The year 2001 opened with a huge challenge—almost all of UNA’s Collective Agreements were up for re-negotiation in the first months of the year.
In December 2000, UNA sent formal Notice to Commence Collective Bargaining to the Employers of nurses in most of Alberta’s hospitals and community health settings, as well as to a number of nursing home Employers (The Community Continuing Care Employers’ Board of Alberta—CCEBA, Bethany Care—Cochrane, and the Good Samaritan Society). Notice to Bargain was also sent to the Alberta Cancer Board.
Prior to these formal notices sent, UNA organized a large delegate meeting to set the Union’s in-going demands. Through heated debate and a process of democratic voting, delegates put together a final Contract Demands package.
Expectations of UNA members were high. Alberta nurses were looking for significant contract improvements to help stem the critical shortage of nurses. Retention (keeping nurses in the profession) and recruitment (attracting additional nurses to the profession and to Alberta) became the focus for both the Employers and the Union.
At the very outset of negotiations, UNA knew that this round had to be different. UNA members were very vocal about not wanting to bargain in the media nor to be brought to the verge of a total shutdown of Alberta’s health care system by Employers who in the past had seemed more interested in preparing for a strike than in bargaining seriously and fairly to avoid one. In addition, UNA members were very clear that they wanted intense bargaining done within a tight framework, rather than one which stretched over months.
UNA reached a communications protocol with the Emplorers that prevented public/media discussion of negotiating proposals and progress. In the 1999 round of bargaining, the Employers had launched an aggressive media campaign with costly advertising using fear tactics regarding job action. UNA had strong interests in avoiding such “public bargaining” and in investing time and effort to secure agreements in a timely fashion.
UNA opened bargaining at a number of different tables in January. The main table represented hospital and community nurses; the long term care tables addressed the needs of nurses employed by CCEBA employers, by Bethany—Cochrane and by the Good Samaritan Society; and finally, there was a table bargaining for the nurses employed by the Alberta Cancer Board. One major aim was to keep the contracts at all tables on parity with each other and to achieve the greatest gains for all nurses represented at the different tables. UNA made it very clear that no table could conclude until acceptable agreements were reached at all tables.
Intensive, almost daily, negotiations for hospital and community followed—and after 12 days the parties asked that a mediator be brought into the process. Michael Necula—the same mediator who mediated in the 1999 provincial round of bargaining—began mediation talks on February 15.
UNA then applied for mediation at the long term care tables and the Cancer Board table. Michael Necula was named mediator.
UNA sent out a bargaining survey January 31 to determine once again the bargaining priorities of members. Reflecting the demands of 16,600 members, the survey focused on monetary provisions and priority areas such as benefits. The response rate was great and provided the UNA Negotiating Committees with solid statistics that the Employers could not ignore.
During the period of intensive bargaining, Premier Ralph Klein called a provincial election for March 12, 2001. This political climate did nothing but increase the potential for positive bargaining outcomes for nurses.
The mediator tabled his hospital and community reports, and his recommendations followed the Unions demands for major improvements for nurses.
Included in the improvements was a wage increase of at least 22% over two years; increased premiums; special leave days; professional development leave; increased benefits including vision care, drug care and dental care; 2% Employer-paid RRSP contributions; supplementary vacation leave; $100 reimbursement for professional license fees; zero tolerance of abuse signage; and many other increases. Community nurses finally won a re-evaluation of their previous experience for the purpose of determining proper placement on the salary scale.
March 2, 2001, the UNA Negotiating Committee called a Reporting Meeting in Calgary and delegates were clear that ratification of the facility and community agreements would only take place if the other tables were acceptably settled.
On March 7, the mediator tabled his reports for the long term care tables and recommended the same improvements as the facility and community tables and also recommended common contract expiry dates. The Alberta Cancer Board table reached agreement without a mediator’s recommendations.
On March 8, the UNA ratification votes for the new Collective Agreements won overwhelming support from UNA members with a 93% voter support and unanimous Local support. Nearly 20,000 nurses in 143 Locals were eligible to vote.
On March 18, 2001, the PHAA Employers announced their ratification of the facility and community agreements; on March 19, CCEBA, Bethany—Cochrane and the Good Samaritan Society Employers ratified the settlement. The Alberta Cancer Board also ratified.
The new Agreements gave most Alberta nurses the best contract terms in Canada and soon came to be known nationally as “the Alberta Rate”.
Following the successful completion of these tables, UNA opened bargaining at a number of other negotiating tables: Rivercrest Nursing Home, Salem Nursing Home, the Victorian Order of Nurses, Canadian Blood Services, Chantelle Management in Lethbridge, Central Park Lodge Bowcrest, Central Park Lodges in Calgary and Medicine Hat, Chantelle Management in Grande Prairie and six Extendicare Nursing Homes.
In April, 2001, Rivercrest nurses achieved and ratified a wage increase of 11% plus a guarantee that for every 64 hours worked they would be paid 69 hours of pay—an additional 8% wage increase. They also achieved two additional increment steps and a two year contract.
Spring 2001 was also the time for bargaining with the Victorian Order of Nurses. These nurses agreed to a one year term with a 7.5% wage increase.
On May 25, 2001, the contract for the Salem Nursing Home came into effect achieving hospital rates for these nurses as well as parity in the areas of overtime, charge pay, premiums and an additional 2% RRSP. This was a mediated settlement with Michael Necula as mediator.
