The Marxist-Leninist Daily

This summer, Alberta nurses have taken to the streets across the province to demand an end to health care cuts.
Left: Members of the United Nurses of Alberta and the Alberta Union of Public Employees rally outside the office of provincial Minister of Health and Wellness Ronald Liepert. Right: Nurses rally in Banff. (Photos: UNA)

Health Care Is a Right!

Across Alberta people are in action to oppose the stepped-up assault on the right to health care. In the face of growing wait times, shortages of acute and long term beds and staffing shortages, especially in nursing, the government has announced that close to $1 billion will be slashed from health care funding. This is the largest cut to a health care budget ever made anywhere in Canada.

In making these announcements, Alberta Health Services CEO Stephen Duckett dragged out the tired, old, and totally discredited mantra that current health spending is "not sustainable." Health care is a right! How dare the government claim that it has no responsibility to provide this right with a guarantee and that even the existing level of health care is contingent on the price of oil? The claim that anticipated reduced provincial government revenues from oil and gas justifies this broad attack shows that the government does not accept any responsibility whatsoever for the health and well-being of the people. What motivates the government is how best to serve the monopolies who put them in power and keep them there.

What is being fought out here is what portion of the added-value created by the workers is claimed by the workers either directly in wages and benefits or indirectly through social programs and what portion goes to the capitalists, including that portion funnelled through the state treasury and handed back to the monopolies. It is the hard work of the working class applied to the bounty of mother earth that is the source of all wealth. Added-value created by the working people is the only source of claims for workers, capital and governments. The monopolies are demanding a larger and larger share of the added-value, including through plunder of the state treasury. Funding is being withdrawn from public health care in order to hand the wealth created by the working people over to the rich.

Another aim is to satisfy the parasites who want to expand the health care "market" as a source of profits for themselves and a small section of society. To cover up their schemes, they yell and scream about "rising costs," claiming that private delivery will make health care "more efficient" and make "best use of resources."

Ed Stelmach, Health Minister Ron Liepert, Alberta Health Services CEO Stephen Duckett or any of the parties in power in Canada for that matter are not motivated by efficiency and best use of available resources. If this were the case, then they would be turning their guns on the profits of the pharmaceutical industry. They would ask how many billions of dollars have been handed over from the public treasury as profits to Microsoft, IBM and others in the huge electronic health records schemes. They would ask what the social cost has been as a result of turning cleaning services over to private monopolies who bear direct responsibility for vastly increased illness and death from hospital-acquired infections. They would be the ones pointing out that for-profit health care is not sustainable and using the U.S. example as their proof. Everyone knows that they will do no such thing.

Diversions

In the course of waging this battle, how to respond to diversions is an important question for health care activists. It goes without saying that the purpose of creating a diversion is to send people off course. In the case of health care, the aim of this focus on "unsustainable costs" is to divert from the main issue at hand, which is how to provide the right to health care with practical guarantees. The anti-social agenda, which has as its base the outlook that there is no society, only the market, denies that society has responsibility for the health and well-being of its members. Instead it demands that everyone fend for themselves. Those with wealth of course do not have to "fend" for themselves or anyone else. The pro-social agenda affirms the right of all members of the society to health care. This why it calls on Canadians to demand that governments stop paying the rich and increase funding for social programs and expand free, public, high-quality, comprehensive health care. Investing in health care will benefit the entire society and stimulate the economy. Slashing social programs in order to hand over billions from the public treasury not only deepens the crisis but is accompanied by anti-social state arrangements which increasingly deprive the people of any say whatsoever over the affairs which deeply affect their lives.

The forces trying to block society's progress and drag us backwards must not be permitted to succeed in making the "unsustainable costs" of health care the issue. When the rich and their governments talk about curbing "costs" to health care, they consider the health care providers and workers to be a "cost" which must be trimmed to the bone by cutting staff and attacking the living and working conditions of health care workers. By focussing on "trimming costs" they claim that they are not going to reduce services. Nothing could be more ridiculous or more treacherous.

