In the early months of COVID-19, as the first lockdowns came into effect, long-term care homes (CHSLDs) in Quebec became epicentres of infection and death. Recently this has been brought back into focus by a scathing report written by Quebec ombudsperson Marie Rinfret and a separate inquiry by coroner Géhane Kamel. The CAQ have been forced onto the defensive for their handling of the first wave of the COVID-19 pandemic, but the blame for this catastrophe runs far deeper than simply François Legault and his party. This crisis had been prepared by decades of cuts and attacks by all the major political parties and their capitalist masters so that when the pandemic hit, the whole system crumbled under its own weight.
Hypocrisy and neglect
The unavoidable conclusion of Rinfret’s report is that residents in long-term care fell under the “blind spot” of the CAQ’s COVID-19 preparations. In March the province relocated more than 1,700 hospital residents into private care homes, packing them beyond all reasonable capacity, and from the very beginning these facilities were left unequipped to handle the crisis. There were shortages of protective equipment, disinfectant, and sanitizing stations. The massive enrolment of nurses into the public sector earlier that year had led the management of a number of private care homes to replace outgoing nurses with workers hired from temp agencies—who were paid little more than minimum wage and often were not even offered training as care providers. The preparation was disgraceful, and as the pandemic struck Quebec, staff shortages became rampant in these private facilities. The CHSLDs crumpled under the weight, and an utter catastrophe was made inevitable. Of the 5,634 deaths that had been reported in Quebec by the end of the first wave, 3,849 had come from CHSLDs.
Former health minister Danielle McCann, who was in office during the first wave, claims to this day that the government told the CHSLDs to “get into action” as early as January of 2020. Rinfret, however, found no evidence whatsoever that they had actually done this! In fact, it was not until March 12 that the Ministry of Health and Social Services warned the private CHSLDs to prepare for the arrival of COVID-19, and promised to provide them with protective equipment. The protective equipment never arrived and the workers in the CHSLDs were left begging to the void for support from the government. It was not until April 10, after the Montreal Gazette published a story on the Herron long-term care home—where residents had been left to suffer and die without water or basic hygiene for days on end—that the government-run Health and Social Services Service Centres finally took action and brought in more staff. By then, 31 people had died.
As much as François Legault and the CAQ have tried to paint the wave of deaths that swept through long-term care homes as caused by a lack of information, or their inability to predict the future, the fact remains that there were weeks in which the Health Ministry did nothing while receiving constant updates as to the descending chaos in the long-term care system. Annick Lavoie, director of the Association des établissements privé, had been sending emails to the deputy minister responsible for seniors’ care as early as March 16 to say that no personal protective equipment was arriving. By March 19 she had sent another email, by which time she claimed the situation was already critical. By April 1 Lavoie wrote, “Quebec is headed to a hecatomb in the CHSLDs”, and 10 days later her prediction played out in full in the public eye with Aaron Derfel’s devastating article in the Gazette—which finally prompted a response from the Ministry of Health and Social Services. But this was only a last ditch effort at saving face. While Legault and McCann console themselves with high sounding phrases like, “we did all we could”, the fact remains that they had every opportunity to right the course and chose to do nothing!
Both the Liberals and the Parti Québécois have seized this opportunity to put the CAQ under hot water. But as we’ve explained before, there is blood on the hands of the PLQ and the PQ as well. Under both Liberal and Parti Québécois governments, the last three decades have seen a swell of privatizations in the long-term care sector, along with hospital closures, massive cuts to health care, and an overall decline in the working conditions of health-care providers. Quebec’s ombudsperson had already warned the government about the sorry state of CHSLDs in previous reports, even before the pandemic. Under the watchful eyes of the different capitalist parties, our elders were sent into the waiting arms of gangsters and parasites like Samir Chowieri, the convicted con man with a major stake in the now infamous CHSLD Herron. These governments gladly offloaded them into the care of businessmen who saw them as nothing more than sources of revenue, and the caregivers as nothing more than cheap and exploitable labour.
In private hands, every possible corner was cut to ensure profits. From residents they gouge hundreds or even thousands of dollars every single month, meanwhile paying their workers as little as humanly possible. The staff shortages that exacerbated the disaster did not appear out of thin air during the pandemic, but had become the norm over decades of austerity. In understanding the crisis that swept through the long-term care sector, we should rightly recognize the role played by the CAQ government as a catalyst. But we cannot on that account lose sight of the fact that it was these decades of cuts, privatizations, and the inhuman profiteering of the capitalist owners of the CHSLDs that was the ultimate cause.
Where do we go from here?
Recently, the CAQ has proposed to increase the number of inspections of private long-term care facilities. In keeping with their alibi of having not had enough information to respond, this will give them an affordable opportunity to save face and pretend to be doing something. But ultimately this will change very little, if anything at all. Even in March, at the height of the crisis, inspections were made, recommendations were sent, and nothing was done. More inspections will only serve to clarify the exploitation of both care workers and the elderly residents in these institutions, not to correct it.
What we need, if we are to attack the root of this issue, is to remove the profit motive from the long-term care sector. For our elders to be guaranteed a secure, comfortable existence, we have to nationalize long-term care and place it under the democratic control of the residents and the staff. The hopeless pleading to bureaucrats for action must be replaced with direct democratic control by the workers in these facilities over the networks of supplies and resources. Only on this basis can we begin to dismantle the structural causes which lead to the exploitation of the elderly for revenue and of nurses and caregivers for cheap labour—and which which led to the infections and deaths during the first wave. To ensure that this atrocity is never repeated, we need democratic workers’’ control.