A Sector in Transition

Fuelled by the devastation brought on by COVID-19 and seen across the province — and country — the challenges facing Ontario’s long-term care (LTC) sector have come into sharp focus. This renewed focus on LTC isn’t only true for the thousands of families with loved ones residing in Ontario’s LTC homes, it has also sparked a broad public dialogue about how we treat and care for the province’s elderly and most vulnerable — a dialogue that is not lost on the political parties and leaders hoping to win the vote of Ontarians on June 2.

As two public affairs professionals with expertise in LTC — including a former long-term care policy lead in the Ford government and a registered social worker who has worked on the front lines of LTC — we have some insight into what’s to come. Above all, it’s clear that in this election a battleground has been drawn over each party’s vision for the future of LTC, including how care will be delivered, what the LTC homes of our future will look like and, perhaps most importantly, who will own them.

Where the major parties stand

There is a lot to be debated about how to improve the LTC system in Ontario. But the issue dominating party platforms and media headlines is who will keep, and who will work to eliminate, for-profit models of care.

The NDP were the first to come out publicly with a stance against the continuation of for-profit models of LTC. As the pandemic ravaged homes, reports of troubling living conditions and increasing death rates emerged; the NDP charged that this was disproportionately in for-profit homes. New Democrats were quick to call on government to put an end to for-profit homes, which aligned with their criticism of private health care. The NDP have committed in their platform to phase out for-profit operators within eight years by immediately stopping new licenses and contracts to for-profit LTC operators and providing financial supports to municipalities and not-for-profit operators to take over operations of these homes.

The Liberals were slower to put their stake in the ground. Over the course of the pandemic, there were indications that the Liberals had a growing openness to the idea that profits and care were, on principle, not a good mix, at least in LTC. Nevertheless, it was surprising that the Liberals, as part of their seniors’ platform, announced their own pledge to eliminate for-profit LTC by 2028 — a reversal of a longstanding (if, for some in the party, uncomfortable) policy position.

Ontario’s Progressive Conservatives remain the outlier, but so far are not wavering in their stance. Instead of focusing on the financial model of homes, the PCs are zeroing in on what they are doing to fix LTC, emphasizing investments they’ve made to build new beds and ease wait lists, hire more staff to provide care, and implement a new hours-of-care standard — along with a focus on enhanced accountability for operators. But with little mention of LTC in Budget 2022, it’s clear that the PCs believe their path to an improved LTC sector has already been made clear and are turning campaign focus to other key post-COVID and recovery issues.

What this means for the sector

A lot can change over the course of an election campaign, but current polling still suggests a renewed majority mandate for the Ford Conservatives is a likely outcome on June 2. However, in recent weeks we’ve seen some increased support for the Liberals, tightening the race between them and the PCs. At the same time the NDP, with an uncharacteristically strong war chest, are prepared to put up a fight as the best alternative to the Ford government.

A return to a PC majority means a return to the same approach we have seen and heard from the governing PCs for the last number of months. As is often the case, we do expect the cabinet to be shuffled following the departures of Rod Phillips and Christine Elliott, and potentially more ministers once the votes are counted. The LTC sector in Ontario should be prepared for new faces, from Ministers to their staff, at Queens Park. When Cabinet is named, there will be a plethora of opportunities for operators and stakeholders to (re)introduce themselves and their organization, leveraging the renewed mandate and pressure to make significant strides on LTC policy.

Although a change in government seems unlikely, there is a path for a minority mandate for the PCs. Both the Liberals and NDP have stated they will not support a PC minority’s agenda, which would stifle the PCs’ ability to drive substantive change in LTC, or any significant policy item. This requires advocates to build relationships with and understand the direction of all three major parties. While this can be a daunting situation, having the right team on your side will help.

While neither the Liberals nor the NDP have formally committed to forming a coalition government to oust a PC minority, recent events at the federal level signal that a partnership, even if not a formal coalition, may not be out of the question. Coalition governments require advocates to be nimble and maintain relationships across party lines while understanding LTC priorities across the board.

Never knowing which way the wind will blow means being prepared for all possibilities. Knowing the right people is important, but more important is understanding how the parties think, what motivates them and their rationale for policy design.

At H+K, our team offers an unrivalled breadth of experience and depth of expertise in politics and government relations, strategic communications, crisis management, and health policy generally and long-term care particularly. We are a team of former Ministers, Deputy Ministers and political staffers, health professionals, and public affairs and communications experts. We are ready to bring our diverse perspectives and deep expertise to understand your critical needs and equip you with the strategic advice you need to hit the ground running on June 3.

The right team can make the difference

No matter the outcome on June 2, long-term care is going to have a pivotal place in the government mandate. Focused attention, scrutiny, and expectations will remain high and will be placed on both the sector and the government’s (renewed) mandate on LTC. H+K’s experts and strategic advisors can help navigate the various opportunities to get you in front of the right decision-makers, at the right time and with the right message.

Getting in the door is the easy part, understanding the policy and dynamics at an expert level to support implementation of meaningful policy that will change the lives of residents, families and front-line workers in long-term care — that’s the hard part, and we’re here to help.