Health Care Reform
Legislation on For-Profit Hospitals Stalls – Blue Ribbon Panel
Bill 37, the Act that the Alberta government was pushing to allow the Minister of Health and Wellness to approve private, for-profit hospitals, was still an issue in 1999. Following wide-spread public resistance in 1998 that stalled the legislation, the government tabled the Bill and appointed a “Blue Ribbon Panel” to review the legislation. The mandate of the Panel included the question of whether Bill 37 would protect Medicare.
The Panel came back with some critical suggestions, but generally agreeing with the legislation, and giving the government the go-ahead. As the citizen’s organization, the Friends of Medicare put it: “We are now faced with the successor to Bill 37, which will approve private, for-profit hospitals.” The very logic of the two-tiered system that will arise and evolve with private, for-profit hospitals demands that the public system be of poorer quality than the private system. Without this difference in quality people will have no motivation to pay extra for private treatment. And those offering private treatment will recognize this, and use political pressure to keep the climate necessary for the survival of their profits.
• Alberta Health Summit ‘99 Surprises Government with Solid Support for Public Health Care
The Alberta government went looking for public support and rationale for privatizing and moving to a two-tier health system with one of its “consultation” exercises, the Health Summit, held at the end of February, 1999. But the results of the summit showed solid support for Medicare and urged the government to bolster its commitment to improve the public health system.
UNA Executive Officers Heather Smith, President, Bev Dick, Vice-President and Pauline Worsfold, Transitional Officer, were among the 100 “stakeholders” invited, along with 100 “ordinary” Albertans, to form the summit.
Setting up the meeting, Premier Ralph Klein told the media that he was looking for an answer to “how much is enough?” about Alberta funding for health care. The summit could not put a dollar figure on it, but did say very clearly: “Government should ensure that there is sufficient funding available to support and sustain a comprehensive, publicly-funded health system. Funding for health should not be at the expense of other priority areas including education, social services, and intrastructure.”
Other conclusions of the Report included:
1. People know what they want from the health system
2. People want a comprehensive, publicly-funded, publicly-administered health system that is flexible and meets changing health needs
3. It is time for a clear plan for the future of Alberta’s health system
4. Government should work with health professionals and providers, Regional Health Authorities, and post-secondary institutions to develop sound workforce plans to ensure that there is an adequate supply of health professionals and to anticipate and prepare for future needs in the health system.
• Health Ministers Talk About Staff Shortages
Canada’s Health Ministers wound up their September 1999, Charlottetown meetings saying all the right things about the future of Canada’s health care system. Announcing the results and establishment of several task forces and committees, they also talked, in indirect ways, about the nursing shortage. In their closing statement the Ministers said:
“All Ministers recognize the importance of ensuring the availability of well-trained health professionals to Canadians, regardless of where they live in Canada. Ministers noted that meeting this challenge will involve action on a number of fronts, and that no single, simple measure will suffice in isolation. Simply producing more doctors will not, alone, ensure access. They underlined the importance of doctors, nurses, and other health professionals working in interdisciplinary teams, ideally under alternative delivery and payment models, to more effectively meet the needs of patients.”
These Ministers also called for the establishment of a Nursing Advisory Council to the Federal Minister of Health. The Health Ministers also released the second major study of the country’s health. The report noted that overall satisfaction of Canadians with our health system has been dropping in recent years. “The public’s assessment of the overall quality of the health-care system, although still largely favourable, has declined to some extent since the beginning of the decade.”
• Premier Promises Private Health Care
In November 1999, the Premier went on television promising to re-introduce legislation in the Spring Sitting of the Legislature 2000 — legislation that would absolutely allow for private, overnight “clinics” thus creating a private health care system. The UNA Executive Board, in its November meeting authorized a political action plan to challenge the Premier on this issue.
Regional Health Authorities
Early in 1999, the Premier fired the entire Regional Health Authority and some of the managers in Lakeland, Region 12 for running a deficit budget. He appointed an official administrator to assume fiscal responsibility and the entire Region lived through the rest of 1999 with few managers, few decision-makers and little leadership.
This fiasco in Region 12 was followed in April by the Premier firing John King, the Chair of the Calgary Regional Health Authority (Region 4) and appointing former Cabinet Minister and Minister of Finance, Jim Dinning to the chairmanship. At the same time the Chief Executive Officer, Paul Rushforth, was fired and replaced on an interim basis by Al Martin and then on a permanent basis by the former Deputy Minister of Health, Jack Davis. It was during these “shuffles” that Rod Love, former advisor to the Premier, was appointed to handle the Calgary Regional Health Authority’s public relations and communications. What is significant is that all these appointments were made from amongst the Premier’s closest associates. The promise to have elected independent Regional Health Authorities appeared to be very remote. In September Mr. Dinning announced that he could not balance the books and that Region 4 had a $52 million deficit.
Once again one of our UNA health units was “rearranged” bringing the Thorsby, Beaumont and Leduc offices of Local #90 out of Crossroads Regional Health Authority (Region 9) and into the Capital Health Authority (Region 10). The nurses in these three offices were moved not only into a new Region but also into a new Local — Local #196, Capital Health Community. This has been a source of endless stress and dislocation for these members.
