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Ontario is promising a review of the province’s long-term care system after the COVID-19 pandemic, but won’t commit to making it public or independent from government.

The move comes after a health care union called for a public inquiry into the deaths of more than 1,100 residents and at least three front-line workers, and as it was revealed the province has been inspecting senior’s facilities during the pandemic by telephone.

Merrilee Fullerton, Minister of Long-Term Care, said Thursday “all forms of review are on the table,” but the scale, scope, and terms have yet to be decided. “Once we emerge from this pandemic, we will get to the bottom of this,” she said in a tweet.

When asked if the review will be public and independent, Premier Doug Ford said details will be released in the coming days, but the government’s current priority is to help care homes handle the COVID-19 crisis.

"We know the system’s broken,” Mr. Ford said. “We’re going to have a complete review, not just of long-term care – I think the whole system of government.”

But some advocates say the province should begin its work immediately.

“Waiting until the pandemic is ‘over’ is not acceptable," said Laura Tamblyn Watts, chief executive officer of CanAge, a national seniors’ advocacy organization. “COVID may just become part of our routine lives in the way that the flu and viral pneumonia may be. We can’t keep putting this off.”

Sharleen Stewart, president of the Services Employees International Union Healthcare (SEIU), which represents 25,000 frontline health workers, said her union is still calling for a public inquiry into the province’s handling of long-term care.

“We have to look at what went wrong during the pandemic,” she said. “We have to account for why [there were] so many deaths.”

A Globe analysis of long-term care homes hit hardest by the coronavirus – those where at least 15 per cent of residents have died – reveals that the vast majority are owned by private, for-profit companies. Only six of the 21 homes are owned by not-for-profit entities or municipalities.

A report released this week by the Ontario Health Coalition, an advocacy group that lobbies for public health care, made similar findings. Among 93 homes with COVID-19 outbreaks, for-profit entities accounted for 700 of the 1,057 deaths.

NDP Leader Andrea Horwath called for further scrutiny of the different types of ownership in the senior-care system.

“I oppose profits being made by corporations in long-term care. Let’s lay all the facts on the table in a thorough and independent public inquiry,” she said.

In Ontario, concerns have been raised repeatedly about the adequacy of staffing levels, personal protective equipment and inspections at long-term care homes across the province.

Health Minister Christine Elliott confirmed on Thursday that some inspections during the pandemic have been done by telephone – instead of in-person – to prevent the transmission of the virus. “It wasn’t done in the most ideal of circumstances,” she said. A Ministry of Labour spokesperson did not say how many inspections the ministry has done by phone.

The government waited until April 15 to temporarily ban employees in seniors’ residences from working in more than one home. The province’s 34 local health units didn’t begin testing every resident in long-term care until April 21. By that time, 295 residents in these homes had died.

Miranda Ferrier, president of the Ontario Personal Support Workers Association, said the review should look at how long-term care facilities typically didn’t give full-time hours to personal support workers, requiring them to earn a living working at multiple homes. The government bumped up salaries for front-line workers late last month.

“Unfortunately, what we’ve seen is that it’s been the workers who have brought it in, unintentionally of course,” Ms. Ferrier said.

Ms. Ferrier said a full inquiry would take too long and the government could address many issues by speeding up the implementation of recommendations from the public inquiry into the case of Elizabeth Wettlaufer, the Ontario nurse who confessed in 2016 to murdering eight residents of long-term care homes.

As of Wednesday, 1,111 residents of long-term care homes have died of COVID-19 in Ontario. There are currently 174 outbreaks in the province’s seniors’ homes.

With a report from Jill Mahoney in Toronto

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