Learning from the pandemic? Planning for a long-term care labour force
In long-term care (LTC), labour shortages have reached crisis proportions. “In the first quarter of 2021, the health care and social assistance sector experienced a larger year-over-year increase in job vacancies than all other sectors” (Statistics Canada, 2021). Although intensified by the pandemic, the issues are not new in Canada or other high-income countries, as we and others, such as the Organisation for Economic Co-operation and Development (OECD) and the International Labour Organization (ILO) have been demonstrating for over a decade. Our research () that included Ontario, Nova Scotia, Sweden, and Norway shows that, while wages, benefits, job security, abuse, violence, high turnover, the low value placed on the work and reliance on a precarious, mainly female and often racialized immigrant labour force are common in all countries, there are significant differences among jurisdictions. COVID‑19 has prompted varied responses to the labour crisis, including special investigations producing a wealth of evidence. This evidence highlights the growing need for LTC planning as populations age and demands on those providing care change. Such reports and strategies offer an opportunity to learn from and with each other, as do the experiences of those involved in LTC. Planning is more urgent now as staff and management numbers fall with workers attracted to safer, more rewarding jobs. Our main objective is to identify major components of a labour force strategy that will ensure a healthy and competent LTC labour force for the future. For us, a labour force strategy must address conditions of work because they are conditions of care, going beyond wages, benefits, access to full-time employment, ongoing training and career opportunities, to include issues such as racism, harassment, autonomy and time to care, recognizing care is a relationship. Pre-pandemic research and commissions on the need for labour force strategies provide the background for investigating new issues and strategies emerging during COVID-19. Comparing two social democratic countries with two Canadian provinces will capture international issues and ways to address them while allowing us to explore specific conditions within each jurisdiction taking context into account. To reach this objective, we propose two primary methods. First, we will conduct a critical analysis of policy documents and research studies on labour force planning before and during COVID-19. Second, through key informant interviews we will investigate what governments, employers, workers, unions, families and residents have learned from the pandemic and how they plan to ensure an adequate labour force both now and in the future. The methods and analysis are guided by feminist political economy allowing us to link the global to the local and to identify forces at work while ensuring an intersectionality analysis. Employing these methods, our unique international, interdisciplinary research team has been studying LTC for over a decade, mentoring many students in the process. Our long-time and continuing partnership with unions, government and employer organizations provides access to key informants and grounded analysis. Our extensive experience sharing with governments and community organizations through multiple means will ensure evidence is accessible and useable in planning for care, as made visible by the many citations in government documents, public hearings, and the media, as well as in the academic literature. In addition to theoretical and empirical contributions, the research will provide evidence for essential policy development at international, national and local levels, research that is useful to governments, employers, unions and community groups.