The Capital Health Authority (Region 10) concluded an agreement with UNA as to how postings of new positions and hirings will be done within the Region. The first opportunity goes to the bargaining unit (Local) working for that specific employer; if no one applies the posting goes to all other bargaining units (Locals) working for that Employer; if there are still no successful applicants, the jobs can be posted in other facilities in the Region; and finally the jobs are posted externally.
Regional Health Authorities with deficits were promised a bail out by the Premier but warned that deficit budgeting was not to continue nor were budget over-runs.
In July 1999, UNA organized Local #210, Central Park Lodge Bow-Crest Care Centre in Calgary with 10 members.
On September 3, 1999, UNA Local #133 faced the unhappy fact that the Vilna Health Centre closed and thus the Local was closed as well.
In October 1999, UNA organized the nurses at the Good Samaritan Stony Plain Care Centre which became UNA Local #212 with nine members.
In December 1999, the nurses in the Community Health Nurses’ Association in Region 4 (Calgary area) voted to join UNA and will become UNA Local #211 on January 1, 2000 with over 650 members.
Preparations for the 1999 round of bargaining began with the election of a large Negotiating Committee representing hospital (16,000 nurses) including about 5,000 long term care nurses; community (1,350 nurses) and long term care (500 nurses) Locals. This Committee later formed subcommittees to deal with each of three sectors.
Preparations for the 1999 round of UNA negotiations continued in October of 1998 with the Demand Setting Meeting where the decision was made to
consolidate the hospital, community and long term care Locals whose contracts expired March 31, 1999. In addition, this round was to bring together hospital, community and long term care contracts such that UNA would achieve a provincial Collective Agreement for all those nurses to cover such major areas as scheduling, layoff and recall, wages and benefits. Nurses were determined to bargain together for the best deal for everyone. No one group would be left behind and UNA would have an Agreement for every group or no deal at all.
On January 21, 1999, UNA’s Negotiating Committee exchanged bargaining proposals with the hospital Employers and did the same on January 22 with the community Employers. The Provincial Health Authorities Association of Alberta (PHAA) represented both hospital and community Employers. Nine (9) long term care Employers formed an Employers’ Association called the Continuing Care Employers’ Bargaining Association (CCEBA). These long term care Employers consisted mainly of nursing homes and auxiliary hospitals formerly covered by the provincial facilities’ Collective Agreement. The action of setting up separate bargaining was a flagrant attempt to force major rollbacks on long term care nurses whose Employers deemed their work as less difficult and less important than work done in acute care facilities and in community nursing — even though more than five thousand (5,000) long term care nurses continue to work under the facilities’ contract.
If the long term care Employers were going to decline to negotiate at the main hospital table then UNA was not prepared to cooperate and bargain at a single long term care table. UNA refused to meet these nine (9) long term care Employers at a single table and insisted that they meet separately at nine (9) different tables — a position upheld by the Labour Relations Board after UNA filed a complaint.
UNA and CCEBA agreed to exchange proposals on February 25, 1999, at one (1) table and to set bargaining dates thereafter for each of the nine (9) separate tables.
At this point in bargaining, the UNA Negotiating Committee was at the hospital table, the community table and nine (9) long term care tables.
Bargaining at all eleven (11) tables was slow as the Employers refused to remove their proposed rollbacks (especially for community nurses) and gave clear indication that little money was available from PHAA or long term care coffers. The PHAA’s opening monetary offer on February 19, 1999, (hospital) and February 23, 1999, (community) was a three percent (3%) wage increase in the first year and a one and one-half percent (1-1/2%) increase in the second year of a two year contract. The long term care Employers tabled proposals to abolish, amongst other things, all recall rights and if the Union did not agree, all severance provisions would be eliminated.
Thus, all UNA bargaining began in difficult circumstances and the job ahead for the UNA Negotiating Committee was a huge challenge. The Employers seemed entrenched, willing to give little, and the UNA membership remained adamant that major gains had to be made in order to protect health care and at the same time to improve the health and safety of themselves and their worksites. It became clear that nurses across Alberta identified the shortage of nurses, the deterioration of health care and the recruitment and retention of nurses as critical bargaining issues.
UNA members at the 1999 Annual General Meeting, at the Demand Setting Meeting and through several surveys were insistent that bargaining be done as quickly as possible with none of the past’s eighteen (18) and twenty (20) month bargaining time frames. Membership pressure was put on the UNA Negotiating Committee to achieve a solid Memorandum of Settlement in the shortest period of time possible.
In addition, membership surveys showed that working conditions, especially the inordinate and unsafe use of mandatory overtime and the shortage of nurses had to be addressed and resolved at the bargaining tables.
An additional force was membership demands that UNA act strategically to keep all eleven (11) tables moving at the same speed and in the same direction in order to come as close as possible to a common provincial Collective Agreement. This was made much more difficult by the fact that UNA was attempting to combine not only its own historical contracts but also those of the former Staff Nurses Association of Alberta (SNAA) Locals, many of which were very different in form and content.
