as the premier seemed to assert this week, prevent government from implementing measures in the short term to address immediate needs and gaps in the sector.

A formal inquiry can provide another critical function that an informal “commission” cannot. In cases where there have been significant injuries, illnesses or losses of life, inquires can make significant contributions to the grieving and healing processes of survivors and the families of victims.

The act of establishing a formal inquiry is itself a public acknowledgement of the significance of the events and losses that have occurred. Perhaps even more importantly, inquiries provide a structure for survivors to give meaning to their losses — specifically in making sure that there is a full public understanding of what went wrong, and what steps can be taken to prevent anyone else having to suffer the same tragic outcomes.

The decision on whether to call a formal inquiry into the long-termcare sectors’ handling of the COVID-19 pandemic is a test of whether the provincial government really meant what it said about an “iron ring of protection” around the care-home sector. And whether it really is prepared to learn from past mistakes and take steps to make sure they are never repeated.

Bruce Campbell is an Adjunct Professor of Environmental Studies at York University. Mark Winfield is a Professor of Environmental Studies at York University. Pat Armstrong is a distinguished research professor in sociology at York University.