441-00901 (Civil and human rights)

As we have seen throughout this pandemic, vulnerable populations have been greatly affected by the consequences of this public health crisis. COVID-19 has resulted in tragedies in long-term care facilities and nursing homes right across the country, and exposed long-standing issues affecting the sector.

The Government of Canada is committed to supporting Canadians, including seniors, through the development of policies, programs, and initiatives that promote the health, well-being, and quality of life of older adults, and through addressing issues in long-term care.

The provision of health care services, including long-term care, falls under the jurisdiction of the provinces and territories. Provinces and territories are also responsible for the establishment and management of hospitals and other facilities, including nursing homes. While a provincial responsibility, the Government of Canada is working collaboratively with provinces and territories to improve the quality and availability of long-term care, and to support training and better wages for personal support workers. The Minister of Health’s most recent mandate letter reiterates the Government’s commitment to ensuring seniors get the care they deserve. This commitment builds on past efforts to support long-term care throughout the COVID-19 pandemic.

To address significant challenges revealed during COVID-19, in the 2020 Fall Economic Statement, the Government of Canada announced the creation of a new Safe Long-Term Care Fund. This fund has transferred $1 billion to the provinces and territories to protect people living and working in long-term care. Provinces and territories are using this money to improve infection prevention and control in facilities, including to assess infection prevention and control readiness, improve infrastructure such as ventilation, and address workforce gaps, including hiring more staff or raising wages.

In addition, Budget 2021 announced a further $3 billion investment over five years, starting in 2022-23, to support provinces and territories in their efforts to ensure standards for long-term care are applied and permanent changes are made. This funding will help support workforce stability, including through wage top-ups and improvements to workplace conditions (e.g., staff to patient ratios, hours of work) and strengthened enforcement (e.g., enhanced inspection and enforcement capacity, quality and safety improvements to meet standards), including through accreditation and regular inspections. The Government of Canada will work collaboratively with provinces and territories to flow this funding as part of our collective efforts to make sure that seniors and others in care settings live in safe and dignified conditions.

The Government of Canada has also responded to COVID-19 in long-term care facilities in a number of other ways:

• $740 million to provinces and territories for vulnerable populations, including those in long-term care, as part of the Safe Restart Agreement in 2020
• Workforce supports from the Canadian Armed Forces and Canadian Red Cross in long-term care facilities
• Public Health Agency of Canada guidance on infection prevention and control and patient care in long-term care / home care during the pandemic
• Enhanced supply and coordination of personal protective equipment
• Procurement and coordination support for rapid testing and vaccines
• Funding for Healthcare Excellence Canada’s LTC+ program, to share best practices across long-term care facilities and seniors’ residences
• Program coordinated by Employment and Social Development Canada for training and work placements for personal support worker interns

Canadians ultimately want to age at home or in their community, close to family and loved ones. That is why the Government of Canada is providing $6 billion over ten years – starting in 2017 – for provinces and territories to improve access to home and community care services, including palliative care. This investment is helping more Canadians receive the care and services they need so that they may remain at home longer. In addition, the Government of Canada has established an expert panel to examine measures, including a potential aging-at-home benefit, to further support Canadians who wish to age within the comfort of their own homes.

The Government of Canada also recognizes the importance and the need for accessible and comprehensive care for Canadians who are living with life-limiting illnesses. Every Canadian who is approaching the end of their life deserves to receive care in the setting of their choice and to live out their days in comfort and dignity.

Our Government has collaborated with provinces, territories, health care providers and stakeholders, to develop a Framework and implement the Action Plan on Palliative Care, including investments of $53.9 million from 2019 -2027.

The Action Plan on Palliative Care lays out Health Canada’s multi-year plan to tackle issues identified in the Framework on Palliative Care in Canada. Actions include raising awareness of the importance of palliative care; providing public education on grief; improving palliative care skills and supports for health care providers, families, caregivers, and communities; enhancing data collection and research; and improving access to culturally sensitive palliative and end-of-life care.

The Government of Canada also recognizes the conscience rights of practitioners and other health care providers. With regards to medical assistance in dying (MAID), the legislation clearly states that nothing in the law compels a person to provide or assist in providing MAID, and recognizes the right of health care providers to choose whether or not to participate in providing MAID. Specifically, the legislation notes in section 241.2 (9) of the Criminal Code that “For greater certainty, nothing in this section compels an individual to provide or assist in providing medical assistance in dying”.

Our Government will continue to work in collaboration with provinces and territories to help ensure seniors get the care they deserve, both at home and in long-term care facilities, and support access to quality palliative care. It will also continue its work to ensure that the MAID system continues to protect those who may be vulnerable and support the freedom of choice and autonomy of those who are eligible and who choose MAID.