Ontario Council of Hospital Unions-CUPE
261 Gerrard Street East
Toronto, ON M5A 2G1
Ontario Health Coalition
15 Gervais Drive, Suite 201
Toronto, ON M3C 1Y8
Advocacy Centre for the Elderly
2 Carlton Street, Suite 701
Toronto, ON M5B 1J3
Dear Mr. Hurley, Ms. Mehra and Mr. Webb:
RE: Request that the OHRC conduct an inquiry on systemic discrimination against the elderly in the provision of health care in Ontario
I am writing to response to your March 16, 2021, letter requesting that the Ontario Human Rights Commission (OHRC) undertake a section 31 public interest inquiry into systemic discrimination against the elderly in the provision of healthcare in Ontario.
The information in your letter about the history and consequences of de-hospitalization and the rationing of long-term care resources raises important human rights concerns about the adverse effects experienced by older persons in their interactions with the healthcare system, especially during the current COVID-19 pandemic. As you noted, the OHRC has previously reported on some of these same issues and the particular vulnerability of and barriers faced by older persons in the healthcare context, for example in our Policy on discrimination against older people because of age.
The OHRC will not be undertaking a section 31 public interest inquiry into this matter.
However, we recognize that there are significant and pressing concerns about systemic discrimination linked to healthcare, the operation of long-term care facilities and the availability of viable community alternatives to institutionalization. The OHRC is currently monitoring human rights issues in these areas.
As part of this work, the OHRC has written to the Long-Term Care COVID-19 Commission (LTC Commission) and is tracking its progress. As you know, the LTC Commission was launched to conduct an independent investigation in response to the disproportionate effects that COVID-19 has had on long-term care residents and staff.
The OHRC’s August 2020 letter to the LTC Commission Chair highlighted the experience of older persons in the healthcare system, as well as the intersectional factors that bear on this issue. In that letter, the OHRC encouraged the LTC Commission to place human rights principles at the centre of its review, stressed that the residents in Ontario’s long-term care facilities are particularly vulnerable to discrimination, including because of age, and urged the LTC Commission to consider the various human rights characteristics, discriminatory conditions and systemic structural forces that may underlie the issues within its mandate. We also emphasized the need to recognize how long-term care staff, especially personal support workers (PSWs) who are disproportionately racialized and/or newcomer women, experience intersectional discrimination and face compounding challenges and barriers to employment – issues which are now also the subject of a Human Rights Tribunal of Ontario application.
If you have not already done so, we urge you to provide the information in your letter to the LTC Commission to inform its final report and recommendations. Many of the issues you raise align with aspects of the LTC Commission’s mandate, which includes making findings and recommendations on the pre-COVID-19 state of the long-term care system and its relationship to other aspects of the health care system. Indeed, several of the LTC Commission’s interim recommendations highlight the need for better coordination between hospitals and long-term care facilities.
The OHRC has also identified discrimination against older persons as a key area of concern in our work relating to the COVID-19 pandemic. At the outset of the pandemic, the OHRC released a policy statement to guide all levels of government to adopt a human rights-based approach to managing policy, legal, regulatory, public health and emergency responses to COVID-19. Since then, the OHRC has been working to ensure that any COVID-19-related triage protocol is implemented in a way that does not discriminate against vulnerable groups, including older persons.
The OHRC appreciates the detailed and comprehensive information you provided about the history and context of Ontario’s health system structuring, current practices and policies, and the effects of this system on older persons. The OHRC also acknowledges the many first-hand accounts we have received from individuals, including family members of older persons in care, nurses and personal support workers. This information and the personal narratives will be an invaluable resource for the OHRC as we continue our work in these areas.
Ena Chadha, LL.B., LL.M.
cc: Hon. Associate Chief Justice Frank N. Marrocco, Chair of the Independent Long-Term Care COVID-19 Commission
Hon. Christine Elliott, Minister of Health
Hon. Merrilee Fullerton, Minister of Long-Term Care
Hon. Doug Downey, Attorney General