Bargaining continued with the Employers holding steadfast to their rollbacks and continuing to attempt to take the eleven (11) tables in different directions. Many different negotiating sessions took place between January and April with the feeling that little progress was being made.
In April, the PHAA applied for mediation to the Minister of Labour. UNA’s Negotiating Committee set April 29, 1999 as the date of a Reporting Meeting and sought membership direction from the delegates regarding UNA’s participation in mediation. The direction given was to participate in mediation only if all three sectors — hospital, community and long term care — were included and the appointed mediator was the same person for all tables.
PHAA agreed to a common table for the mediation of hospital and community contracts the day after UNA’s Reporting Meeting. The same mediator, Michael Necula, was appointed by the Minister of Labour for facilities and community. At this point UNA determined that it was now to UNA’s advantage to bring all nine (9) long term care tables together for common mediation. CCEBA agreed with the exception of Bethany Care, Cochrane who refused. Thus, by May UNA was involved in three (3) mediation processes — hospital and community combined; CCEBA; and Bethany Care, Cochrane with the same mediator in all three (3) mediations.
The mediator moved between UNA’s Negotiating Committee, PHAA, CCEBA and Bethany Care, Cochrane for what seemed for the membership to be an interminable period of time.
In addition to directing the Negotiating Committee to participate in joint mediation at all tables, the Reporting Meeting also mandated the Negotiating Committee to call a general membership vote with the ballot reading: “Do you accept the Employers’ last offer?” The date of such a vote was left to the discretion of the Negotiating Committee.
While the news media and a high-budget publicity campaign by the employer focused on money issues and salaries, UNA turned attention to lack of staffing issues with a proposal for the Employers to agree to hire “2,000 new nurses”.
During lengthly mediation sessions in the months of May and early June, the Employers offered minor financial improvements but left their proposed rollbacks on the tables. This Employer position remained firm and the UNA Negotiating Committee called for a membership vote to be held on Monday June 14, 1999. The Employers applied to the Alberta Labour Relations Board to have the vote declared illegal and the Labour Board ruled that such a vote was illegal and prohibited any vote to be held by UNA on June 14, 1999.
Meanwhile, UNA locals and the Provincial and Southern Alberta Regional offices were preparing for the possibility of a vote in defiance of the LRB ruling and for the possibility of illegal strike action. Local Information Meetings became a focal point of much discussion and debate. The UNA membership was not prepared to settle for less than would resolve their working conditions.
Late on Friday, June 11, 1999, word came from the UNA Negotiating Committee that the Employers had offered an improved salary grid, had removed all rollbacks and were verbally saying that they would accept the mediator’s frame-work for a settlement. This mediator’s proposed settlement included additional “market adjustment” salary improvements; an increase for on-call pay; restrictions on the amount of on-call work; a prohibition against the unreasonable use of mandatory overtime; a provision that all superior benefits would be retained by the affected Locals; and a removal of all rollbacks as well as many other improvements. It also included complete amnesty prohibiting the Employers from charging UNA for all strike preparation costs incurred by the Employer such as area evacuations, and providing protection for UNA against any third party civil action.
The Minister of Health and Wellness, Halvor Jonson wrote UNA a letter promising to hire one thousand (1,000) new health care workers but the PHAA negotiators refused to commit specifically to hiring more nurses, nor to hiring a specific number of RNs and RPNs within that 1,000.
On June 14, 1999, the mediator tabled his Mediator’s Reports for hospital and community and on June 16, 1999, he tabled his Mediator’s Reports for the CCEBA long term care table and for the Bethany Care, Cochrane.
The UNA Negotiating Committee examined the reports carefully and “reluctantly recommended” acceptance by the membership. On June 28, 1999, the membership voted to accept all the Mediator’s Reports as the basis for new Collective Agreements.
UNA had succeeded in keeping all three sectors — hospital, community and long term care — together and had moved much closer to a common provincial Collective Agreement. In addition to the highest nurses’ wage increases in Canada in 1999, UNA also had all superior benefits protected for affected Locals and achieved scheduling provisions for community nurses which provide protection and safe nursing practice, provisions which will take effect in the year 2000 for some and in 2001 for others. They had also achieved superior on-call provisions which would provide relief to the membership as well as a provision restraining the Employers’ use of mandatory overtime.
Hospital, community and long term care bargaining was over but UNA was also at other tables — Canadian Blood Services, Central Park Lodges, Chantelle, Extendicare and the Victorian Order of Nurses.
UNA was also contracted to do the bargaining for the Calgary Community Health Nurses Association which achieved much needed improvements for these nurses. This association has contracted for UNA to provide continuing labour relations services.
Grievances, Arbitrations, Mediations and Hearings
In 1999, UNA members and their Local Executives and Grievance Committees monitored the Employers’ application of all UNA’s Collective Agreements and grieved when necessary. Labour Relations staff offered support, advice and hard work to ensure that all UNA duespayers were accorded full contract rights.
UNA filed 616 grievances in 1999, 132 of which were advanced to arbitration. UNA received 20 arbitration awards in 1999.
In addition, UNA members were represented at AARN hearings; WCB appeals and Short and Long Term insurance appeals.
