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  • Writer's pictureMichael Wolfson

Accountability in long-term care

Without concerted action, problems in long-term care will continue to fester, and indeed grow with Canada’s aging population.

Thursday, March 7, 2024


It has only been the unnecessary spike in residents’ deaths from the pandemic that brought problems in long-term care to light, writes Michael Wolfson. Darryl Dyck The Canadian Press file photo

Memories of the tragedy in Canada’s long-term-care (LTC) homes from the pandemic are fading all too fast. However, this tragedy was not an accident; it was the result of a series of deeper problems with the ways LTC is funded, managed and understood. Without concerted action, these problems will continue to fester, and indeed grow with Canada’s aging population.


Addressing these problems requires actions on a number of fronts, from operating standards to staffing, to assuring the human rights of LTC home residents. The most important actions form the core recommendations of a recently released report from the Royal Society of Canada (RSC).


One reason for the failures in Canada’s LTC homes is their general invisibility. It has only been the unnecessary spike in residents’ deaths from the pandemic that brought these to light. With this tragic visibility, there has been a flurry of government actions. But as myriad experiences have taught us, as soon as the light fades, actions weaken.


One of the core recommendations of the recent RSC report is the creation of a robust “accountability framework,” in turn, based on strong data reporting. This is not a new idea; the 2003 first ministers health accord also spoke repeatedly about accountability. However, governments’ support for the underlying data waned over only two or three years, as did support for the short-lived Health Council of Canada a few years later.


In order to avoid yet another failure, we must understand what an accountability framework involves, and why it has failed in the past.




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