Divide and Rule Tactics

During the assault on health care in the 1990s, all kinds of divide and rule tactics were used. For example, physicians at one hospital were incited to advocate closure of another. All kinds of diversions were raised about who was supposedly "more efficient" which strengthened the hand of those trying to drag society backwards. The Alberta government has now pulled out its old bag of tricks to try and set one collective against another. This is why it wants to encourage "suggestions" as well as why it has introduced the idea of "competition" between institutions. By making an announcement that it wanted fewer registered nurses (RNs) and more licensed practical nurses (LPNs) for example, the government is trying to incite the collectives of the LPNs to remain silent about the attacks on the nurses and to negate the stand that An Injury to One is an Injury to All! By trying to put the health care workers and professionals and health care activists on the defensive so that "efficiency" and "cost cutting" are accepted, then all the stops will be pulled out -- pitting the cities against the countryside, one group of workers or providers against another, and on and on.

By continuously claiming that public health care is inefficient and wasteful, the rich and their governments put pressure on health care staff and activists to become defenders of the status quo in violation of their own conscience. We fought the government tenaciously when it began to slash the length of hospital stays and send patients home long before they were ready. Many nurses and others objected that they were being forced to violate their own conscience and act against the best interests of the patients. Now it seems to go unchallenged that every reduction in the length of hospital stay is considered "progress," "positive," "good news" and so on. Why? Because that person is not in the hospital and not being cared for from funding of the public health care system. Similarly, the claim that wait list times have been reduced can be made if increasingly people do not even make it onto the list.

Once the right to health care is not the principle used to guide the fight against the wrecking of the health care system, then the movement becomes prey to the pressure to show how "efficient" the public system is, even at the cost of patient care. This is an affront on the very idea that people's health is the reason for providing health care. It is inhuman and fundamentally anti-social and a concession which the forces fighting for the right to free, comprehensive, highest quality health care which is there when we need it cannot accept.

The Need for Redress

The issue of the collective right of Canadians to health care when they need it is a question of providing redress when governments fail to fulfil their obligation to provide the resources which ensure that care is timely and available at the highest quality standards of living the society has given rise to. This is how an individual right is guaranteed. For years, governments have presented a Sophie's choice - either accept rationing and long wait lists as the price of maintaining a public system or permit those with wealth to buy their health care in the market, abandoning the most vulnerable. Such pathetic arguments are beyond contempt.

Why I Am A Worker Politician

I am a worker politician and a candidate for the Marxist-Leninist Party of Canada (MLPC) in Edmonton-Centre to unite the people to enforce a pro-social agenda the people themselves elaborate. Defending the right to health care means restricting monopoly right so that not a single penny of health care funding goes to line the pockets of the rich owners of private clinics, insurance companies, seniors' facilities and so on. It means taking up our social responsibility to organize an effective opposition and prepare to implement a program that guarantees the rights of all and provides a new direction to the economy to serve the people and nation.

As is the case in all fields of life, the vicious assault on health care shows the urgent the need for the people to establish Committees for Democratic Renewal so they become decision-makers. The establishment parties of the ruling elite are set on a path of wrecking and destruction of the social fabric of the society. They cannot solve a single problem facing the society because they are dead set against renewal and people's empowerment. When criminal acts are carried out against the people, such as the destruction of the public health system, it is simply not an option for the people to remain powerless. As workers we must empower ourselves and exercise our right to solve the economic, political and social problems facing the society. This is the crucial work to build Committees for Democratic Renewal where citizens and residents can themselves work out which programs serve their interests. These committees have as one of their crucial roles to oppose all the diversions which seek to paralyze the movement for change.

I am calling on everyone to join me in taking up the work for renewal, for a new direction to the economy and for a society which provides the rights of all with a guarantee. I can be contacted at (780) 484-2961 or at edmonton@mlpc.ca.