In 1999, 47 workshops were offered to 1379 participants.
The basic workshops on Local functioning, Grievance handling, Professional Responsibility Committees, Staffing Committees, Occupational Health & Safety Committees, Contract Interpretation and Ward/Office representatives were offered to the membership.
In addition, Locals organized workshops to meet their needs and worked with UNA’s Education Officer to provide workshops to members on Protection for Persons in Care; Freedom of Information and Protection of Privacy, Nurse Abuse and LPN Regulations.
In March 1999, UNA sponsored a two-day conference on the state of long term care nursing. Dr. Mary Harper from the United States provided an overview of the status of long term care in the US and set the scene for an examination of Canada’s services. It was a sobering and learning-filled two days which saw UNA provide in-put to Mr. Dave Broda, MLA for Redwater, who is chair of a committee investigating long term care in Alberta. The conference concluded with a strong message from Maude Barlow, chair of the Council of Canadians, on the urgency for Canadians to protect and expand our public health care system and specifically to expand coverage to and regulation for long term care.
In April 1999, UNA hired a new Communications Officer, Keith Wiley. Keith landed into the middle of tense negotiations and was able to join in UNA’smedia strategy to highlight nurses’ demands for improvements in working conditions. A plan to place UNA ads regarding nursing shortages in key newspapers was successful in answering the very extensive Employer ads which mainly focused on nurses’ demands for money.
UNA continued to keep in one-to-one communication with the members through the UNA Newsletter.
Breaking news was shared across the province via the computer UNA Stat vehicle as well as using UNA’s phone fanout system.
Negotiations was a critical time to maintain strong communication within UNA and this was achieved by providing a constantly updated 1-800 number for 24 hour access; by ensuring regular phone fanouts; by using the UNA Net; by providing up-dates in the Newsbulletin and in UNA Stats; and by holding Information Meetings across the province. Locals used their phone fanout system to contact members.
Member in-put to the Negotiating Committee was regular and critical in determining shifting priorities.
UNA maintained a high media profile throughout 1999.
Research and Policy Development
UNA created a new Research and Policy Development position and Melanie Chapman assumed these job duties in July, 1999.
This job will provide expanded research capacity to UNA as well as additional time to develop Professional Responsibility, Occupational Health and Safety and Staffing data bases.
This job will also encompass the political action component arising out of the research on health care and nursing issues. It will also provide additional information on labour relations issues such as de-mutualization of insurance companies — an issue which directly impacts on many UNA members.
United Nurses of Alberta continued to be in the forefront as an organization that makes very effective use of an integrated electronic communication system. The system proved its worth as an integral part of the negotiating process. The Negotiating Committee was able to access the UnaNet directly from the meeting room. Members were kept posted day and night as the process unfolded. The information provided by members on the system had a direct impact on the direction and outcome of the negotiating process.
In 1999, there were 360 users accessing UnaNet. Just over a hundred new user accounts were created since March 1, 1999. This number included members taking over Local Executive positions and UNA computers. Slightly more than half of the new users were connecting with their own computers. Interest in negotiations prompted general members to request direct access to UnaNet. UNA provided technical support for these members by telephone related to the use of FirstClass software.
• Network Infrastructure
A high-speed connection between the main office and the Southern Alberta
Regional Office provided faster access to e-mail and other critical information such as grievance and membership files. All users were able to track when all messages were read.
The network system of backups was upgraded and re-organized. All office systems (except the FirstClass server) were automatically backed up during the night.
The Internet provided fully integrated access to our internal e-mail system and the Internet e-mail system. Hardware and software upgrades done early in the year were fully implemented prior to negotiations. The upgrade provided access to more users during peak periods of negotiations.
Access to our internal e-mail system was given to members as requests were received. Members who have Internet accounts could easily be accommodated and be more involved in the day to day discussions.
The Internet is used more and more as the standard medium for information exchange. UNA Labour Relations staff started using Quicklaw regularly to research for grievances and arbitrations. Postal Codes, Health Care information, government information and news releases are all available through simple searches.
• Data bases
In 1999, UNA developed database tools for the Locals to use to manage membership information. The database could be run on either Windows or
Macintosh and allowed the Local membership secretary to submit their edits to the Provincial office electronically. The database also implemented a system of electronic submission of expense claim forms that was developed to facilitate centralized accounting.
• Computer Education
The Systems department worked hard to provide computer education in conjunction with the District meetings. These education blocks required many hours of preparation and organization. In 1999, over 30 members participated in the education sessions that were provided in conjunction with the District meetings. This resulted in more District reports being filed electronically and an overall improvement in general computer skills.
• UNA Net Administration
The Systems support staff attended the FirstClass Administrator course. This course enabled the Systems department to learn the intricate details of the new software and how the server interacts with the world wide web and the security features required to use these services.
• Local Visits
The Systems department visited over 75 Locals in 1999. Various needs were met such as upgrading, repair and training. These visits provided a one-to-one learning environment that addressed specific and relevant skills, as well as giving the opportunity to upgrade software and re-configure the systems.
• Document Standards
All Locals are now able to download and view PDF files. This established a consistent format for document posting across the province.