Canadian Blood Services was the next contract to be re-negotiated. This agreement was also achieved with the help of Michael Necula as the mediator. The contract provided parity with hospital nurses in such areas as wages, premiums and benefits. New to this contract were educational allowances for nursing degrees and accrual of vacation for part-timers.
July 2001 was the time when Chantelle Management, Lethbridge began negotiations with UNA for a new contract which was ratified October 1. It provided hospital wages effective July 1, 2001, and increased benefits. It also provided for a re-calculation of recognition of previous experience for all employees on a one-for-one basis (long term care experience) and a three-for-one basis (other nursing experience).
Negotiations for the other two Central Park Lodges—Calgary and Medicine Hat were completed in September 2001 with the help of a mediator. They achieved a Long Term Disability Plan, hospital rates, higher premiums and professional development days.
Negotiations for Central Park Lodge—Bowcrest, were completed in October 2001 with basically the same settlement as the other Central Park Lodges.
Chantelle Management in Grande Prairie went into bargaining in the fall of 2001. The end result was big salary increases as their rates of pay went to hospital rates. Their premiums also increased as did their vacation entitlement. Overtime went to double time and they achieved one-for-one recognition of previous experience up to five years. All current employees then had their placement on the salary grid re-calculated to reflect one-for-one recognition
UNA members in six Extendicare Nursing Homes were also in bargaining. After a few rounds of negotiations, UNA applied for mediation. The Employers then offered parity with hospital contracts in areas such as wages, overtime, charge pay and responsibility pay as well as increases in pension benefits and weekend premiums. Negotiations were completed by November 3 and both parties then ratified the new contracts. UNA Extendicare Locals are in Lethbridge, Leduc, Fort McLeod, Mayerthorpe and Edmonton (Somerset and Hollyrood).
And finally, in November, UNA negotiators met with the PHAA to negotiate, as per a Letter of Understanding, new language identifying which courses are eligible for education allowances. Yet to be developed is language regarding which university degrees attract education allowances. The first part of this agreement (courses) will be sent out for UNA member ratification on January 16, 2002.
In 2001, UNA organized nurses in a number of new Locals and welcomed other non-unionized nurses into existing Locals.
Local #215, Extendicare, Viking, was organized in late 2001 and was included in the new Extendicare Collective Agreement.
Local #217, East Central Regional Health Authority Community, was organized and UNA thereafter signed a memorandum with their Employer that brought these community nurses all the provisions of the new provincial community Collective Agreement while keeping the Local’s previous superior provisions. Under this new contract, nurses will achieve salary increases of as much as 30%. This Local includes Camrose and Stettler and runs east to the Saskatchewan border.
Local #218, David Thompson Regional Health Authority Community, voted to join UNA in August. These nurses were not previously in a union and although their employer matched UNA wage rates, there were lower premiums in place, no supplementary RRSP provisions and no PRC or OH&S Committees. The members of this new Local voted overwhelmingly on December 19 to ratify their first UNA Collective Agreement, which closely follows the provincial community Collective Agreement. The hours of work provisions will come into full effect by the end of 2002.
Local #219, Shepherd’s Care Foundation in Edmonton, started life as a UNA Local with a hearing at the Labour Relations Board to challenge the Employer’s bad faith actions in the organizing process. Thereafter, this new Local exchanged bargaining proposals on December 20—-with the Employer tabling rollbacks. Bargaining is slated to conclude in early 2002 with the intent of achieving the general terms of the provincial hospital agreement with some Local conditions.
Local #196, Capital Care Community, welcomed about 50 nurses from Regional Continuing Care into the Local. These nurses should rightfully have been in UNA since regionalization but were wrongfully identified by the Employer as “management exempt”. A Letter of Understanding was signed in early October recognizing all their previous experience and their seniority from March 1, 1995. They also had some superior salary rates and previous scheduling plans red-circled. Negotiations took over two years to conclude—the longest process of UNA organizing in 25 years.
In 2001, UNA developed a comprehensive Organizing Manual which up-dates all of the legal and time-sensitive procedures outlined in the Labour Relations Code and interpreted by the Alberta Labour Realigns Board.
Grievances, Arbitrations, Mediations and Hearings
In 2001, not only was bargaining a major piece of work, but so too was the monitoring and application of each Collective Agreement managed by UNA. Locals and their Labour Relations Officers worked hard to offer support, advice and direct action regarding members’ contract rights.
UNA filed one thousand six hundred and eighty (1680) grievances in 2001, nine hundred and forty-one (941) of which were advanced to arbitration. The actual number of arbitrations heard was ten (10) with eight (8) arbitration awards received. UNA involved mediators in the resolution process twice.
In addition to direct grievance/arbitration work, UNA members continued to be represented by UNA at AARN and RPNAA hearings; at WCB appeals and at Short and Long Term Insurance appeals. UNA also represented nurses ready to return to work through the duty to accommodate process.
Prior to 2001, Employers required pregnant employees to begin their maternity leave when they had to leave work—normally four weeks prior to delivery. When January 1, 2001, brought changes to Employment Insurance benefits, extending them to 50 weeks, many nurses who had to leave work some time before delivery date, were not able to maximize their full 50 weeks after the birth. UNA had contested the Employer’s maternity leave policy through hundreds of grievances some as far back as 1991. Finally the PHAA agreed that pregnant women who have to leave work pre-delivery can access their sick leave or short-term disability insurance thus saving the full 50 weeks for post-delivery.
