Executive summary

The COVID-19 pandemic exposed and exacerbated the crisis in care that has been brewing in Canada for many years. After decades of underfunded care services, underpaid care workers, increased reliance on racialized migrant women to perform care work, and inaction on rectifying the heavy and unequal care workload, care systems in Canada broke down under the social and economic stresses of COVID-19, and communities were left stranded with completely inadequate services. Today’s increased attention by governments and the public at large on the importance of care to our society and economy presents a unique opportunity to rethink how paid and unpaid care work are valued and how care systems can be strengthened to ensure quality care to those who need it.

This report applies Oxfam’s Care Policy Scorecard Tool to provide a comprehensive assessment of the current state of care-related policies in Canada. For too long, women have disproportionately provided care – unpaid in the household and underpaid in the economy – holding back efforts to close the gender gap. This assessment takes a holistic and rights-based approach to care, which recognizes that women’s unpaid care work increases when basic care services are inadequate or unaffordable and care workers do not have access to dignified work. Therefore, the assessment not only considers health care and child care policy, but other areas such as employment protections, immigration policy, and infrastructure investments, as they influence who provides care, how it is delivered, and who has access to care services. As such, the report looks at 21 indicators across eight policy areas to assess whether the right policies are in place at the federal level to provide an enabling environment for the provision of a wide spectrum of care services to ensure care work and workers are valued and care responsibilities are more equally shared within households and between families and the state. Ultimately, the provision of affordable, accessible and quality care to those who need it requires a wholeof-government approach and this report provides an overview of what that would entail.

Overall, this report finds that existing federal care policies in Canada are strong in many areas. Recent federal investments in childcare, public transportation and long-term care are a step in the right direction to reduce and redistribute care work. These investments also provide models for how the federal government can take leadership and encourage provinces to invest in care.

However, the federal government still needs to address some of the major gaps in federal care related policy. For instance, failure to guarantee and provide access to clean drinking water on-reserve increases care work for women in many First Nations communities. Also, Canada has no federal initiatives to engage Canadians on shifting social norms around paid and unpaid care work, an important aspect to redistributing care work and ensuring care work is valued and adequately rewarded. As well, migrant workers in care sectors lack decent working conditions and labour rights protections, and in many cases cannot access care services themselves. Most importantly, much more progress is needed to ensure equitable access to care for marginalized groups, especially migrant, racialized and Indigenous peoples, and people with disabilities. Racism, ableism, sexism and other forms of systemic discrimination are embedded in Canada’s policy landscape but also in the ways care is delivered and accessed.

Supporting and redistributing unpaid care work will require investing in care-supporting infrastructure, ensuring equitable access to public care services, funding community-based options for care, enabling care-supporting workplaces and providing cash transfers to unpaid caregivers.

Based on the assessment, the following recommendations are made to build care enabling systems that provide more equitable and just access to care, reduce and redistribute women’s care responsibilities and reward care workers with decent working conditions and compensation:

1. Increase federal funding to expand non-profit and publicly managed early learning and child care, strengthen bilateral agreements with the provinces and territories and ensure accountability by the provinces and territories to meet the principles and targets set out in the federal framework, and develop a workforce strategy for child care workers that ensures adequate compensation and dignified working conditions.

2. Mandate provinces and territories to meet the new standards for long-term care, and support the development of public and community-based long-term care options.

3. Expand Canadian Medicare to include pharmacare, dentistry, vision, physical rehabilitation and mental health services, particularly for lowincome families and individuals.

4. Establish the Canada Disability Benefit to provide adequate levels of social protection and increase the child disability benefit to ensure all people with disabilities can access the care services they need, and ensure people with disabilities have community-based care options.

5. Raise parental benefit levels for the second caregiver to encourage further redistribution of care within households.

6. Establish a national food program in schools and provide cash transfers to all families experiencing food insecurity.

7. Increase investment in publicly constructed and operated public transportation services, especially in remote and rural communities, that take into account the particular needs of women.

8. Continue to invest in drinking water infrastructure in First Nations communities to end all drinking water advisories as soon as possible.

9. Ensure all Canadians have access to cellular and high-speed internet services, especially in rural and remote communities to enable access to a wider range of services.

10. Introduce policies that educate people about gender stereotypes and norms around care work. Currently, there are no national policies to fund education campaigns that pertain specifically to care work within Canada.

11. Develop a national strategy to recruit and retain care workers, considerate of global care chains, and ensure care workers are fairly compensated, have paid sick leave and enjoy dignified working conditions.

12. Immediately eliminate employerrestricted work visas for temporary foreign workers and provide all temporary foreign workers with permanent residency upon arrival.

13. Implement Employment Insurance reforms expanding access, particularly for precarious workers, and boosting the benefit rate, and implementing a permanent minimum weekly benefit.

14. Broaden access to the Canada Child Benefit for families with precarious status by repealing legislation tying eligibility to immigration status.

15. Ratify ILO Convention 189 on the rights of domestic workers.

While many of Canada’s care systems are delivered at the provincial or municipal levels, which are not assessed in this report, federal leadership is crucial to establishing national minimum standards, provide necessary investments and close policy gaps in federal jurisdiction. Beyond this report, it is hoped that the Care Policy Scorecard Tool can also be applied at the provincial and municipal levels to provide a more complete picture of the state of care policy in Canada.