Long Term Care Minister Merrilee Fullarton painted a bleak picture of the early days of the COVID19 outbreak last February and March. She and her deputy Minister Richard Steele were essentially trying to build a Ministry of Long-Term Care while simultaneously fighting COVID outbreaks in the homes under their direction. Long-term care had only been severed from the Health Ministry a few months earlier At Friday’s hearing, in testimony where she at times appeared to get emotional, Fullarton told the Long-Term Care COVID counsel John Callaghan, “there was very little done in long-term care, (when it was part of the Health Ministry) so there wasn’t much structure there. So, we had to create — essentially create a ministry.”
Ministry just getting started as COVID hit
Deputy Minister Steele added, Richard added, “having been involved in other circumstances where the ministries are split up with a smaller one being carved out of a larger one, inevitably there are a series of things that need to be built over time. So, there would be a number of things…that wouldn’t necessarily have been in place for day one.” This echoed comment made by the Ontario Hospital Association earlier that suggested creating a separate ministry for LTC was not working, certainly not when it was trying to establish itself at the beginning of a pandemic.
Long term care cut out of communications
Shortly after the COVID outbreak a turf war erupted, with the Ministry of Health issuing directives to the Long-Term Care sector without involvement of Fullarton’s Ministry, she issued a memo reading, “Just wondering why Ministry of Health is issuing, … the guidelines without Ministry of Long-Term Care. I understand MOH is the lead, but MLTC must be part of this communication to our own sector…I understood the necessity of having the Ministry of Health as the lead, but I believe very strongly that our – the trust in our ministry would be put at risk if we weren’t able to communicate with our sector.”
Disagreement with Williams
There was also an apparent disagreement between Fullarton—a family doctor–and Ontario Chief Medical Officer of Health Dr. David Williams over how serious of a factor was community spread in the growing crisis in the long-Term Care sector. She said her intuition as a doctor suggested to her that it was a serious issue, bur deferred to Williams, because she was not qualified as a public health expert. At which point commission counsel John Callaghan interjected, “Well, I mean, it sounds like you had a fair bit of information in terms of intuitively, because you ended up being right.”
Put her foot down about soothing video
Then she described a situation where Health officials tried to get her to appear in a video reassuring people that the COVID risk at that point was low. She told the commission, “I was very concerned about doing a video that would show or tell people that the risk was low, even though that was what health experts and the health leaders in Canada were saying. I did not want to make a video indicating that.”
Critical shortage of PSWs
She also shed some light on why it was not possible to quickly deal with the issue of Personal Support Workers (PSWs) working in multiple facilities in order to obtain full–time hours. It was this practice that was believed to be a significant factor in spreading COVID through the long-term-care homes. “There was the risk of the precarious staffing that we had. And there was…great concern that by limiting staff to one location only that we would tip some of the homes into collapse.” All this was happened at a time when the long-term care system was short 3,000 PSWs and as Fullarton said, “given the fear in the community, we were challenged to attract people to the sector during that.” Commission Counsel Callaghan asked and Fullarton agreed that fully 40 percent of people who are trained as personal support workers either never enter the field on graduation or drop out shortly thereafter.
The Ford government obviously agreed to the calling of the Commission into LTC and COVID, but can’t be too happy about what is being said in testimony. So far witnesses have painted an alarming picture of a disjointed health care system, mixed communications, and jurisdictional silos– a system where hospitals are the gold standard crowding out other sectors of the healthcare system. It is also clear that any meaningful fix for the system will require a lot more money than is currently being allocated. The challenge there is to figure out how increased funding doesn’t simply find its way to the shareholders of a system that is 60 percent privately owned.