Long Term Care
St. Michael’s Health Centre, an auxiliary hospital in Lethbridge, announced that it would be cutting six full-time Registered Nurse positions and replacing them with LPN’s and a personal care assistant. These cuts were announced in the face of continuing issues of chronic understaffing and numerous complaints. Under the guise of the “assisted living” concept, Employers in long term care facilities are hoping to reduce the number of Registered Nurses and to replace them with lesser-skilled workers, leaving vulnerable residents to be cared for by fewer RN’s than the legislated minimum for nursing homes. St. Michael’s is a designated hospital under the Hospital’s Act, and as such, should have higher RN staffing levels than a nursing home.
UNA challenged the layoff, first by filing a grievance and then by writing a letter to the government’s ministry of Health and Wellness expressing concern over the cuts and asking the government to intervene to stop the cuts. Health and Wellness responded that staffing levels are the responsibility of facility administration.
The grievance going to arbitration asserts that St. Michael’s is not being fair and reasonable by violating legislated nurse staffing regulations. This arbitration is scheduled for February 2, 2002. In the meantime UNA went to court and applied for an injunction to stop all RN layoffs until the matter could be heard in February. At the court hearing, UNA lawyer, Sheila Greckol, made the case that residents would be put at increased risk as well as the RN’s remaining on staff at St. Michael’s being put at increased professional risk. On October 31, UNA won the court injunction and prevented St. Michael’s Health Centre from laying off the six RN’s.
Province Wide Grievances
UNA tried to resolve interpretive differences with the Employers over contract rights by filing grievances across the province.
• Retention and Recruitment Initiatives
Prior to 2001, different regional health authorities set up different retention and recruitment programs and incentives, most of which were not negotiated with UNA. During 2001 negotiations, UNA put the Employers on notice that all such initiatives that affect the terms and conditions of employment must be negotiated directly with UNA. UNA filed policy grievances with all those regional health authorities that have not negotiated retention and recruitment initiatives with UNA.
• Over Age 65
UNA challenged the health care employers’ policies that cut off an employee’s benefits at age 65. Over 140 grievances were filed with UNA taking the position that denying benefits to employees who were 65 and over was discriminatory. The Health Organizations Benefit Plan finally agreed to implement all benefits with the exception of Long Term Disability.
• 80% Direct Payment
UNA filed policy grievances on behalf of all Locals covered by the new contracts, which provided for 80% direct payment “for all physician or dentist prescribed medications”. Some Employers issued Blue Cross prepayment cards but most Employers decided to maintain the lists of prescriptions covered by their insurers rather than “for all physician or dentist prescribed medications”. These grievances will be heard in 2002.
• Reimbursement of $100
The new provincial Collective Agreements and many of the smaller contracts introduced the provision of a $100 Employer-paid reimbursement for professional fees. The Employers attempted to impose region-wide interpretations, which deny full reimbursement to some nurses. Again UNA has filed both policy, group and individual grievances on this matter which will be settled or arbitrated in 2002.
AARN Appeals and Charges
Local #115 at the Foothills Medical Centre filed an AARN complaint against a nursing manager for creating “an unsafe nursing practice environment” by implementing mandatory overtime post night shift. The manager’s position was that the Collective Agreement allowed for a maximum of 16 hour per day and that on several occasions she was justified in adding an extra four-hour shift onto the regular eight-hour night shift. This was only one of many extreme workload cases and UNA took the position that managers must be held accountable professionally. The outcome of this complaint was the Executive Director responded in a letter dated May 28, 2002 and advised that the Vice-Chair of the PCC has ordered that no further action be taken regarding this complaint.
Alberta Labour Relations Board
In May 2001, LPN’s and other hospital employees who belong to the Alberta Union of Provincial Employees held a brief strike. In response, the Alberta Labour Relations Board imposed a two-month dues cessation penalty. AUPE appealed this decision to the courts. UNA watched the case closely because a similar dues cessation policy could directly affect UNA in a provincial strike. UNA intervened at the LRB hearing opposing the LRB’s dues cessation policy.
In response to the LRB’s imposition of a two-month dues cessation on AUPE, UNA withdrew its representative from the LRB and adopted a policy of non-cooperation with the LRB saying that “it is regretful that the LRB has chosen to abandon its intended role of a collaborative remedial instrument in order to assume a role of advocate for the Employers and of a tool of the government”.
Workers’ Compensation Board
Injured workers “camped-out” in front of the WCB offices, and their actions combined with a large number of signatures on a petition forced the government to set up two committees to review WCB and WCB Appeals. The MLA Service Review looked at accountability, case management, medical panels, privatization and internal WCB appeals. The Appeals Review Committee examined issues of fairness, justice and process. New WCB legislation is scheduled to come forward in the Spring of 2002.
In September, 2001, a Minister’s Symposium on the WCB was held to allow stakeholder groups input into WCB reform. UNA attended and met with other stakeholders. The process included a proposal for a new authority to oversee WCB, which the stakeholders opposed. On the other hand, stakeholders supported independent Appeals Advisors; the separation of the Appeals Commission from the WCB portfolio; the publication of the Appeals Commission decisions; and a new Medical Panel model.
