What surprises me is that we don’t hear more outraged voices on this issue, considering the large number of people who stand to benefit from an expanded and improved childcare system. Pieta Woolley reminds us that:

Given that about 30.4 percent of British Columbians live in a household with kids 12 or under, the child-care issue theoretically affects more citizens than seniors’ issues (14.6 percent of B.C. is 65 or older), aboriginal issues (4.8 percent of the B.C. population is status), and public transit (4.7 percent take transit to work; all numbers according to the 2006 census).

UBC’s Paul Kershaw, assistant professor of political science, proposes an interesting theory as to why childcare is neglected in this year’s party platforms:

1. The costs scare politicians.
“By today’s standards,” he said, “it’s relatively expensive. And by that I mean we haven’t had to create a new social program in quite some time, as we did having to create health care and unemployment insurance and pensions. These are very expensive programs, but they’ve become normalized so we don’t view them as such. Health case is $15 billion, and childcare is $1.5 billion, so it’s no small chunk of change for any provincial budget. That’s one of the key reasons it’s a hot potato.”

2. Politicians won’t fund health promotion.
“We’re wonderful about treating illness after the fact. We will spend hundreds of thousands—if not millions—to save one preterm baby, but we are very uncomfortable about promoting housing for families with children that is affordable, or making the case that no one goes hungry in our province, or is homeless. Even when you get into the middle class, and childcare is largely a middle class issue, we don’t seem too concerned that we get these kids off to a good start in life. We let parents put together a patchwork of inadequate supports. We could really do so much to promote health if we go it right in the early years.”

3. Feminist arguments are considered fringy by politicians.
“No one wants to talk about gender inequality anymore….Even when both parents work full-time, women shoulder the responsible to shoulder childcare alternatives when regular care falls through, they stay home when the kids are sick. That’s just how houses are making decisions. Just 15 percent of people taking parental leave are men….Public policy seems content to say, women, figure it out yourselves….We are content to burn out women.”

4. The baby boomers are a “Canadian blight”.

“We are unwilling to ask tough questions about generational inequality….This is the generation that has their hands on the levers of power that’s tolerating 30 percent of our school-age population showing up vulnerable. These intergenerational justice questions are getting sidelined, because the dominant question seniors are wanting to ask is how much money is going to be there for me to get that next knee replacement. We need to make sure people are comfortable and cared for, but before we start debating whether people are eligible for three knee replacements, I think we really do want to think about what it means to promote health over the lifecourse and get that part right.”

I find the last point particularly interesting, as it starts raising questions about generational inequality. Can it be that politicians pay more attention to seniors because unlike children, seniors can vote? Consider also that seniors traditionally have high voter turnout rates, much higher than those of young people, the group that includes most parents of young children.

I hope I’m not being too cynical here. But it would be nice if the parties running for election would do something to dispel that cynicism. (if I may borrow from the conclusion of a recent Paul Krugman blog post)

For more excellent coverage on childcare in the election campaign, check out Ms Woolley’s articles Parties mum on time lines for child-care plans, Political parties ignore recent government-written plan for childcare and UBC prof gives four reasons BC isn’t delivering childcare.

As the baby boomer generation ages, the need to strengthen and expand the supports available to seniors in their homes becomes more pressing. In our province, the pressures created by the aging population have been compounded by sharp cuts in the numbers of acute care and long-term care beds over the last decade, which shifted the burden of care for the frail elderly onto community-based services and individual families. Without adequate funding to match the increased need, access to home support has been reduced for those with more moderate needs, compromising the preventative functions of home support.

A newly released CCPA paper, Towards an Enhanced and More Accessible Home Support System for BC’s Seniors, puts forward a concrete policy proposal for improving home support in our province.The paper identifies three major areas of concern in home support — recruitment and retention, the organization of home support delivery and the level of service hours provided — and proposes tackling those in tandem. Our recommendations are designed to supports service integration and continuity of care, and to take into account the important interconnections between the quality of service for clients and the working conditions of staff. As a result, our proposed reforms would have mutually reinforcing effects and would ultimately result in better quality care and more accessible care for those who need assistance to remain in their homes.

We cost out our recommendations and call for an immediate increase of the home support budget of health authorities by $100 million per year to implement them. This represents just over 0.7% of provincial health care spending for 2007/08 and is entirely affordable even during a recession. And if this seems like a big number to you, just remember that while enhancing home support costs more at the start, over the long term these reforms can reduce health care costs elsewhere in the system.

Fundamentally, providing an accessible home and community care system for our frail seniors is not only the morally right thing to do for our elders, it’s also the smart thing to do in terms of containing health care costs. Caring for seniors in the community is considerably cheaper than keeping them in hospitals (which is what happens when there is no available spot in residential care for seniors who can’t live independently).

An op-ed published in the Vancouver Sun on Thursday calls attention to the serious problems in seniors’ care in this province. The authors, Jeremy Tate and Marcy Cohen, who co-authored a recent CCPA study An Uncertain Future for Seniors: BC’s Restructuring of Home and Community Health Care, 2001-2008, blame “years of poorly planned restructuring and a failure to maintain (let alone enhance) access to key services” for the decline in seniors’ care. They call for “leadership and commitment to transparency, public consultation, good planning and increased access to seniors’ care.”

But do the party platforms promise to deliver any of these things?

There are certainly important differences in the two parties’ approach towards seniors’ care. The Liberal platform mentions seniors 23 times, but seldom in the context of health care. The closest they come to seniors’ care is promising to invest in housing, more specifically 1,000 new homes for “seniors and people with disabilities.” Their health budget, however, tells us not to expect any meaningful increases in care beyond current levels.

The NDP platform, in contrast, explicitly acknowledges that seniors’ health care needs are not currently met as well as they should be, pledging to improve seniors’ care by adding 3,000 new residential care beds, re-opening some 300 beds in closed facilities (like Cowichan Lodge) and establishing a Representative for Seniors to address their issues and recommend policy reforms. There have been questions, however, as to whether the amount of money allotted for the cause would be sufficient.

I fully support participatory democracy and am happy to see our government put money towards community engagement, but why only in “up to five communities across the province”? And perhaps more importantly, how are these communities going to be seleced?

On another note, the news release claims that:

This follows through on a key recommendation from the Premier’s Council on Aging and Seniors’ Issues, chaired by Dr. Patricia Baird, and is part of Seniors in British Columbia: A Healthy Living Framework, where government committed to explore innovative and sustainable models to provide non-medical home support services.

However, this is a rather broad interpretation of what “follow through” means. Dr. Baird’s report recommended that the BC government introduce “a new broader and more widely available home support system” across the province, which was estimated to cost around $120 million. It did not call for a community engagement exercise in a select few communities.

Although the news release mentions that the United Way of the Lower Mainland “will begin implementation of a new model in one community this year,” I can’t help but wonder whether, after the election, this Community Action for Seniors’ Independence project would sink into oblivion much like the feasibility study on all day kindergarten did.