• At the November Executive Board Meeting, Florence Ross’ title was changed from Systems Coordinator to Director of Information Systems.
Short staffing, excessive use of mandatory overtime and a nursing shortage all combined in 1999 to cause severe deterioration in working conditions. These working conditions were the main focus in bargaining and continued through 1999 to raise serious patient/client/resident concerns.
UNA’s Professional Responsibility Committees and Staffing Committees worked hard to address these concerns but progress was slow as managers tried to deny or downplay the seriousness of the complaints.
The issues of recruitment and retention continued to be given insufficient attention by Employers and our Professional Responsibility Committees and Staffing Committees continued to raise specifics of these problems — too few nurses; inappropriate use of LPN’s; inappropriate use of casuals; failure to post permanent positions; excessive use of mandatory overtime; and long periods of on-call/call back duty.
In 1999, all community and facility Locals in provincial bargaining now have the right to form a Staffing Committee and a Professional Responsibility Committee.
Occupational Health & Safety
All of the worksite problems that give rise to unsafe patient care also create unsafe and unhealthy working conditions for nurses and other health care providers.
Rising stress levels primarily due to short-staffing and the excessive use of mandatory overtime have caused increases in sick leave usage, WCB injuries; Long and Short Term Disability claims and tired and demoralized nurses.
UNA’s Occupational Health & Safety Committees continue to raise these issues with management and although progress is never dramatic, stress reduction and healthy and safe worksites continue to be the goals.
Through 1999, talks continued on independence for nurses’ pension funds. At the end of 1999, LAPP self-administration seemed close.
The control and management of over 8 billion dollars was at stake in negotiations over the independence of the Local Authorities Pension Plan (LAPP), the pensions of almost all UNA nurses. For several years the LAPP has been moving toward independent control of the pension plans which had been under provincial government direction. Concluding the final deal on the independence of the LAPP, initially proposed for 1996, has taken longer than expected, however.
The Lapp Board presented the government with a plan for independence and requested special legislation for the LAPP self-government. Alberta Treasury, the legal sponsor and trustee of the LAPP, hired pension experts to assess the Board’s proposals. With the recommendations from the experts in hand, LAPP and Alberta Treasury representatives refined the independence proposals.
“The thrust of the benchmarks (recommendations from the experts) is to protect plan stakeholders by ensuring the governance arrangements can withstand any adverse scenarios that may arise over the life of the plan,” says a joint
communique issued in late 1999 by Provincial Treasurer Stockwell Day and Richard West, chair of the LAPP Board and a UNA Labour Relations Officer.
Independence of the Pension Fund from the government first came up nearly fifteen years ago when the province recognized that it didn’t have enough money in the fund to cover the pension commitments already made (an “unfunded liability”). The province had always guaranteed the pensions, so if the fund fell short, any additional financing would have had to be provided by the government.
The agreement with unions, employers and the government was that in return for independence, the LAPP added a special surcharge to pension contribution rates to cover the unfunded liability. By 1998 the plan was fully funded and the surcharge was discontinued.
“The employees and employers paid their share of the unfunded liability and now it is time for the province to complete the deal by passing control of the plan on to the employees and employers,” said UNA President, Heather Smith.
Nurses are a big stakeholder in the LAPP. They make up nearly one eighth of the employees it covers. Municipal employees in Edmonton, Calgary, and other cities, towns and counties, along with non-teaching staff at schools and many colleges are the other major employee groups. UNA has a position on the LAPP Board of Trustees and for the last four years, UNA Labour Relations Officer Richard West has been the UNA representative. He has been the Chairperson of the LAPP Board since 1998.
Nurses at the University of Alberta Hospital and Community Health and Homecare Nurses throughout the province have now been brought in to the same pension plan as other UNA members. The Provincial Cabinet approved Regulations on December 7, 1999 to facilitate the transfer of Regional Health Authority Employees that continued to be in the Public Service Pension Plan (PSPP) to the Local Authorities Pension Plan (LAPP).
The pension status of these nurses had been an issue since the creation of the Regional Health Authorities in 1995. The good news in 1999 was:
• Employees’ pensionable service will be transferred intact
• The pension benefits under each plan are the same
• Employees will not have to apply, the transfer is automatic on January 1, 2000
• And, employees’ pension contributions will drop slightly.
Local Authorities Pension Plan deductions for employees are 0.65% lower than PSPP deductions.
Members continued the buyback of service arrangements made under the PSPP.
The LAPP will now be the pension plan of all eligible employees of Regional Health Authorities. This makes pension benefits easily portable between different regions. A nurse can leave one region, commence with another and continue building her/his pension.
The Government has not dealt with the issue of those employees who contributed to the PSPP but are not currently part of the plan. These “deferred”
members have, for the moment, been left with the PSPP. The union and
employers continue to argue that this is a significant disadvantage for this group of employees and that they should be given the option of moving to the LAPP if they return to work for a Regional Health Authority. Discussions on this issue are ongoing.