The WCB faced a deficit for 2001, and in October the Board of Directors decided to increase Employer premiums by an average of 27% and to raise the maximum insurable earnings for injured workers from $50,000 to $58,000 per year.
In 2001, 88 workshops were offered to 1848 participants.
The basic provincially-funded workshops included:
How to Run a Local
In addition, a new full-day workshop on Occupational Health and Safety was provincially-funded.
UNA also organized a series of contract interpretation workshops to introduce the details of the new Collective Agreements.
UNA also continued its program of providing educational sessions at each District Meeting.
Locals continued to organize and fund workshops on such topics as the Duty to Accommodate, Staff Abuse, the Health Information Act, Job Search and Computer education.
The provincial Staff Abuse Prevention and Management Initiative continued to meet as a coalition of unions, management and government representatives and continued to develop materials, including a video, on staff abuse.
In November 2000, the UNA Education Officer participated in the planning and implementation of the two-day educational component of the CFNU Biennium held in Edmonton in June 2001. UNA hosted and participated in this CFNU Biennium.
Research and Policy Development
On the research side, a number of projects were undertaken. One of the first projects of 2001 was to distribute, collect and analyze the Bargaining Survey. Done during negotiations for the 2001-03 contracts, it gave voice to the more than 16,000 members currently in active bargaining. Almost 9,000 surveys came back, re-affirming the wishes of the membership to the Negotiating Committee in many areas, including: salary, differentials and premiums, key staffing and workload issues, and the relative ranking and priority of a wide range of issues. Other surveys followed during the course of the year, including a Post-Bargaining survey of the Executive Board, Local executive and a random sampling of members, to determine the effectiveness of bargaining, and a survey of the Alberta CFNU delegates to determine the pluses and minuses of the Biennium.
Research was also compiled for a number of other interest areas. Research was done into the nature of Sick-Building Syndrome and Building-Related Illnesses for the backgrounder supporting the UNA policy regarding Sick Building Syndrome. Other research was compiled for educational presentations on Personal Directives and Enduring Power of Attorney, the potential impact on nurses of the Health Information Act, and OH&S documents on back pain and latex allergies. Material for the highly successful Resume Building and Interview Workshop was developed, with the workshop continuing to be booked into 2002.
A number of pension changes occurred in 2001.
The Local Authorities Pension Plan (LAPP) announced the lifting of restrictions on pensioners who choose to continue to work after retirement. Retiring pensioners must resign their positions (and lose their seniority) but may return to work to a new position the next day. Former requirements for a three-month break and a maximum of 84 days paid employment per year no longer apply. If pensioners return to work within 6 months they can port their vacation entitlement and their sick leave bank into their new job.
Nurses who have accounts with both the Local Authorities Pension Plan and the Public Service Pension Plan had until December 31, 2001, to consolidate their pension plans—usually into the most recent plan.
Occupational Health and Safety
2001 saw the rise of a number of occupational health and safety issues.
The dramatic increase in the overtime hours worked and in the use of mandatory overtime were major factors in the AARN developing a policy in July on nurses working extra hours. The AARN consulted UNA regarding their overtime policy. The AARN document recognized the hazard of using overtime hours to make up for low staffing levels: “The chronic use of extra hours to provide adequate nursing coverage is an inadequate and ultimately detrimental solution to a deepening shortage of qualified nursing professionals”.
The AARN made it very clear that when fatigue threatens a nurse’s fitness to practice safely, she has the right and duty to withdraw from or refuse requests or requirements to work extra hours. The policy also noted that nursing managers share in the responsibility for providing safe care and are “obliged to promote practice environments where fitness to practice and safe care can be maintained”.
The Canadian Institute of Health Information’s annual report noted that nurses have a high rate of injury, largely from lifting and moving patients. The report noted that “nurses are more likely to miss work because of illness or disability than workers in other sectors”. The report also noted that there were 7% fewer RN’s per person in Canada in 1999 than in 1994.
• Frustration and Dissatisfaction
A massive five-country study of 43,000 hospital nurses said that nurses are among the least satisfied workers and that most nurses in all countries share concerns about staff shortages and quality of care. While 16% of Canadian nurses reported wanting to leave their job, 30% of younger nurses were planning to leave the profession.
• Zero Tolerance
Many of UNA’s new Collective Agreements provide for zero tolerance of staff abuse signage to be publicly-displayed in the workplace. When the
Employers showed hesitation in putting up such signs, UNA produced its own signs and put them up in each worksite. Some Employers allowed the signs, others removed them. Almost all Employers promised action on signage and abuse policies and protocols.
• Healthy Workplaces
In September, Judith Shamian of the Office of Nursing Policy of Health Canada held a stakekholder consultation on nursing worksites. Entitled, Healthy Nurses/Healthy Workplaces, the resultant report highlighted the need for improved nursing workplaces. Quoting high rates of absenteeism and illness, the report called for the creation of a national network and working committee dedicated to the task of improving nursing workplaces.
• Nurse Abuse
The UNA Annual General Meeting included a panel presentation on nurse abuse. The panel included Detective Dean Vegso of the Calgary Police Service, lawyers Lyle Kanee and Shawn Beaver, and Carole Estabrooks, from the University of Alberta Faculty of Nursing. UNA delegates asked numerous questions and identified multiple abuse issues so much so that the session went overtime as members made it clear that abuse and violence are major stresses in their workplaces.
