Health Care Reform
1995 was year three in the government’s four-year “restructuring” of health care. As in 1993 and 1994, “restructuring” meant cutting, downsizing, reducing and closing. In their haste to balance the budget, the Klein government continued to cut spending in health care—this year by $217 million. The results were privatization, layoffs and the substitution of unskilled workers in place of knowledgeable and highly-skilled health care providers.
UNA had accurately forecast that the real motive behind the “restructuring” has always been the government’s wish to replace a publicly-funded and publicly-administered health care plan with an American-style system wherein everything takes second place to profit. 1995 saw the expansion of private health care services in Alberta to the extent that the federal Minister of Health financially penalized Alberta stating that the facility fees charged by private health care services contravened the Canada Health Act. The Klein government maintained that this was not a contravention and refused to prohibit such facility fees.
In the workplace, UNA members continued to witness the deterioration of care—patients in some long term care facilities were rationed to 4 diapers in a 24-hour period; seniors in one hospital were allowed $1.78 per day in medications and no more; patients were discharged with chest drains, IV lines and catheters; seniors were gastric-tube fed rather than handfed because it was more cost efficient; and people lined up for a year-long wait for orthopedic surgery. The examples multiplied all through 1995.
In addition to watching the deterioration of patient care, UNA members also experienced a dramatic increase in their own stress levels as they bade farewell to laid off colleagues and then were expected to do “more with less”. Increased back injuries, sprains, stress illnesses and accidents were another clear indicator that Alberta’s health care facilities are more and more dangerous workplaces.
Patient-Focused Care programs continued to be implemented causing great upheaval in UNA worksites. A major issue for UNA members was the replacement of skilled professionals with unskilled and under-educated workers. Another major issue continued to be the RN’s or RPN’s responsibility and liability for the administration of medication done by lesser-skilled workers.
1995 saw not only the closure of hospital beds throughout the province, but the closure of whole hospitals and the conversion of full-care acute hospitals into community health care centres. The difference between these two is largely a function of diminished services, especially emergency services, in community health centres. Even many highway signs which once were a white H on a green background depicting a full-care hospital were replaced by a white cross on a brown background depicting a community health centre.
Regional Health Authorities
April 1, 1995, was the official date that the 17 Regional Health Authorities and the two Provincial Boards replaced over 200 Boards of Trustees. Only the private Boards of Trustees remained in existence. The Regional Health Authorities were all appointed and assumed responsibility April 1 for the administration of hospitals, health units and long term care facilities in each of their Regions. The Provincial Mental Health Board and the Provincial Cancer Board took over the administration of those services across the province.
The difficulty immediately facing the Regional Health Authorities and the Provincial Boards was the $217 million cut which also came into effect April 1, 1995. More layoffs, more bed closures, more reductions in services and longer waiting lists resulted.
For some UNA Locals the Regional Health Authority boundaries were particularly difficult to adjust to. Most of our health units were split into two or three Regions and became subjected to different policies, different management plans, different programs and different day-to-day problems.
The Labour Relation Board certificates which identify each of our UNA bargaining units were the focus of a great deal of negotiating because the names of the employers all had to be changed. This may sound like a simple enough issue, but it grew in complexity as we tried to maintain separate Locals at each facility when the proposed employer name was to be the same for all facilities in a single Region. This issue of certificates was not fully resolved in 1995 and would continue to be a focus of negotiations in 1996.
At the UNA Annual General Meeting, the delegates voted to change the boundaries of the five UNA Districts so that all Locals in a Region would be part of the same UNA District. Many Locals were moved from one District to another in order to provide all of our presidents in one Region with the opportunity to meet with the other Locals in that Region to strategize and coordinate activities.
Over the year, UNA bade farewell to our Locals in Willingdon and Elnora as those hospitals were closed and the nurses laid off or took voluntary severance.
During 1995, UNA continued the difficult task of negotiating for severance packages for senior workers choosing to resign in the face of layoffs and for more junior workers being laid off. We were successful in achieving severance packages in most regions but in the end were unable to secure the maximum we wanted nor were we able to negotiate the same deal in each Region. The result was a patchwork of severance arrangements most of which needed improvement. The issue of severance packages was taken up by our negotiating committees and would be negotiated at 1996 bargaining tables.
