Residents in long-term care facilities are some of the most vulnerable in our society. They are often very elderly, suffering from physical and mental disabilities, such as dementia or Alzheimer’s. What’s worse is that many are in complex, long term care facilities alone, with no family or friends near by. They are unwell, living in a place that they would never choose to be and they are very lonely.


Housekeeping staff are the unsung heroes in many facilities, whether it be acute or long-term care. They mop floors, clean bathrooms, change soiled bedding. They haul out the dirty laundry and bring in the clean. They sanitize and deodorize. Their work keeps diseases from spreading and saves lives.


While housekeeping staff are not directly responsible for patient care, they see patients for a minimum of 20 minutes a day. Their presence in the room often gives people who are lonely support. They also play an important role in handing patients blankets and out-of-reach items, opening drink containers, getting personal items, notifying a nurse of problems and conversing with patients. Sometimes patients have legitimate needs that have not been addressed, making the observation of the housekeeper particularly important to the patient’s well-being.


For these residents, the staff that they see each day become their family. Nursing staff, residential care aids and housekeeping staff are there, day in and day out. They see the residents, they know their personalities, they recognize changes in their health, both physical and mental.


Housekeeping staff frequently become close to patients/residents and their families and, as a result, experience a great deal of emotional stress through their job. They see pain, fear and suffering and are affected by the trauma of the patient and their families. In particular, staff endure the emotionally draining nature of working with people who have been abandoned by their families and friends, young people who are critically ill, all the patients/residents who die, sometimes while the cleaners are in the room, and the trauma of finding suicide victims.


Since interactions with patients are not a direct responsibility of the housekeeping staff, the time workers spend doing this type of work is “stolen” from their normal jobs and time becomes a difficult issue.


So how did we get here? In 1995 Cynthia Ramsay  produced a very simple study (Labour Costs in the Hospital Sector) that examined the wage rates paid to specific Hospital Employees’ Union jobs at Royal Columbian Hospital in New Westminster using negotiated collective agreement wage rates at April 1, 1995. She compared these to “similar” jobs and wage rates for Hotel Restaurant and Culinary Employees (Local 40) hotel workers outlined in that union’s Nov. 1, 1991 collective agreement. According to the comparison of jobs deemed to be equivalent to those in hotels, Ms. Ramsay concluded that if this hospital paid the same rates as those earned by unionized hotel workers it would save more than $2.6 million a year.


Let us remember that Ms. Ramsay produced this flimsy study for the Fraser Institute. The Fraser Institute is a British Columbia-based “think tank”.  Its reports and “studies” are often covered in the mainstream media as independent and objective. But the truth is that the Fraser Institute exists to promote rightwing ideology. It was created and is funded by big corporate interests who seek to change government policy to enrich themselves. The Fraser Institute’s research wing was created with money from tobacco companies and thus understandably was a leading opponent of anti-smoking laws, and promoted junk science that denied the harmful effects of second-hand smoke. The Fraser Institute is not a charity. It’s not an independent think tank. It’s a rightwing propaganda outfit propped up by billionaires and corporations.


In 2001, shortly after being elected, the Liberal Government, in part thanks to the Fraser Institute, tore up collective agreements of health care workers. They outsourced work to ‘for profit companies, who’s first priority is making profits for shareholders. Providing quality cleaning and quality jobs, always comes second, third or even 15th in the priority when the care provider is concerned about making profits, first and foremost.


For these huge profit driven corporations, the only way it seemed to maximize profits, was to have staff do more and earn less. It’s not complicated. For housekeeping staff, that meant cleaning more rooms, faster, less often perhaps and certainly with less help from coworkers, since staffing levels continued to be eroded in the chase for more and more profits.


The dramatic decrease in wages and benefits resulted in most housekeeping staff being forced to take on a second job in order to survive.  It is not uncommon to see staff working part-time at 2 or even 3 health care facilities. This has become an evident problem in the COVID-19 pandemic.  As the coronavirus morphed into a community-spread illness, the transmission of the virus through health care staff working in multiple sites is a reality that is now putting the most vulnerable in long term care into a life and death risk. For decades, health care workers were telling anyone who would listen, that cost cutting, low wage and profit driven health care providers have been putting people at risk. Finally, governments are paying attention to what health workers have always known. This could have been avoided if we had just listened to the front line workers all along.


For some, this may be too little too late. How can we estimate the harm, the suffering, the deaths caused by government policy in reducing the importance of these significant frontline workers?


It is now time, no more excuses, for government to fire all of the for-profit health care contractors, tear up their contracts and repatriate all health care workers back under the direct control of government and health authorities.


The COVID-19 pandemic has served a blunt and deadly message on all of society. We need to stop undervaluing front line health care workers.  Many lives depend on our lessons learned.


In the race to the bottom for care, cleanliness and costs, the ultimate losers are the residents and patients. Prior to 2001, housekeeping staff had the time in their day to provide excellent cleaning, but also had time to stop for a few moments and talk to the residents they encountered in their day. Many long-term care residents don’t have anyone in their lives. They don’t receive visitors, they don’t hear from family for months and months, if at all, and they are alone, frightened and sick. Housekeeping staff aren’t just cleaners, they are the smiling face that comes in their room each day. Time to say hello, to listen to a story, to laugh and joke and share a little of themselves is equally as important as the cleanliness of the facility.


For residents in long term care, the nurses, residential care aids and housekeeping staff are their family. They are the inner circle of each resident’s life. We have forgotten about the people in our race to maximize profits. It is time for all of us, to look at the role of health care workers in terms of how much time they have to interact with each resident, and not how fast can they get their work done. They aren’t just cleaners, they are family.


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