• Federal Minister of Health and Wellness Visited Alberta
The Federal Minister of Health, Alan Rock, met with Alberta’s Health and Wellness Minister, Halvar Jonson, in Edmonton on February 23. While Allan Rock expressed “strong concerns” about private, for-profit hospitals, he stopped short of threatening to use federal enforcement powers to halt such a practice. He repeatedly referred to Halvar Jonson as his “friend and partner” signalling a new and rosy association between Ottawa and Alberta — a relationship formerly one of bitter rivalry and discord.
Pam Barrett, the Alberta NDP leader, said the federal Minister “is talking out of both sides of his mouth”. Instead of condemning for-profit hospitals he remains “deafeningly silent”.
• Alberta Medical Association Poll
An AMA poll was released February 23, 1999, stating that long hospital waits are “undermining the quality of patient life” in Alberta. 7,800 citizens
answered a province-wide survey. Dr. Rowland Nichol, AMA President, said “it is obvious that people are afraid, frustrated and don’t trust the system to be there for them.”
Alberta Health and Wellness responded calling the AMA survey results “the AMA annual horror story” and “irrational finger-pointing”.
• Friends of Medicare
On February 24, 1999, Friends of Medicare released its report on the state of Alberta Health Care to the media and to the public. Friends of Medicare felt that the Premier’s announcement last fall that the government would be convening a Health Care Summit to address growing public concerns around health care was a step forward until it became known that the Health Summit was to be made up of only a hand-picked group of government supporters with little or no true public in-put. So Friends of Medicare toured the province with their own inquiry and the results form the basis for their report.
Their recommendations included: that increased money be pumped into the system for more beds and more staff; that medicare be expanded to include home care and community-based services; that a Pharmacare plan be established; that the government abandon Bill 37 which would provide for private hospitals; and that more money be provided for community and home care programs.
• College of Physicians and Surgeons
The College of Physicians and Surgeons decided to go ahead and draft accreditation standards which would govern private, for-profit hospitals in Alberta — whether or not such standards would ever be used. The Health Resources Group which run the “non-hospital” vying for hospital status says that they do not care if Bill 37 ever passes into law as they could operate as a full acute private hospital with only the approval of the College of Physicians and Surgeons — and their accreditation standards.
UNA attended the meeting where the College decided to proceed with draft accreditation standards and later Bev Dick, UNA Vice-President, commented to the media saying that it was completely inappropriate for the College to be moving in this direction when the results of the Blue Ribbon Panel and the Health Summit are yet unknown. “By doing this the College gives the impression to Albertans that they support private, for-profit hospitals.”
On Friday, October 1, 1999, the College’s Council “postponed considering” regulations for private hospitals. “They did the right thing, because these are major political decisions that need a political forum”, said Heather Smith, UNA President.
The effect of the college’s decision was to delay the possibility of official approval of for-profit, private hospitals in Alberta.
Many UNA members contacted the College, the Premier and the Minister of Health and Wellness and the calls had an impact on stopping the first step of the government’s strategy to ease in private, for-profit hospitals.
However, the government announced it would be tabling a new and revised version of Bill 37.
• Long Term Care Conference
On March 5th and 6th, 1999, UNA sponsored a long term care conference to determine the actual state of long term care services in Alberta.
The two days provided much discussion and information sharing. A full report on this conference has been prepared by UNA and is available upon request.
• Newfoundland Nurses Strike for One Week but were Legislated Back
A tentative agreement was rejected by the Newfoundland and Labrador Nurses Union membership in December of 1998. The 4,600 nurses of Newfoundland and Labrador Nurses Union took a strike vote and results came back March 10. There was a 96.7% vote in favour of strike action with a high voting turnout of 91%. March 23 the nurses’ strike began. But just one week later, April 1, the Newfoundland government legislated the nurses back to work with an imposed settlement of 7%. That legislation also removed binding arbitration as a possible outcome for nurses, and prevented them from striking for two years.
UNA supported the nurses in Newfoundland and Labrador with financial contributions and messages of solidarity. UNA members began wearing white ribbons to show their solidarity with nurses across Canada who were striking for better patient care and better working conditions.
• UNA Supported SUN
The Saskatchewan Union of Nurses were fined $120,000 for defying a government and court imposed end to their 10-day strike in April. The court also awarded $30,000 in legal costs to SAHO, the Employers’ organization. The province’s hospital association had asked the union be fined $1 million. UNA contributed substantially to the Saskatchewan nurses during their strike.
SUN members went back to work after reaching an agreement with Saskatchewan Premier Roy Romanow and the government. But shortly afterwards SUN learned that SAHO wasn’t prepared to honour the deal. The nurses nearly went back out on strike when the agreement wasn’t upheld. In the final agreement of July 5, SUN received a 13.7 percent settlement of which 11.5 percent is a salary increase over the next three years. Saskatchewan nurses finally got the deal they thought they had when they ended their 10-day strike in April.
• International Day of Mourning
April 28 is the International Day of Mourning, a commemoration of dead and injured workers around the world. UNA joined the Alberta Federation of Labour and other labour organizations in a commemorative event and the UNA Executive Board encouraged all UNA Locals to become involved in this day of recognition, as we are reminded that all of our worksites can be hazardous places.