UNA successfully applied for certificates for our new Locals at the Viking General Hospital and the Edmonton Board of Health. We also signed a service contract with nurses working in the Peace River Health Unit.
One Nurses’ Union
Delegates to the 1993 and 1994 UNA Annual General Meetings directed the Executive Board to pursue the possibility of entering into talks with the Staff Nurses Associations of Alberta (SNAA) to determine whether or not it was possible for all Alberta nurses to belong to a single union. 1995 was a year filled with exploratory meetings and task-oriented committee work aimed at developing a working model for a single union. Members of UNA’s Executive Board met with SNAA representatives to map out a process for the development of one union by January 1997. In the Fall of 1995 it looked as if the process might be speeded up such that the new union could come into being in 1996. However, both organizations realized the original timeline was a wiser course to follow. Talks were scheduled to continue into 1996 with a report to be tabled to the 1996 Annual General Meeting.
1995 was not a “bargaining year” for UNA in that most of our Collective Agreements did not expire until March, 1996. In order to prepare for these expiry dates, UNA held a Demand-Setting Meeting on November 6 and 7, 1995. For the first time in UNA history, the hospital and health unit Locals were both present and developed a single demand package. In other years, the two groups have met separately and developed separate demand packages for bargaining. Both the hospital and health unit negotiating committees were present and received direction and in-put from the delegates. Again in an unprecedented move, only one delegate per Local represented each of our bargaining units at Demand-Setting rather than the larger delegate entitlement for the Annual General Meeting. 300 delegates, Board members, observers, staff and guests attended the Demand-Setting Meeting.
1996 would be a big bargaining year for UNA, but we began the process well with the strong voices of our membership directing the Negotiating Committees at the Demand-Setting Meeting. Bargaining would begin in January of 1996.
Grievances, Mediations, Arbitrations, Appeals and Hearings
1995 was a busy year as UNA members, Local Executives and UNA staff worked to monitor the application of Collective Agreements; attempted to mediate contract disputes; represented grievors at arbitration hearings; and provided assistance and representation at appeals and hearings.
UNA filed 673 grievances in 1995; scheduled 102 arbitrations; and represented grievors through 117 days of arbitration hearings.
In addition, UNA also provided representation to members at AARN hearings; at Workers’ Compensation Board appeals; at Unemployment Insurance Commission hearings; at pension appeals; and at meetings with insurance companies over short and long term disability denials of claim.
The issue of transfers were particularly important in Edmonton and Calgary as the new Regional Health Authorities transferred services from one location to another. UNA represented its membership at negotiations with both Region 4 (Calgary) and Region 10 (Edmonton) to ensure that the rights of our members were given full accord when transfers took place.
UNA continued its successful educational program of attaching an educational activity to UNA meetings. Workshops at District Meetings included political organizing techniques; labour relations aspects of illness issues; professional responsibility and patient advocacy; and regionalization and severance.
In addition to District workshops, UNA also provided instructors for workshops in local administration, professional responsibility, occupational health and safety, grievance and media. These workshops were held at the Local level and proved popular with the members.
In 1995 UNA provided 55 workshops to 1338 participants. UNA staff also continued to be asked to make presentations to outside groups on Patient-Focused Care and Total Quality Management programs.
In 1995, UNA provided relevant and pertinent information to its Locals and members through the production and distribution of the UNA Newsbulletin, UNA STAT, and Frontline. In addition, fact sheets and copies of important documents were sent to all Locals.
UNA also did an increasing amount of media work in order to raise the profile of health care, patient needs and nursing. Heather Smith very ably presented UNA’s position on vital issues to the people of Alberta and, on occasion, to all Canadians.
• The year 1995 was another year of political activity for UNA. We worked with other unions and community groups to oppose the Klein agenda in health care and in other sectors. We joined with the Friends of Medicare, with the Raging Grannies, with seniors’ groups, with the Official Opposition and with women’s groups to raise the voice of opposition to the government’s on-going slash and burn agenda.
• In May, we joined with the Health Sciences Association of Alberta and the Canadian Health Care Guild in a Walk-A-Block for health care action. On health care worksites around Alberta, workers and their friends and patients showed their support for Canada’s health care system and their opposition to the health care cuts and the privatization of our health care system.
