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Letters

Untangling the spin about long-term care in BC

In recent months the provincial government has acknowledged that it has not delivered the 5,000 new long-term residential care beds promised during the last election. But it continues to claim success in its overall approach to restructuring BC’s continuing care services, even if falling short on the beds promise. We are told that there are plans for thousands of new beds, and that we need not worry because although the population of seniors is growing, they are healthier than ever before.

This would be well and good if it weren’t for the reality facing thousands of seniors and people with disabilities who depend on BC’s continuing care system. That reality is a system in steady decline, and in a significant degree of chaos. This is the result of a long-standing lack of investment by successive provincial governments, and of deep cuts and reductions in access made since 2001.

Continuing care refers to the continuum of programs designed to maintain or improve the health and functioning of frail seniors and people with disabilities. These services are delivered outside of hospitals and doctors’ offices. They include home care (nursing), home support, assisted living, residential care and other community-based services.

During the 2001 provincial election campaign, the current government promised to address pressures in the hospital system by building 5,000 new long-term residential care beds by 2006. After the election it shifted gears and began talking about “de-institutionalizing” senior’s care and moving to a new assisted living housing model, while still promising to create 5000 new beds.

In reality, since 2001 the government has closed 2,529 residential care beds, and has created only 1,065 assisted living spaces. This leaves BC with more than 1,400 fewer beds than there were in 2001.

The government claims these numbers are wrong and that it has built thousands of new beds. However, these figures were carefully gathered over many months, are current as of December 2004, and were verified by the health authorities themselves.

So why the discrepancy in the numbers? First, the government is counting renovated beds as new beds. If you trade in your car for a newer model, you still only have one car. Second, the government is counting seniors’ housing where some meals or cleaning are provided, but no actual care. This is not part of continuing care, and will not help frail seniors with more significant care needs.

The government also points to the thousands of new beds it promises to build over the coming years. The problem is that most of these will be assisted living spaces, not residential care. Residential care includes 24-hour nursing supervision and can accommodate the needs of the very frail elderly. Assisted living, on the other hand, provides a very limited number of services to seniors who can still direct their own care. .

This shift in focus to assisted living is one of the problems with the government’s approach to restructuring. The assumption is that assisted living can be used as a less costly substitute for residential care. Assisted living is a good option for those seniors who can live semi-independently, but it is not appropriate for an elderly person with, for example, dementia, or significant mobility challenges.

It is a contradiction for the government to claim it is creating more opportunities for people to remain independent and at the same time reduce access to home health care services, which help seniors stay in their own homes. Access to these services in BC has fallen to 30 percent below the national average, and is second lowest in Canada.

Lack of adequate continuing care services means seniors and their families are forced to pay for care privately or provide it themselves. Those who can’t afford to pay or who don’t have families to support them often simply go without until they are admitted to a hospital emergency ward in crisis. This is precisely what is happening across the province, and the result is increased wait times and backups for everyone requiring acute care — as several health authorities now acknowledge.

Exactly how much this is costing the health care system remains unknown. We do know that housing seniors in acute care beds costs many times more than it does to house them in residential care. We also know that while health care spending is up, access to acute care, residential care and home health services has declined since 2001.

The government’s restructuring of continuing care services has caused undue suffering for some of the most frail and vulnerable members of our society and increased wait times for everyone requiring hospital services. It is time to go back to the drawing board.


Marcy Cohen is the lead author of the study Continuing Care Renewal or Retreat: BC Residential and Home Health Care Restructuring 2001-2004, released recently by the Canadian Centre for Policy Alternatives. It is available free at www.policyalternatives.ca.


Whither the BC Liberals? 

Following a BC Association of Social Workers political forum in Victoria on April 27th to which no Liberal candidates showed up, a member of the BCASW had this to say:     “Many of Gordon Campbell's South Island Liberal candidates blew off Victoria Wednesday night.” They didn't show up at First Metropolitan United Church in Victoria for a forum sponsored by the Vancouver Island Branch of the BC Association of Social Workers. They were invited, in some cases, weeks ago. Despite that, Liberal Susan Brice was a no show as was Sheila Orr.  Jeff Bray didn't even have the courtesy to get back to us; neither did Ida Chong.     
Democratic Reform was there. So were the Greens and the New Democrats. We even had an independent candidate.  