• Sick Building Syndrome
In response to some UNA Locals that were dealing with “sick buildings” including those with asbestos, toxic mould and other environmental hazards, the UNA Executive Board passed a policy regarding sick building syndrome. Inadequate ventilation and humidity problems are the major contributing factors. The World Health Organization estimates that 30% of new and recently-renovated buildings have SBS complaints.
Regional Health Authorities
A number of significant developments took place both within the RHA’s themselves and with forces that affect the RHA’s.
The provincial government announced that the election of two-thirds of the Regional Health Authority Boards would take place with the Municipal Election on October 15, 2001. There would be a total of 189 regional health authority members, 126 of whom would be elected and 63 appointed. Both elected and appointed members would serve for three years. Owners of businesses that contract with the Authorities would be eligible to run if the business does not make over half its money from the Authority. In 2001, directors made about $100,000 for serving on the regional board.
In preparation for the Fall elections, Health and Wellness announced changes to the boundaries of 10 of the province’s 17 Regional Health Authorities. As a result of boundary changes, Mannville Health Centre, Fox Creek Health Centre, Grimshaw/Berwyn District Hospital and Redwater Health Centre transferred to different Regional Health Authorities. This meant a change in the administration of these worksites as well as changes in union certification for the affected Locals.
• Nursing Shortage
Probably the biggest challenge in front of all health care Employers is the serious nursing shortage. It is far more than an Alberta or a Canadian problem. It is worldwide.
While the actual number of registered nurses working in Alberta increased slightly in 2000, the increase was well below the rise in Alberta’s population. The number of nurses per 100,000 of Albertans declined from 80.3 in 1994 to 73.6 in 2000. Statistics for 2001 will probably show a further decline.
In addition, Canada continued to experience a dramatic shift in the average age of its workforce. Alberta nurses’ average age is 47 years—higher than the national average of 43.4 years.
• Nursing Education
With increases in funding to the province’s nursing faculties, the number of RN’s being prepared for the profession is climbing. By 2002, 665 new graduates are expected. One important factor, however, shows that this number is not adequate. Half of Alberta’s 20,000 nurses will retire in the next ten years. That means that Alberta will need 1,000 RN’s per year just to keep levels at their current shortage condition—not a viable number. The Calgary Regional Authority released a five-year plan in which they identified their need over the next five years to include 5,000 new registered nurses. Retention and recruitment remained a huge issue for Regional Health Authorities and the Mental Health Board and the Alberta Cancer Board.
• Conflicts of Interest
In 2000, UNA submitted a detailed report on the potential for conflicts in the Calgary Regional Authority to the Auditor General. The report documented the fact that senior officials and CRHA staff were affiliated with health corporations that have contracts with the Calgary Region. Many questions have been asked regarding how the Authority can properly do business with its own senior employees and officials. The same concern was raised regarding physicians who are both employed by the Region and at the same time contract work privately with the Region.
The Auditor General urged the Health Authorities to include senior managers in their conflict of interest guidelines and called on the Authorities to ensure that conflict of issue problems be included in their annual reports to the government.
Health Care Reform
The year 2001 saw many changes implemented in the health care system and many more changes proposed. UNA was an active intervenor in many of the issues and remained watchful of many others.
• Health Care Reports
In April 2001, Roy Romanow, the former premier of Saskatchewan, was named by the federal government to head up a commission on “The Future of Health Care in Canada”. It was set up in two parts: the first to hear from health care stakeholders and providers, and the second to hear from all Canadians. Mr. Romanow has indicated that he will deliver an interim report in January 2002 after the first part is complete, and will then undertake public hearings, with a final report tabled in November 2002. UNA made a presentation to the Commission provincially and will be preparing responses to the Commission’s Interim Report.
The Romanow commission will be the first national inquiry into the state of health care since the National Forum on Health in 1994. It is also the first Royal Commission on health care since Justice Emmett Hall’s landmark study of 1964.
Mr. Romanow was invited to address the delegates to the CFNU Biennium in June and received a standing ovation when he said that medicare must be run in the public interest not in the interests of corporate profits. Romanow told delegates that he is eager to involve nurses directly in the Commission and invited submissions saying: “I call on all nursing professionals to help the Commission, and to help all Canadians, with these difficult issues and choices”.
Senator Michael Kirby headed up the Standing Senate Committee on Social Affairs, Science and Technology, which was to prepare a report on where it thinks medicare should go. Kirby is expected to release the fifth and final volume of his report in February 2002. Volume 4 provided a clear framework for the recommendations in Volume 5. The Report clearly stated that there is not enough money in the public treasury to cover the expanded health demands of Canadians. Therefore, the Canada Health Act should be amended to break the government’s monopoly over physician and hospital services. Volume 4 also suggested that the government should remove the ban on the sale of private insurance for medically-necessary services, and that user fees or financial penalties or a special income tax levy on the sick might also be possible solutions. Given the first four volumes, it is unlikely that the committee will recommend that Ottawa and the provinces expand the current medicare system.
Of particular note is the fact that Senator Kirby is well-connected to the private health sector, primarily through his role as an active director of the nursing home giant Extendicare Inc. He also sits of the boards of six other companies, including the Bank of Nova Scotia.
Don Mazankowski, former Deputy Prime Minister in the Mulroney government, was named by Premier Ralph Klein to chair the Premier’s Advisory Committee on Health. His interim reports bode badly for the final recommendations. Using carefully-crafted language, the interim report actually harkened back to old, discredited ideas strung together in such a way as to provide the rationale for the dismantling of the public health care system.