• UNA presented briefs to the Health Workforce Rebalancing Committee on the questions surrounding the licensing of health care professionals. We also presented a brief to the Alberta Association of Registered Nurses opposing their proposal to implement a professional portfolio requirement for all registered nurses in order to maintain a license.
• UNA members in each of the Regional Health Authorities continued to work hard to implement the Health Workforce Adjustment programs which distributed monies to health care workers who were laid off as a result of the “restructuring”.
• UNA commissioned the Population Research Laboratory at the University of Alberta to ask nine questions during an annual survey of Albertans. The results validate what UNA has said all along—the majority of Albertans do not support the Klein government’s vision of health care reform. The survey showed that there was widespread concern among Albertans about the quality of health care and the treatment of health care workers. As expected, individuals who said they would vote Conservative if a provincial election were called, were the least likely to agree with the criticism but even among hardcore Conservative voters, around half agreed or strongly agreed with statements that were critical of government health care policies.
• UNA has continued to be active on the Nursing Workforce Planning Council trying to secure information from various sources on what is happening to the provincial nursing workforce. The Committee is identifying and tracking the number of unskilled, unregulated and unaccountable health care practitioners that are being introduced into the industry. As more and more professional jobs are lost and more and more lesser-skilled and unskilled workers are hired, the ability to get information about the profiles of the workforce becomes less and less reduced.
• In July, the Alberta Cabinet attempted to remove all legal obligation for hospital employers to have registered nurses and registered psychiatric nurses on the premises at all times. When UNA raised this change in legislation regulations, the government said that they had no intention of removing legal obligation and were only doing “housekeeping” changes. When confronted, they put the wording back to its original state.
• In November, hospital workers in Calgary forced the provincial government to blink in a political showdown over job security, contracting out and reductions to the health care budget. It began when 120 CUPE laundry workers walked off the job at the Calgary General Hospital. AUPE laundry workers at the Foothills Hospital joined the illegal strike. Their walkout sparked support from other hospital workers, many of whom joined the strike. An injunction was secured against picketing at or near Calgary hospitals and the response of many unionized workers was to join the picket lines. UNA members picketed outside and joined technicians and doctors inside in a work-to-rule action. Health care workers in Edmonton, Grande Prairie and Lethbridge also prepared to join the strike. By the fourth day of the strike, Klein did what it has refused to do since 1993—he blinked and blinked hard. He withdrew the planned health care cuts for 1996-97 and pressured the Regional Health Authorities to meet with the unions and settle the issues. The resulting settlement was a stay of execution for hospital workers who still face major cuts in the 1995-96 budget. The unions reluctantly accepted the inevitable—major health care unrest if job insecurity, privatizing and massive layoffs continue. A week after the Calgary settlement, health care workers in Lethbridge held a week-long strike over the same issues. The public backed the strike action in both Calgary and Lethbridge—and the Klein government knew that they had reached the end of their ability to cut into health care any farther.
• December 31, 1995 was the deadline for all Canadian provincial and federal governments and for all US state and federal governments to register their laws and regulations that they wanted exempted from the competition rules of the North American Free Trade Agreement (NAFTA). This was a one-time listing of exemptions that could not changed after December 31. By December 22 no Canadian government had registered a single statute or regulation. All provinces were relying on the federal government’s advice that the general exemptions in NAFTA were sufficient to protect our health care, education and social services. Many experts in the field of free trade disagreed and advocated that specific exemptions were required. UNA lobbied the federal government as part of a larger citizens’ lobby and won a three-month extension. This issue continues to be an important piece of political work for UNA.
Annual General Meeting
The 1995 UNA Annual General Meeting was held on November 8 and 9 in Edmonton and was attended by 400 delegates, Board members, staff and guests. The two days were tightly-packed to cover the long agenda but again the delegates dealt with matters efficiently and expeditiously. Policy resolutions and constitutional amendments were presented to the assembly and were voted on. Bev Dick was elected as the UNA Vice-President for a two-year term and great appreciation was shown to retiring Vice-President Sandie Rentz for her valuable contributions to the union.
UNA continued with its computerization plan to increase both the quantity and quality of communication. 25 Locals were added to the computer network in 1995, bringing the total number of computerized Locals to 89.
UNA also became the first, and to date the only, Canadian nurses’ union on the Internet. Our Internet address:
A Web Site was established to provide information to the public and links to other labour organizations around the world.
URL – http://www.una.ab.ca