The Liberals missed a great discussion. We talked about the service needs of blind persons and children living with cognitive disabilities. We learned how difficult it is for young and old alike to access life saving healthcare and medications. We listened while mothers of young children spoke of the challenges of raising kids under current income assistance policies. We heard about hunger, disability and abuse. We talked about child welfare, the environment, education, and economic strategies for the forest industry, small towns and small business.     

We heard from 94-year-old Kay Scott who told us of her life and struggles. She clearly had seen it all but showed up to talk to her candidates. She has hope.

And that's what this forum was all about. Hope. We didn't just hear about problems and pain, we heard about solutions and possibilities. Folks had lots of truly great and fabulously grassroots ideas and ideals.
It really is too bad Sheila and Susan and Ida and Jeff didn't show up.  It might have helped them better understand Victoria and its citizens. Gordon Campbell and the BC Liberals appear to be avoiding these kinds of discussions with British Columbians. I think speaking with and listening to the citizens of this extraordinary province would help them be better politicians and decent human beings.  It's really too bad.  
  
I hear the BC Liberals will be at the Victoria Chamber of Commerce all candidates meet early in May. It costs money to go to that. I wonder if Kay and the others can afford to fork over $50 for the privilege of meeting with a real live Liberal candidate?   

By e-mail from David Roy



Outrageous

Open letter to Member of Parliament Colleen Beaumier

Please find attached an open letter to Member of Parliament Colleen Beaumier  regarding her anti-woman and racist comments at a community consultation  regarding Canadian Citizenship. It is these types of attitudes among  powerful decision makers in Canada that make it even more essential that we mobilize to assert the rights of women and the rights of the child. April 27, 2005

RE: An open letter to Member of Parliament Colleen Beaumier

Dear Honorable Colleen Beaumier,

On behalf of Grassroots Women, a BC-based women's organization with a sister organization in Manitoba, I am writing to express our outrage about your comments at a recent Citizenship and Immigration Standing Committee Consultation. Your comments regarding the rights of women who are not Canadian citizens / permanent residents in Canada to have children were nothing short of anti-woman, racist, and inciting of hatred.

On April 11, 2005, Grassroots Women appeared before the Citizenship and Immigration Standing Committee to participate in a democratic consultation regarding Canadian Citizenship. During our presentation, we spoke about women's inalienable right to choose when to have children regardless of their immigration status. We informed the committee, however, that:

"Canadian-born children of non-citizens are increasingly being consigned to second-class citizenship. For example, there have been cases where the Canadian children of domestic workers under the Live-in Caregiver Program have been denied medical coverage if their mother's status as a temporary worker runs out. In other cases, these Canadian children are effectively deported if their mothers are deported because they have no one else to look after them in Canada. The rights and best interests of the Canadian child are essentially denied in these cases. Proposals to expand the definition of Canadian-born children who will not qualify for Canadian citizenship will only exacerbate this problem and in fact could result in Canadian born children effectively being stateless."

Your response, both during the open session and privately afterwards, was essentially that you don't believe women have a "right" to have children.

In reference to non-citizens / permanent residents who have Canadian born children, you claimed that they "have children only to make their own lives better."

 This presumption is outrageous considering the reality of life fortemporary workers and refugee claimants in Canada. Temporary workers under the Live-in Caregiver Program (LCP) are here in Canada for up to three years without permanent residency status. Refugee claimants spend up to eight years waiting for their status to be recognized. Do you suggest that Canada should be able to deny their right to have children? Should their basic human rights as workers and women be trampled over merely because they do not have status in Canada? Do you advocate that these children who are born in Canada and live in Canada for years should not have the same rights as other Canadian citizens?

This type of commentary fuels racist, anti-(im)migrant sentiment and
deepens a citizenship divide where migrant, immigrant and refugee communities in Canada - particularly women - continue to be segregated and economically marginalized. Yet, as an elected Member of Parliament, you have a duty to follow and defend the principles enshrined in the Canadian Charter of Rights and Freedoms. Therefore, we demand a public apology for these remarks.

 Sincerely,

 Rachel Rosen
 Coordinator, Grassroots Women
 www3.telus.net/grassrootswomen