According to the International Confederation of Free Trade Unions, over 334,800 workers worldwide are killed each year and some 160 million workers contract occupational diseases because of unsafe working conditions.
1999’s theme for the International Day of Mourning was “The Plight of Women Workers”. On April 28, UNA encouraged all Locals to recognize the workers in their worksite who have been injured or killed.
• April 29, 1999 Rally
When 400 nurses convened in Edmonton on April 29, 1999, for a bargaining Reporting Meeting, they took advantage of their gathering and held a noon hour rally at the Legislature calling on the government to increase monies into health care and to address the nursing shortage in Alberta as well as UNA’s bargaining demands.
• International Nurses’ Day — May 12, 1999
Nurses’ Week — May 10-17, 1999
Nurses’ Day is celebrated around the world to express appreciation for the nurses who do the direct hands-on care in hospitals, in the community and in long-term care facilities.
Alberta’s nurses have worked very hard and made many personal sacrifices while trying to maintain the quality of care of their patients during recent years of health care cuts.
As we enter the new Millennium, nurses look hopefully for progress toward better conditions where they have the time and resources to provide the quality of care they want to be able to give.
This week in 1999, we recognized the great contribution to our health and well-being by Alberta’s professional nurses.
• Post-Card Campaign
UNA launched a post-card campaign directed towards the government to resuscitate health care and hire more RN’s and RPN’s.
• UNA Shared Solidarity with Quebec Colleagues
In late June, tens of millions of dollars in looming fines did not deter Quebec nurses (FIIQ) in their strike for better working conditions and salaries in that province. Quebec nurses are some of the lowest paid in Canada and the province has a significant problem with nurses “going south”.
Through Bill 72, Quebec nurses were legislated back to work shortly after initiating their strike, but defied the law and faced penalties including fines of millions of dollars for the union, and loss of seniority, and two hours of pay for each hour on strike, for individual nurses, and the cessation of union dues.
In a July vote on whether or not to continue the strike, over 20,000 nurses, 93% voted to keep walking. Friday, July 9 marked the two-week mark for what was to become a 23-day strike.
The Quebec government continued to refuse to negotiate with FIIQ, while they were on strike, but seemed to be running out of options as the nurses defied the government’s back to work legislation. Public support for the nurses remained high and a Parti Quebecois strategy to have members write and phone in a campaign against the nurses appeared to have backfired when it hit the media.
“This struggle we are pursuing is also a struggle to guarantee quality services for the people of Quebec in the years to come. The people of Quebec and our patients know that nurses are women with heart, they will discover that they are also women of courage,” Jennie Skene, FIIQ president said.
Quebec’s nurses, after over three weeks of strike action, voted resoundingly (75%) to reject a settlement that had been recommended by their Negotiating Committee and approved by a province-wide delegates’ meeting.
The rejection effectively kept the nurses on strike. The President of the Federation des Infirmieres et Infirmiers du Quebec (FIIQ), Jennie Skene suggested the nurses consider dropping the essential services they had been providing, and move to a complete strike position, or even a mass resignation.
Finally the FIIQ initiated mediation action and after 23 days of strike action, knowing that mediation on non-monetary items would begin August 25 and that their salary demands would be part of a large-scale provincial employee negotiations on salaries and benefits, the Quebec nurses reluctantly returned to work. By initiating mediation action, the Quebec nurses were in a legal strike position in November 1999.
UNA sent substantial financial aid provincially and many UNA Locals, Districts and individuals sent donations and letters of support to Quebec nurses.
UNA also sent flowers and a message to Quebec nurses:
“Solidarity is your strength.
We admire your courage and dedication to achieving a fair collective agreement that respects your true value.
At the 1999 UNA Annual General Meeting, Michele Boisclair, Vice-President of FIIQ, tearfully accepted a special UNA loan to FIIQ to cover operational expenses, and warmly thanked the delegates and membership for their solidarity and support.
UNA launched a button campaign For All of Us! to raise money from across Canada to support FIIQ.
Even as 1999 ended, the final resolution of the Quebec negotiations remained unknown.
• Canadian Labour Congress/Canadian Federation of Nurses’ Union
UNA delegates attended the Canadian Labour Congress triennial (in Toronto) and Canadian Federation of Nurses’ Union biennial (in Fredericton) national meetings and truly raised the profile of nursing amongst the trade union movement especially at the Canadian Labour Congress. At the Canadian Federation of Nurses’ Union, the UNA delegates met many other Canadian nurses and came to realize their common struggles. They also attended dynamic education activities.
• Pauline Worsfold Given National Nurses Award
UNA’s Transitional Officer, Pauline Worsfold, was presented with the highly respected Bread and Roses Award for her contribution to unionized nursing in Canada at the Canadian Federation of Nurses’ Unions Biennial Convention in Fredericton, New Brunswick in June. Tears flowed as a very surprised Pauline received the award, presented to her in part for her role in the SNAA/UNA amalgamation.
• Nursing Shortage
UNA called on the Alberta government to address the nursing shortage.