Medical savings accounts, the de-listing of insured services, increased premiums, user fees and private health care were all put forward as potential solutions to the basic assumption that Alberta can no longer afford to sustain the public health care system. This basic premise was not explained or supported or buttressed with hard evidence. Mazankowski’s final report is expected to be tabled in January 2002.
Again, as with Kirby, the question of conflict of interest pertains to Mazankowski who is a director of Great-West Life Assurance, a Winnipeg company that sells private insurance.
• Medicare Support
On the other side of the ledger, Ralph Nader, the well-known consumer advocate, addressed the CFNU’s national Executive Board in Ottawa saying: “The big US insurance and hospital companies would like to see Canadian Medicare go down, because as Canadian Medicare succeeds, it calls into question all the money these huge corporations make off the backs of both the sick and the healthy in the US”. Nader urged the CFNU to counter the corporate campaign of misinformation and self-interest.
The former premier of B.C., Dave Barrett, gave a rollicking and impassioned talk at the UNA Annual General Meeting. He urged members to get involved in politics and in international health care policy and social policy debates. Barrett is now the chair of the Tommy Douglas Research Institute, and has made strong public arguments for strengthening medicare. Barrett warned nurses and the Canadian public that corporate interests threaten the public health care system and action is needed from all Canadians to preserve, strengthen and expand the public system.
• International Trade
The privatization of Canada’s health care system is part of an international corporate agenda, commonly called “globalization”. The fight to preserve, strengthen and expand public health care is in direct opposition to the agenda of corporate health care, which visualizes a private international market with promises of huge profits. The international free trade agreements threaten, not only Canada’s ability to make its own choices about health care, but also the very legality and legitimacy of public health care. The World Trade Organization and General Agreement on Trades and Services are major players in this global corporate scheme. They could lock in privatization and make it extremely difficult for any country to protect and expand services such as Medicare. The WTO agenda is to break publicly-provided services in education and health care so that corporations can find new avenues of profit.
UNA invited researcher, public policy advisor and physician Allyson Pollock, from England where she heads up the Health Policy and Health Services Research Unit at the University College of London, to address the delegates at UNA’s Annual General Meeting. Pollock reiterated that high on the agenda of the WTO is the privatization of health, education, welfare, social housing and transport. She gave a detailed account of how privatization in the UK’s National Health Services pulls money out of beds, staffing and community care. More and more of the public money is going into the hands of private investors and corporations. The decision to use private financing has cost patients and staff dearly as the spiraling costs of private finance have to be taken out of patient services. Pollock said that in the UK the private use of finance has become a major political issue as schools, hospitals and transportation infrastructure are all mortgaged to the future. “It is bad management and it is bad politics” she commented.
UNA continued to research this international corporate agenda and to apply such knowledge to the Canadian and Alberta initiatives that flow from such globalization. The threat to Canada’s health care system comes not only from provincial premiers who want to privatize health care; and from federal politicians who have sold health care to corporate interests through free trade agreements; but also from the large and very active corporate players including pharmaceutical, insurance and service sectors who are lining up to capture chunks of the gross domestic product that governments currently spend on public services including health.
The Canadian Centre for Policy Alternatives report on Medicare warned that the expansion of Medicare to include pharmacare, home care, dental care etc. could be challenged under the General Agreement on Trade in Services (GATS). Canada may already have lost its capacity to expand the public health care system and further trade deals could damage capacity even further
• Health Care Funding
The Alberta government announced a $200 million “one-time only” funding allotment to the province’s Regional Health Authorities. The budget top-up was made because of population growth and an aging population. The theory was that the money would open 1,000 new beds and hire 1,000 new nurses. UNA criticized the string of extra “one-time only” announcements and called for stable and predictable health care funding.
The federal government announced a $54 million investment into Alberta’s primary care reform initiatives. The federal department said that this is the first investment of the $800 million Primary Care Transition Fund that was made part of the federal-provincial-territorial health accord. Health Canada said that primary care is meant to be the first step in the continuum of care, emphasizing health promotion and illness prevention.
CFNU members meeting in Victoria at the time of the Premiers’ Conference urged the full restoration of federal health care funds to the provinces but “with strings attached”—meaning health care dollars must go directly to health care and not to such provincial schemes as tax reduction. The CFNU also demanded that the power of federal funding must be used to stop the increasing privatization that provinces are implementing.
• Health Information Act
Bill 40, which became the Health Information Act, was strenuously opposed by UNA. The Union’s analysis identified major flaws in the legislation—flaws that leave Albertans concerned about the privacy of their personal health care information. UNA produced a special brief to the Minister of Health and Wellness, in which the Union stated: “The Regulations fail to provide any guidelines or safeguards that would relieve the concerns in relation to the Act about too great a scope for the collection, use and disclosure of personal health information”.
The HIA provides that a custodian (employer) must establish sanctions that may be imposed against affiliates (registered nurses are considered affiliates) who breach or attempt to breach the custodian’ administrative, technical and physical safeguards in respect of health information. The discipline under the separate legislation of HIA leaves nurses without the protection of the grievance-arbitration procedure.
UNA continued to monitor the application of the HIA and will work towards having it amended.
