Long before the global pandemic reached Canada, the care of our most vulnerable citizens had challenged many governments, communities, and families. “Care work” was “women’s work,” and therefore underpaid and undervalued. That often meant difficulty retaining staff and inadequate quality of care, particularly in for-profit settings.
When COVID-19 struck, no one suffered more than residents in long-term care. According to the Canadian Institute for Health Information, 80 per cent of COVID deaths in Canada have been in retirement homes and homes with 24-hour nursing care.
There’s been plenty of debate about how best to respond to the crisis. Solutions include better regulations, more inspectors, and more staff. Some jurisdictions have added new beds to reduce overcrowding. But the bigger concerns are ownership of long-term care facilities, and how the care economy operates more generally.
Does profit have a place in the care of our most vulnerable citizens? It’s time to look more closely at the many alternative models that put people, not profit, at the heart of community care.
COVID has illustrated the strength of the non-profit approach and how it’s built to serve communities, in stark contrast to for-profit models. Ownership is key. Non-profit and co-operative housing and services — be they seniors’ homes, supportive housing, or child-care centres — serve people locally and are accountable to communities through their volunteer boards of directors.
On the other hand, large, for-profit chains, while claiming to be better able to provide local services and facilities, have delivered inferior quality of care. According to a study in the Canadian Medical Association Journal (2020), long-term care facilities that are run for profit had more extensive COVID outbreaks and more deaths than non-profit ones.
The non-profit model is established in Canada. For example, in the 1990s, Quebec introduced universal child care as an innovative solution to: the inferior quality but high cost of private daycares; high staff turnover; and stagnant government funding. The policy was instrumental in getting a record number of women into the workforce, and the investment more than paid off in economic spinoffs.
According to Statistics Canada, 20 per cent more women worked in Quebec in 2016 than in 1996 when universal child care was introduced, resulting in more government revenue through provincial and federal taxes and fewer families reliant on social benefits.
Another social-economy model, that of care co-operatives, is thriving in British Columbia. The Victoria Health Co-operative is a community-owned enterprise that brings together health-care practitioners and member-owners. All health co-ops are non-profit; the goal is to cover costs, and surpluses are re-invested in the services offered to patients.
Examples of social innovation often fly under the radar.
In 2018, the federal government committed to enabling social innovation across the country. This was in response to 12 important recommendations from the Social Innovation and Social Finance Strategy Co-Creation Steering Group report, Inclusive Innovation: New Ideas and New Partnerships for Stronger Communities. The government subsequently promised a $50-million Investment Readiness Fund and a $755-million Social Finance Fund.
Thanks to the success of the Investment Readiness Program, there are now more non-profits and co-operatives ready to scale up and replicate innovative solutions in their own communities. The Social Finance Fund, which the government promised but has yet to roll out, could inject much-needed capital into converting for-profit ownership to non-profit or co-operative ownership.
In contemplating a post-COVID economic recovery, accelerating the Social Finance Fund would boost the care economy.
Establishing a national Social Innovation and Social Finance Strategy, as well as a Social Finance Fund, should be part of the solution to the care crisis. They would provide high-quality care and decent work for women, who make up most of the care workforce. They would also generate social and economic benefits in a low-carbon sector.
Andre Beaudry is the executive director of Co-operatives and Mutuals Canada.
Cathy Taylor is the executive director of the Ontario Nonprofit Network.
*The opinions expressed in blog posts are those of the author(s) and do not necessarily reflect the position of CCEDNet