'The gaps are huge': AUPE says continuing care is in crisis

AUPE VP, Sandra Azocar, speaks with Alberta Primetime host Michael Higgins about Alberta’s continuing care system.

This interview has been edited for clarity and length.

Michael Higgins: The provincial government is prepared to offer medical students and family medicine residents bursaries of up to $200,000. In return, new doctors must work in rural communities for three years after graduating. How far do you expect that to go to improving health care in rural Alberta?

Sandra Azocar: You have to admit that it's a good first step in terms of making sure that we have enough doctors that are willing to work and that are committed to work in rural Alberta, however, it's a long-term plan. A doctor doesn't just happen overnight.

What we're looking at is more of a bigger plan in terms of dealing with the chaos that is happening in rural Alberta. As a vice president, I get to travel all across the northwest and I see, all the time, the impacts that closures, supposedly temporary closures, of ERs are having on communities in northern Alberta, and it's not being addressed.

These temporary closures have been going on for a significant amount of time, some for years, and we're not getting the kind of response that we need from the government in terms of dealing with the short staffing, and in terms of hiring people to go work in these communities.

So the first step is a good one, but there's so much more that needs to be done.

MH: Let's say it is successful and it does put more doctors into rural areas. How much of a door might that open for others in the health sector, members of the AUPE, to step back and go ‘maybe a health career in rural Alberta is a viable option’ and then end up following the physician?

SA: Oh, for sure. Any time that you have centres that are actually open, and that provide services, that encourages health care workers to actually stay in their communities and to work there. But what we're seeing instead is actually a move away from that.

We have quite a few centres, for example the Beaverlodge hospital, being closed. What they're going to be doing is turning it into an advanced ambulatory care centre that will only be open 16 hours a day. And so instead of encouraging that multi-use of skills and the possibility of having hospitals do more things, they're closing them and turning everything in rural Alberta into these centres that provide very limited hours of care.

MH: AUPE, this week, is drawing attention to continuing care in our province and raising a red flag. You say it's in crisis. How so?

SA: It's an area that has been in crisis for a significant amount of time, we're talking decades, and now even more so as a result of the Continuing Care Act that was introduced last year, as well as the regulatory changes that were made in February of this year.

Those changes serve only to negatively impact the quality of care that seniors receive.

MH: What are the gaps?

SA: The gaps are huge. Instead of making sure that we have a legislated amount of hours of care, we have funded hours of care. So these for-profit facilities will receive a certain amount, depending on the size of their facility, the complexity of the care that people in their facility need, and the amount of people.

That's all hidden within the contract, so there is no public accountability as to how many hours of care people will be receiving, and that's that has been an issue for a long time.

We have been calling for a minimum of 4.5 hours of care and what we're seeing is the government going in a completely different direction where we will have no ability to determine if the money that's being allocated to these facilities is actually being used for that purpose.

When you have the profit motive included in those services, in this health care service, it always seems to be that our seniors are making the money for them as well as the workers that work in there. Short staffing is a huge issue in these facilities, and that impacts the quality of care.

MH: What kind of trajectory does that that set then? If you look down the road, Alberta's population is swelling. There are a lot of us who, a number of years down the road, that is going to be our reality.

SA: It's going to be a reality and it's going to be a reality that we will not be able to afford. Right now, if you're looking to put any of your loved ones, or if you're looking to go into these facilities, you're looking at anywhere between $3,000 to $10,000 a month just for accommodation charges. And again, these accommodation charges are now outside of the regulations, which means that there is no longer public accountability as to how much these accommodation charges can be increased. So there's all kinds of ramifications down the road.

The good thing about our health care system is that now we're able to keep people alive longer and healthy for a long time so when you actually need to access these facilities, it's because you actually need it for health care purposes. It's not a choice that you make just because you want to live with other people your age.

So what we're saying is that people are being robbed of the dignity that they deserve in their last few years of life by making profit the most important thing, rather than the care that people should be getting and deserve to be getting. And then that leaves our members in an incredibly hard situation. They want to provide the best quality of care, but the short staffing makes it impossible for them sometimes to be able to do that.

MH: There's talk of a looming nurses strike. Their union says the talks are faltering. I know AUPE is among the thousands of public sector workers looking for a new contract as well. What is it going to take for the Smith government to find stability?

SA: What it’s going to take is for them to actually respect and value the work that public sector workers actually do on behalf of Albertans each day.

The public sector is not a group of greedy, overpaid workers. We're so far behind the ball when it comes to inflation and cost of living and the lack of increases. We have members that are unfortunately having to have two or three jobs to make ends meet, we have members that actually use the food bank because they can't make ends meet.

So what this government needs to do is to recognize the value, first and foremost. They have to believe in public services to be able to make this right.