• Nursing Education
The Capital Health Authority in Edmonton announced a fast-track 14-month Registered Nurse program to accelerate the educational preparation of nurses. UNA expressed grave concerns about such a plan—the dilution of education leads to dilution of qualification levels. Further information from Capital Health indicated that the 14-month program would only be available to students who have already completed five or more pre-requisite courses and that the 14-month program is followed by an intensive 6-week clinical internship.
The UNA Executive Board is following up on this program to ensure that there is no reduction in nursing qualifications.
The Faculty of Nursing at the University of Alberta approved a new 12-month program for a BScN degree for RN diploma nurses. It will be implemented in the Fall of 2002.
• Private Hospitals
After stormy protest at its September meeting, the College of Physicians and Surgeons again considered expanding the list of services allowed in Bill 11 for private hospitals. College Registrar Larry Ohlhauser who said last year that hip surgeries were likely too risky to be performed in private hospitals, was faced with the fact that the College was voting on adding hip and joint replacement surgeries, as well as spinal surgeries, to the list allowed in “non-hospital surgical facilities”.
• Canadian Federation of Nurses’ Unions Biennium
The CFNU held its biennial meeting in Edmonton May 28-June1. The first two days were educational and the Education Officers of all the affiliates planned and presented a series of workshops ranging from Canada’s Health Care System to the Nursing Shortage to Retirement Planning. The final two days were spent attending to the business of the federation. It was the first national nurses’ union meeting in which the Ontario Nurses’ Association participated. ONA’s 40,000 members voted in 2001 to join the CFNU. Michelle Boisclair of the FIIQ (Quebec nurses’ union) announced that Quebec nurses are also considering affiliation.
The CFNU was a spirited and energizing event and the new UNA Collective Agreements—the “Alberta Rate”—was referred to frequently as the benchmark for Canada’s nurses.
UNA sent 37 delegates to the CFNU Biennium and all submitted positive evaluations.
One of the main initiatives of the Biennium was the establishment of a national plan to find solutions to the nursing shortage as well as to increase nurse involvement in the shaping of Canadian politics.
Pauline Worsfold, a UNA member from the University of Alberta Hospital and former UNA Executive Officer, was elected Secretary-Treasurer of the CFNU.
• International Council of Nurses
At the International Council of Nurses 20th Quadrennial Congress held in Copenhagen, as study was presented outlining the concerns of nurses in 101 countries across the world. The top 6 issues ranked from serious to very serious were understaffing, occupational health and safety, mandatory overtime, privatization of health care, use of casual staff and the use of unlicensed assistants.
• British Columbia and Nova Scotia
Some very sobering news hit national headlines in late April through to August. Both the BC Nurses’ Union and the Nova Scotia Nurses’ Union were in bargaining and both faced draconian action from their provincial governments. Both governments interfered with the process of collective bargaining by enacting emergency legislation to block free collective bargaining. In essence, both governments announced that the process of bargaining was over and the governments would impose settlements. Both nurses’ unions responded with defiant actions. The Nova Scotia and BC nurses engaged in work to rule, stopped working overtime, threatened mass layoffs and went on wildcat strikes to back their contract demands. Through a long and difficult summer the nurses in Nova Scotia forced the government to withdraw its announced imposition of a settlement and the premier reluctantly agreed to the nurses’ proposal for final offer selection interest arbitration. In August, an arbitrator chose the nurses’ proposal over the government’s proposal for settlement and awarded a 17% wage increase over three years.
The BC government ended free collective bargaining with a legislative stroke—a 60-day cooling off period and a ban on refusal to work overtime. At the end of this period, the government imposed a Collective Agreement on the BC Nurses’ Union. At the year’s end even more horrifying news—the BC government was threatening to withdraw their imposed wage settlement and impose an even lower rate.
Both the scenarios that played out in BC and in NS bode badly for the process of free collective bargaining not only in those provinces but also for all nurses and all trade unionists across Canada. Increased government interference and intervention reduces workers’ rights and unions’ credibility.
The Ontario Nurses’ Association reached a settlement with their Employers which provided Ontario nurses with an 11% wage increase over three years. The agreement also increased premiums and benefits in several areas. In 2002, the top Ontario rate will rise to a slightly higher rate than the “Alberta rate”.
• Alberta Election
The threat of increasing privatization including private hospitals, prompted UNA into taking campaign action during the provincial election. UNA encouraged members and other voters to send the government a message opposing privatization of health care.
UNA used newspaper and radio advertising to remind Albertans about Bill 11 and what it could mean to average families in need of health care.
• Election Project
UNA joined with the AARN and Alberta university schools of nursing in a project to provide Alberta’s 25,000 RN’s with responses from a survey of the political parties on important questions like the nursing shortage, the growing reality of private health care and the future of long term care.
The Action Kits were distributed to all UNA Locals and given to nurses so they could ask candidates tough questions.
• Nursing Week—May 7-13, 2001
In 1985, the Canadian government proclaimed the week of May 12 to be National Nursing Week as a time to recognize the contributions and achievements of nurses. May 12 was Florence Nightingale’s birthday and has been celebrated as International Nurses’ Day since it was declared by the International Council of Nurses in 1971.
Several UNA Locals held a number of highly successful events for National Nursing Week. Activities ranged from a display of staff pictures with old uniforms and caps, to a barbecue lunch, to a display of diplomas, grad pictures and grad books, to a contest to see who could match baby pictures with grad pictures. Nursing week both raises morale and increases the profile of nursing.