In 1999, Alberta needed between 1000 and 1500 registered nurses to fill the 1999 nursing shortage, according to Lorraine Way, President of the Alberta Association of Registered Nurses. That number will increase very soon as population in the province grows. All Canadian provinces are reporting a shortage of RNs/RPNs.
√ The average age of a registered nurse in Canada is 47.
√ The combination of population growth and an aging population means that Canada will need an additional 113,000 RNs in the year 2011 says a research study by the Canadian Nursing Association. The best Canadians can hope for will be a deficit of 59,000 RNs (if only population growth is accommodated); factoring in the aging population creates the worst case scenario:
113,000 fewer RNs than needed.
√ Canada is not the only country facing a serious nursing shortage. In the US, employers are offering signing bonuses and raising the hourly rate (some nurses earn $30 US per hour for day shifts and $36 US per hour for nights). Texas and California aren’t the only two states searching desperately for RNs — just over the Alberta border, Montana is offering $5,000 US signing bonuses with a starting rate of $20 per hour (US).
√ Many experts say that this shortage won’t be part of the usual cycle of nursing employment. The vast majority of today’s RNs will be retiring by 2011 — just as baby boomers start needing their nursing expertise. Nursing students graduating in 2001 and 2002 are in classes that have reached all-time low enrollments. Both women and men have more and better-paying job options these days — nursing has to compete with other professions (such as computer science and engineering) when it comes to remuneration and working conditions.
Starting November 15, 1999, UNA initiated a yearly “snapshot” of the reality of staffing in Alberta’s health care worksites. Rather than depending on government statistics, UNA will determine, Local by Local, the number of beds, the number of patients/clients/residents and the number of staff. Thus UNA will be able to track problems and growth in the health care system.
In September, 1999, 1,000 would-be Alberta nurses had their applications turned down by Alberta’s colleges and universities due to lack of available places in nursing programs.
• Doctor Shortage
In August the University of Alberta Medical School announced that Alberta could be facing a shortage of doctors in just a few years.
In 1998, there was one doctor for every 580 people in Alberta, compared to a national average of one for every 548 people.
By 2019, there will be one doctor for every 750 Albertans if nothing is done to address the shortage, said Dr. Lorne Tyrell, Dean at the University, who also heads the Association of Canadian Medical Colleges. He said the province’s medical schools have to start training more doctors now.
In September, 1999, Alberta Health and Wellness made good on its promise to provide UNA with numbers on how many nurses have been hired since its negotiation promise to add 1,000 new staff in the provincial health care system.
“We are pleased to have these reports,” said UNA President Heather Smith. “The Minister committed to increasing staff levels, and only by supplying us with the numbers can we tell if this promise is being kept.”
The reports, broken down by Health Regions that provided the numbers, show a total of 950 new Full-Time Equivalent (FTEs) positions created by June 30. That includes 464.3 FTE of new Registered Nurse positions”.
“What the numbers don’t indicate clearly,” said Heather Smith, “is the number of positions that have been eliminated or the number of vacancies that are out there unfilled. We are starting a province-wide process to check on staffing levels and problems. There are numbers in the report that may not reflect the real number of nurses now working.”
“The report shows some progress, but we know that the crisis is still very much here, we are still far short of the 2,000 new nurses we know are needed to alleviate the extreme workloads many nurses have to deal with,” Smith said. “Nurses are still running to try to keep up with the needs of the people they care for.”
Counting additional FTEs (Full Time Equivalents) can be a complicated exercise in a large facility where nurses change positions and units, and casual nurses work irregular schedules. Part-time, temporary and casual nurses make up far more of the nursing staff than regular full-time positions.
Annual General Meeting
Delegates from all UNA Locals had important decisions to make at the 1999 Annual General Meeting and began that process by holding Local meetings across the province deciding upon which Constitutional Amendments and which policy resolutions to support.
The debates at the AGM were long but after two days of deliberations the following decisions were made:
• to add a Second Vice-President to the Constitutional list of UNA
Executive Officers. Jane Sustrik was elected to fill this position. Bev Dick was acclaimed as First Vice-President
• to have Districts elect an interim District Representative if an elected District Representative is serving on the provincial Negotiating Committee
• to allow Locals the ability to establish a number for quorum at a Local meeting that is suitable for that Local and is greater than the current Constitutional minimum
• to direct UNA to engage in an active recruitment and retention program
In addition to passing Constitutional Amendment and Policy Resolutions, delegates also overwhelmingly endorsed a motion to make a special interest-free loan of $450,000 to the Quebec Nurses’ Federation, the FIIQ. Michele Boisclair, Vice-President of FIIQ, expressed a tearful and heart-felt thanks to UNA members for their show of solidarity.
UNA President, Heather Smith, announced a Canada-wide campaign “For All of Us” to raise money to support Quebec nurses. Buttons were distributed to all UNA Locals and then to all Canada’s nurses’ unions to sell to raise money for the operational expenses of the FIIQ.
At the 1999 UNA Annual General Meeting, five visitors from China attended the first day’s proceedings to see how an independent, women’s union practices democratic decision-making. These Chinese guests were participants in a month-long tour of Ontario and Alberta to identify how Canadian women have achieved equality in specific areas and where the struggle continues.