With LTC reform, Phillips eyes path to redemption
If not for his public shaming over a Caribbean getaway in mid-pandemic, Rod Phillips would surely be the mighty minister of finance today, basking in the power and prestige of cabinet’s top job.
Instead, he has been reincarnated as minister of long-term care, possibly the most perilous and thankless portfolio in government. Once written off as politically finished, Phillips is helping the PC government dig out of its COVID debacle by rewriting its strategy on longterm care.
His new job is assuredly less powerful. It may just be more meaningful and consequential amid COVID-19.
This week, four months after his rehabilitation and return to cabinet, Phillips rolled out a series of back-to-back announcements to reform an ossified nursing home sector — with more money, more nurses, more inspectors, more fines, more beds. Alternately praised and pilloried for his plan, he at least has one.
Long-term care has languished in Ontario for decades, neglected by both voters and (thus) politicians as an afterthought — until an invisible virus exposed the gaping holes in governance. Can Phillips fix it?
As fate would have it, the politician who was tarred and feathered may now be perfectly placed to clean up an inherited mess.
After the fall comes the resurrection, because political purgatory has a way of reshaping wounded politicians.
The old Phillips did whatever he was asked and tasked to do. As a young political aide he served Mel Lastman in the mayor’s office, went on to make his fortune in the private sector, then won his Ajax seat in the 2018 election that made Doug Ford premier.
He was rewarded with the environment portfolio, but it was not his finest hour. The rookie minister did the premier’s dirty work in opposing a federal carbon tax, mastering the minutiae of emissions reductions targets so that he could out-talk and outfox any interviewer.
It was pointless gamesmanship aimed at winning Ford’s loyalty, and he was rewarded with the finance ministry. It was a major step up — until his vacation misstep cost him his job, and cast his political future in doubt.
Now, the rehabilitated minister has repurposed his brainpower.
He is a humbled man with an ambitious plan.
In theory, the proposals are eminently practical: doubling inspectors, doubling fines, demanding infection control, taking over failed nursing homes, stepping up training and retraining — and insisting on vaccinating of staff.
In reality, Ford’s government had already stopped annual inspections to save money (before Phillips took over). Laudable as it seems to promote training and retraining, it is only by retaining staff — with decent wages — that the hemorrhaging of personal support workers and nurses will stop (a $3-an-hour wage top-up ends next March).
The ideology of nursing home ownership was the elephant in our Zoom room when Phillips shared his plan with the Toronto Star’s editorial board Thursday. Asked whether ownership — and profit-seeking motivation — matters, Phillips insisted that regulation counts most.
The governing Progressive Conservatives are not in the business of expropriating private assets, he muses. New Democrats and Liberals say they’d phase out for-profit beds given the chance, though neither of the opposition parties did that when they had their chance in power.
Today, more than 60 per cent of long-term care is run by profit-seeking corporations. Phillips argues that if we want more beds (the target is another 30,000), beggars can’t be choosers: “It is a difficult problem, but not complicated — we need more beds.”
In fact, it is fiendishly complicated, with many shades of grey — despite the claims from all sides that the solutions are black and white.
Many (but not all) for-profit homes were found to have the highest infection and death rates in the early days of COVID, but the correlations aren’t always correct. Many older not-for-profits — with shared bathroom facilities, packed rooms or poor staffing — also had abysmal records.
Whatever the mix, there is one undeniable distinction between different ownership structures: It’s far easier for profit-seeking corporations to get the financing they need to build new homes, while notfor-profits struggle to raise capital.
Whatever his personal, ideological and political inclinations, Phillips understands better than most the power of non-profits to do good, given the chance. After all, he has chaired his share of NGOs over the years.
If anyone can level the playing the field, permitting nonprofits to access the funds they need, it’s the former finance minister — who was also a private sector wheeler-dealer in his previous life. The sector not only cries out for reregulation but a reconfiguration of the financing — and refinancing — of non-profit homes.
His plan is imperfect but pragmatic. We won’t know for years whether it succeeds or fails — by which time Phillips, like all politicians who pronounce on long-term care, will have moved on.
In truth, the minister is right that Ford’s right-wing Tories are not about to expropriate or banish for-profit nursing homes. Which means that if Ontario’s voters want a change of ownership, they’ll need a change of governments — not just ministers.