• September 11
The UNA Executive Board was in session on September 11 when news of the terrorist attacks on the US were first aired. The Board response was one of shock and fear and grief. The Board had a minute of silence and sent a message of support the nurses of New York expressing condolences to families affected and thanks to the nurses for their extraordinary efforts to provide solace and care. The UNA Executive Board voted to make an extraordinary donation of $10,000 to the American disaster relief effort.
• Bill C-36 Anti-Terrorism Legislation
UNA joined the growing number of Canadian unions and organizations expressing concerns about the scope of the proposed federal anti-terrorism legislation. “Nurses in Alberta were called terrorists for exercising our right to withdraw our services in 1988”, Heather Smith told a news conference on Parliament Hill in Ottawa in November. In particular, UNA was concerned that nurses on strike could be charged under the provisions of Bill C-36. “To include a peaceful strike, even it if is illegal, under the sweeping definition of terrorism, is an affront to logic and to nurses. Anne McLellan must amend her bill to make this distinction clear”, said Smith.
• Canadian Activist Award
The Council of Canadians presented both UNA and the Friends of Medicare with the Canadian Activist Award at the Council’s AGM in Red Deer in late October. Council of Canadian national chairperson, Maude Barlow, presented the award to Heather Smith representing UNA and to Christine Burdett, chairperson of the Friends of Medicare. The Council recognized the contributions both organizations made to the debate on Bill 11 and for their on-going work to protect Canada’s public health care system.
Annual General Meeting
UNA held its AGM in Edmonton on October 22-24, 2001. Over 500 nurses (delegates and observers) as well as numerous guests attended the 3-day meeting. The AGM was a full day longer than previous AGM’s and this made it possible to provide educational sessions. Guest speakers Dr. Allyson Pollack and Dave Barrett gave thought-provoking addresses on the state of public health care, and a six-person panel created a lively debate on nurse abuse. The position of 2nd Vice-President was the only contested position and Jane Sustrick was re-elected.
The question of whether or not to affiliate with the Alberta Federation of Labour and with Labour Councils was addressed and delegates approved that a full membership ratification vote take place.
The delegates also revised the discipline process in the Constitution and expanded the provincial Trial Committee to two representatives per each District.
And certainly not least, the delegates passed a detailed $12 million for 2002.
opposing privatization of health care.
What started as a small network in 1992 has grown to over 500 connected members, many of whom are using home computers. The tremendous growth that occurred in 2001 was due to web browser access and to ease of software installation for home users.
The UNA Net has proven to be an invaluable tool for staff, executives and members. The communication channels have definitely enhanced the work of the Union. The in-house communication network is more than a traditional e-mail system. It’s an on-line conference and collaboration centre that is open 7 days a week year round. On-line conferences include provincial news, contract issues, OH&S problems, professional responsibility issues, CFNU and counterpart information, education and research.
During the provincial election, UNA set up a special conference on UNA Net for political candidates to get messages and information to UNA members. All the parties were informed that they had access to post e-mail messages to the Election 2001 conference.
Once again, UNA took a lead role in media coverage commenting on the many developments in health care and in nursing.
In addition to putting out the regular UNA NewsBulletins and UNA Stat publications, the Communications Officer was also involved in a number of other projects.
• Friends of Medicare
UNA continued to take and active and high profile role in the on-going work of the Friends of Medicare.
• Membership Survey
UNA commissioned a telephone survey of members early in the summer to find out precisely how well the communications and education programs were working. The results, a statistically reliable report, showed a high level of satisfaction, identified where improvements were needed and provided some surprising information about UNA members.
One very surprising outcome was statistical data to show that if Albertans are some of the most internet connected people in the world, Alberta nurses are some of the most connected Albertans. Over 90% of UNA members have internet access.
The other pleasant surprise was the high level of recognition of and satisfaction with the NewsBulletin and UNA Stat.
UNA’s education program and workshops were also highly rated.
And the members expressed a strong endorsement of their Union taking public positions on Medicare and on health policy issues.
• Sheila Greckol
In November, UNA’s lawyer, Sheila Greckol, was appointed to Alberta’s Court of Queen’s Bench. Sheila has acted for UNA in landmark cases but is possibly best known for all her work during UNA strikes. A partner with Chivers, Greckol and Kanee, Sheila now leaves the practice of law to take up the challenge of the judiciary. UNA is ever grateful for Sheila’s hard work and guidance and extends best wishes in her new role as judge of Alberta’s Court of Queen’s Bench.
• Heather Smith and David Harrigan
On November 28, UNA was shocked with the news that Heather Smith and David Harrigan had been involved in an automobile collision enroute to Edmonton from a District meeting in Camrose. Both sustained serious injuries and were hospitalized. David was flown by air ambulance to the Royal Alexandra Hospital and Heather was taken by ground ambulance to the University of Alberta Hospital. David was initially listed as critical and underwent extensive emergency surgery. Both suffered multiple fractures.
UNA offices fielded calls from concerned members and colleagues in Alberta and from across Canada. By year’s end Heather was recuperating at home and David had been moved to the Glenrose Rehabilitation Hospital.
• Heather Molloy
UNA members were saddened to hear of the passing away of Heather Molloy on December 19. Heather had been a long-time Executive Board member and was provincial Secretary-Treasurer for a number of years. UNA extended its sympathy to Heather’s family.