VANCOUVER -- As a care aide, she's charged with looking after grandparents, parents, aunts and uncles on a daily basis and now throughout a global pandemic.
The aide, who spoke to CTV News anonymously for fear she could lose her job for speaking out, said she's worked for the same private facility for nearly a decade. And during that time, she's seen colleagues leave, a change in contracts, and a dip in wages and benefits.
"Although we like to do this job," she told CTV News over the phone, "at the end of the day we are exhausted."
She said working conditions were good at the facility where she works when she started, but in 2015, the home's ownership changed hands and "after six months they contracted it out to another company."
The care aide said they offered to rehire staff, but only 20 per cent returned.
"I am one of them. The contracting company rehired whoever wanted to come back to work, and rehired for lower wages."
This business model in long-term care homes has been going on for more than a decade.
"In 2001 in British Columbia, our long-term care sector, all nursing homes, nursing sectors, were part of a standard collective agreement. They were all part of the same system," said Jennifer Whiteside, the Hospital Employees Union's secretary business manager.
But in 2002, Gordon Campbell's Liberal government passed Bill 29 in an attempt to lower costs. That was followed the next year by Bill 94, which brought public-private partnerships into the health sector.
The legislation effectively stripped care aides and other non-clinical employees of their protections under B.C.'s labour code and has been blamed for outsourcing work and mass layoffs.
Before the bills were passed, there were private for-profit and non-profit operators.
"But they didn't compete with each other in terms of trying to drive down labour costs in order to extract more profit," said Whiteside.
But after the bills were passed, she says, "We saw legislative changes, regulatory changes that allowed private operators really to develop business models that are not necessarily the best for providing the level of care that seniors need."
"I campaigned for 12 years against Bill 29," current Minister of Health Adrian Dix said.
"It's why we made steps immediately when I came to office to make changes."
The NDP repealed the two bills in 2018, "to get rid of those very pieces of legislation," said Dix, but there are lingering consequences.
Long-term care sector was "in crisis" before pandemic hit
"We were in a crisis in this sector before going into COVID," said Whiteside.
"Unfortunately we entered the pandemic not very well situated in our nursing home sector."
The HEU rep says the industry is fragmented and there are at least 100 different unionized contracts amongst B.C.'s care homes, and it's hard to keep staff.
Some are still part of the master collective agreement, including those operated by health authorities, which, for example, set the pay for care aides at $25.30 per hour.
But compared to the industry on the whole, there can be as much as a $7 difference between the health authorities' standard wage and what's paid in the private sector, Whiteside said.
The province's seniors advocate says the wages shouldn't be so dramatically varied.
"I don't think the care staff should be getting different wages not to degree what we're seeing. I just do not think that's appropriate," Isobel MacKenzie said.
MacKenzie said the pandemic has really been "an eye opener" for a lot of people and has revealed "fault lines or cracks" in the care system for seniors.
Some of those fault lines include the challenge to get hire and retain staff. The B.C. Care Providers Association has stressed that for years.
"What you've got right now is a health human resources crisis on top of a pandemic and another health crisis," said Daniel Fontaine, CEO of BCCPA.
"Simply paying more money is not going to solve the problem."
Fontaine said for years the association has been calling on the government to fund more spaces at post-secondary institutions for care aides.
"We've given a road map to government on things like training, making sure we have more care aides trained," he said.
And they're calling on the federal government to "step up to the plate and facilitate through immigration programs, the abilities for care aides who are trained here to live here and remain permanent residents," said Fontaine.
But the province's seniors advocate said the idea that wages are not the issue "sort of belies basic economics of demand and supply."
MacKenzie argued it's not just hourly wages but the salary that needs to change.
"We need to create jobs that will provide an annual income of $50-$60,000 a year."
In the first year after repealing bills 29 and 94, Dix said his government committed $47 million to additional staffing, and has hired 1,000 new care aides. "$45 million of it went to those homes, so those are significant steps to change the system," he said.
"It's kind of like a revolving door": Care aides leave for higher paying jobs
For the care aide who spoke with CTV about her experience, she said the reasons the industry is struggling are low wages and excessive workload.
She said every day, even during the global pandemic, there are vacant shifts, and her employer is always looking for someone to work overtime.
"It's kind of like a revolving door," she said.
If care aides are hired right out of college, she explained, they will come and work for maybe three months to get experience and then leave for a job at a publicly run care home.
Having new staff regularly starting at a care home is hard on the residents.
"That issue of continuity of care for seniors in long-term care is absolutely critical to the quality of care and the health and wellbeing of a senior," said Whiteside.
"Staff turnover and staffing issues more generally are a key predictor for outcomes for residents."
More on this series on CTV News at Six, Tuesday to Thursday.
