Staff and residents in the hall at the Care Oakcrossing long-term care home in London, Ont., on Mar 24, 2022.Fred Lum/the Globe and Mail
Talks over wages and working conditions between Ontario nurses and long-term care homes broke down Friday, with the nurses’ union warning it leaves the system “teetering on catastrophe.”
The Ontario Nurses’ Association (ONA) and 194 for-profit care homes have been negotiating wages, benefits, hours and other labour conditions since March 27.
Elizabeth Macnab, the executive director of the Ontario Society of Senior Citizens’ Organizations (OSSCO), said it is always “dreadful” to hear of bargaining breaking down between employers and workers. In this case, she said, it can be particularly damaging.
“Talks will only be successful when both parties focus on why they exist. There is a joint responsibility to care for the seniors in these homes,” Ms. Macnab said.
Ms. Macnab said she is worried about how difficulties with retaining long-term care staff will affect the amount of one-on-one care residents receive.
In 2021, Ontario introduced the Fixing Long-term Care Act, which outlines targets for direct care. Ontario care homes are expected to have reached a daily average of three hours and 42 minutes of direct care per resident in March. By March 31 of next year, the number of hours must increase to four.
A briefing document prepared for Ontario Long-Term Care Minister Stan Cho indicates the province will not meet its direct care targets. The details of the document, first reported by the Canadian Press, indicate Ontario needs 13,200 additional nurses and 37,700 personal support workers as of this year. The document says staffing shortages will only worsen as the number of homes and the hours of direct care increase.
Shortcomings in Canada’s long-term care system were exposed during the pandemic. A 2022 report from Ontario’s COVID-19 Science Table said older adults living in the province’s long-term care homes experienced some of the most devastating impacts of the pandemic, including a disproportionate number of deaths, and called for policy reform.
ONA president Erin Ariss said Ontario nurses have faced nothing but “utter disrespect” during this round of bargaining, citing income gaps between long-term care and other healthcare sectors.
Relatively low wages are prompting nurses to leave the long-term care sector for more lucrative pay, which can have dire impacts on the direct care available to long-term care residents, Ms. Ariss said.
The collective agreement between Extendicare Haliburton and ONA shows the starting wage for registered nurses at the care home is currently $32.22 per hour. At Haliburton Highland Health Services, which provides hospital care in the same area, registered nurses earn a starting wage of $39.07 per hour. In 52 weeks of full-time work, hospital nurses in Haliburton will earn $20,250 more in gross income than long-term care nurses.
“[Long-term care nurses] are delivering care that is very complex,” Ms. Ariss said. “It is unacceptable that they are making even $1 less than the hospital sector nurses.”
Bass Associates Professional Corp., which is representing the group of employers during bargaining, did not immediately respond to a request for comment. Extendicare, one of the care home chains currently in bargaining, also did not respond.
Ms. Macnab said she is disappointed by the labour conditions in long-term care because precarity for workers is precarity for residents.
“These long-term care beds are the last place people will be on this planet,” she said. “We need to think about what kind of life we want them to experience.”
Ms. Ariss said care homes in Ontario are accountable to the targets set by the provincial government, but for-profit homes must also answer to their shareholders.
The impacts of long-term care staffing shortages are not unique to Ontario. Tim Guest, the CEO of the Canadian Nurses Association, said shortages are being seen across the country. Mr. Guest said low staffing can amplify the workload for nurses, but change is not impossible.
“The federal government has foreshadowed in the 2024 budget a future Safe Long-Term Care Act that will set new national long-term care standards, but a lot of work remains to be done to see these efforts materialize into concrete action,” he said.