Looking back at my time in government, I’m haunted by our handling of senior care

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Pierre Cyr is vice-president of public affairs at FleishmanHillard HighRoad in Ottawa. He previously held a variety of senior adviser roles in provincial and federal governments.

“How does it feel to be adopted?” I have fielded that question a lot in my life, to which my only response is “How does it feel to be biological?” Truthfully, I do not know the difference.

But I do know the difference between being cared for and being genuinely loved.

Since I was adopted at a very young age, I have some memories from my Toronto foster home. These include being bathed in cold water under a kitchen faucet; being left naked and shivering on a kitchen counter for hours in order to dry; and being taught to yell “mommy” and run toward any woman coming through the door.

I feel grateful for the latter. Once my mom Annette grabbed a hold of me, she never let me go.

I recall an instant and dramatic change. Going from being neglected to being the centre of attention in a warm Franco-Ontarian family. I remember vividly the plane ride from Toronto to Timmins, Ont.

Although I imagined deeply moral or philosophical reasons why my family adopted me, their actual reasoning was quite simple: How could we possibly leave you there?

It is a pragmatic approach I wish I had carried throughout my professional career.

The crisis in long-term care homes has made me reflect again about the difference between being cared for and being loved.

Over the coming months, there will surely be a lot of finger-pointing about the institutional breakdowns that occurred. In Ontario, the issues will be investigated by a commission chaired by Ontario Superior Court Associate Chief Justice Frank Marrocco. Other provinces and the federal government may also follow with commissions of their own. A lack of a national approach to standards of care, no clear pandemic preparedness plans for these homes and an overall disjointed co-ordination by all levels of government, are a few of the likely issues. While these points are all valid, they overlook the breakdowns at the individual level. There’s a lack of compassion and accountability that also needs to be called out.

For decades, the vulnerabilities in long-term care homes have been in plain sight. I recall many stories and complaints during my time working for the then Ontario Minister of Health and Long-Term Care in the mid-2000s. We clearly did not do enough.

One area in which we should have done more is in reforming Community Care Access Centres (CCACs).

CCACs at the time oversaw senior care throughout the province, and in 2006 we were reconstituting CCACs to align with the then new Local Health Integration Network (LHIN) boundaries.

When we approached the appointments of chairs and board members to CCAC boards, it became clear that these agencies were full of deeply entrenched individuals who did not like the reform being proposed. Furthermore, these individuals had many allies inside our own ministry. Within weeks, the contents of confidential (but slightly outdated) memos on proposed orders-in-council were disclosed publicly on a health blog.

We knew they could only have come from within. We had our suspicions as to the source and made it clear the leaks had to stop. But by the time the issue was resolved, the damage was done. While we would have liked to have undertaken a massive overhaul of the governance of CCACs, we realized it would lead to a battle we did not have the bandwidth or time to win. We focused our energies elsewhere.

I was a twentysomething political staffer back then. If I could transport myself back to 2006 with the wisdom of a fortysomething, I would have called out the fact that we simply had too many change initiatives happening all at once, and should have timed these reforms for the middle of our mandate, not the end. After all, we were only a few months away from an election and our minister was heavily focused on winning his Toronto region.

Would more radical reforms to CCACs have changed our current outcome? Probably not. In fact, they were absorbed into the LHINs by the Wynne government, and subsequently entirely eliminated along with the LHINs by the current government. Other provinces and countries have also seen COVID-19 outbreaks in long-term care homes. However, we would not have lost a decade in improving senior care if we had overhauled these agencies with people who focused more on protecting our seniors, and less on protecting their own turf.

It is easy to be distracted in politics and much more difficult to call out long-standing issues. If a problem has existed for decades, it can’t be that big of a deal, right? This is the type of rationale that permits systemic issues to persist.

I see the same type of reasoning being applied to issues today. Seasoned officials will raise jurisdictional and fiscal arguments when arguing against measures. “We don’t have the resources,” or, “It’s not our job.” These sound like the same arguments that left an orphaned toddler shivering on a kitchen counter 40 years ago.

While they are not wrong, their approaches are also not right: they lack courage, and they help explain our current lack of pandemic preparedness. Many of these officials are smart enough to know that once the dust settles, heads will need to roll. After all, a major risk was not identified or resourced properly, killing thousands, tanking our economy and sending their political masters scrambling.

I hope twentysomething political staffers and departmental officials will hear my advice. You do not want to look back at your decisions years later and realize that you missed a big opportunity.

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