The Ontario government promised Monday to establish a new standard that would see nursing home residents receive an average of four hours of direct care every day, but critics said the province wasn't moving fast enough to implement the measure.
Premier Doug Ford pledged to achieve the standard by 2024-2025 and said the province will need to hire "tens of thousands" more personal support workers, registered practical nurses and registered nurses to provide the care.
"This is a gold standard in the long-term care sector," Ford said. "And we won't settle for anything less."
A chorus of advocates and unions in the sector have called for a minimum four-hour standard of daily care for years.
Those calls have intensified since the start of the pandemic after more than 2,010 long-term care residents have died of COVID-19.
Ford said when the new standard is achieved, it will represent a major increase over the two hours and 45 minutes of direct care that is the current daily average received by residents.
He said additional details on the standard will be laid out in the provincial budget later this week, and a long-term care staffing plan will be released next month.
"We know such an important change will take time to recruit and train the necessary staff," Ford said. "But we start that work in earnest right now. It's long overdue."
The CEO of the Registered Nurses' Association of Ontario called the announcement an "empty election promise" because of its long implementation timeline.
Doris Grinspun said without a commitment to enshrine the standard in legislation and speed up hiring during the pandemic, the pledge rings hollow.
"How many more seniors will needlessly die and how many more staff will get sick?" she said. "They've lost plot. They lost a script. They're not even saying the right things anymore."
The secretary-treasurer of the Canadian Union of Public Employees' Ontario chapter said Ford's promise is good to hear but its implementation must be expedited.
Candace Rennick said the government must also fund hiring properly, with the union estimating it will take $320 million to fund the new standard.
"We need to see a financial commitment, targets, benchmarks and accountability and enforcement around those targets," she said.
NDP Leader Andrea Horwath said long-term care residents and their families cannot wait years for the new standard to implemented.
"If it's a priority, if it's something you really believe needs to happen, then it can happen, much, much quicker than four or five years down the road," she said. "There will be thousands of people in long-term care who won't see the quality of care they deserve."
The NDP have introduced four private members' bills, most recently last week, in a bid to secure a four-hour minimum standard of care in nursing homes.
Liberal Leader Steven Del Duca said if the government had the political will, it could make the standard a reality much faster.
"It's the right direction to move in at a high level, but it should be done quicker and decisively," he said. "Doug Ford has all of the power and resources available to make that happen."
Earlier this month, the province's Long-Term Care COVID-19 Commission said Ontario must spend more money, on a permanent basis, so the homes can hire more personal support workers and nurses.
The commission -- which is investigating how the novel coronavirus spread in the long-term care system -- also said the province should implement its own staffing plan that came out of an inquiry into a serial-killing nurse who preyed upon nursing-home residents.
The province released that staffing study in July in response to the inquiry about Elizabeth Wettlaufer, a long-term care nurse who used severe staffing shortages to her advantage. She killed eight residents over nine years with lethal injections of insulin, often while working alone on the night shift.
That study recommended a minimum of four hours of direct care per resident per day.
Meanwhile, Ontario reported 948 new cases of COVID-19 on Monday, and seven new deaths due to the virus.
The majority of the cases were in the hot spots of Toronto, Peel Region, York Region and Ottawa.
Ford said his cabinet would be considering a plan to loosen restrictions in hot spot areas during a meeting Monday afternoon. He did not share details on what will be considered.
"We'll see what they're recommending to open up safely," he said. "We have to create a happy balance."
A 28-day period of restrictions on Toronto, Peel Region and Ottawa is set to expire at the end of this week.
Ontario's associate medical officer of health was asked Monday if the province was considering a tiered COVID-19 restriction system, which would lay out criteria for when tighter measures should be imposed on regions, but she said work on the plan was still ongoing.
"I think we'll be looking at different strategies and stages," Dr. Barbara Yaffe.
This report by The Canadian Press was first published November 2, 2020.