* Peggy Morton is the Marxist-Leninist candidate in Edmonton Centre. She is a former health care worker and former President of Local 2111, Canadian Union of Public Employees.

More than 500 People Attend Meeting
to Save Alberta Hospital Edmonton

More than 500 people filled the hall at a standing room-only rally organized on September 2, 2009, by the Alberta Union of Public Employees (AUPE) to oppose cutting acute care beds at Alberta Hospital Edmonton. Speakers explained that Alberta Hospital Edmonton (AHE) is a world-class mental health treatment facility in northeast Edmonton which serves people from all over Western and Northern Canada. Alberta Health Services (AHS) has announced that it will not proceed with the badly-needed redevelopment at AHE and will instead move patients "into the community." At least 150 beds are involved and as many as 300 or the 410 beds at AHE are threatened.

MC Mark Wells introduced speakers Doug Knight, AUPE President, Austin Mardon, mental health advocate, and Dr. Krista Leicht, a psychiatrist at Alberta Hospital Edmonton. Following their presentations everyone was invited to participate. Many people came forward to speak. They included people with mental health illness and their families, staff from Alberta Hospital, psychiatrists from all over Edmonton, representatives of other health care unions and many others. The entire meeting was marked by its enthusiasm and spirit as speaker after speaker was met with applause and cheers. The determination of all those present not to permit the government to commit this crime was palpable.

The speakers and participants expressed a very high level of concern about Alberta Health's sudden proposal, without consultation with anyone, to cut 150 beds and to place patients in so-called "community facilities" which many pointed out were essentially non-existent. The proposal was called "ludicrous," "tragic," and "irresponsible." Many people gave concrete examples of how Alberta Hospital and its staff provided essential services and critical assistance to their family members suffering from mental illness.

Alberta Health has stated that it will cut the beds first, then decide what will happen to the patients, while it claims that none of the patients will end up on the streets, and that patients would only be moved to appropriate accommodation. Speakers pointed out that even if this was true, it says nothing about those who will require the services of Alberta Hospital in the future, who would certainly end up on the street or even thrown in jail. This was the result of closing BC's Riverview Hospital, which was later acknowledged by the BC government as a "failed experiment." Already Alberta Hospital has a 20 day waiting period for beds and huge wait lists for specialized programs and the cuts will only exacerbate these problem.

Several speakers and participants clarified the issue of "community care," a longstanding excuse for government cutbacks to hospital health care. "Community care" may sound benevolent but such statements are just an attempt to cover up the reality. The fact is that there are reasons for having psychiatric hospitals staffed with professionals. The hospital is part of an integrated psychiatric system and cannot be "replaced" by community care. Already 99 percent of people being treated for mental illness are being treated in the community. The meeting was told that the staff of Alberta Hospital are unanimous about the importance of saving and expanding Alberta Hospital, as well as developing and expanding community facilities. At present not only it is difficult to access the hospital but it is also extremely difficult to find appropriate community facilities, staff, and programs. Often there is not a single empty mental health bed in all of Edmonton. Community care is not just an issue of finding a "place" but of being able to meet the complexities of living faced by people with mental illness.

Many speakers and participants pointed out that the issue was people whose lives are affected, not the "bottom line." In any case, the meeting quickly put to rest the lie that the cuts to Alberta Hospital Edmonton are necessary because of the economic recession. A psychiatrist from the hospital pointed out that there have been cutbacks to mental health care even during the so-called "boom" times. The number of Alberta's mental health beds is only half the national average. There have also been cuts to other aspects of healthcare and to social organizations in general.

Several participants suggested that the attack on Alberta Hospital may be related to a government grab for the real estate. Alberta Hospital Edmonton occupies quite a large site adjacent to the new Anthony Henday ring road and is no doubt in the sights of big land speculators and developers.

One speaker congratulated everyone who spoke in the face of the so-called "Code of Conduct" that the Alberta Government has forced on health care workers. Under the Code, which is a McCarthyite attack on people's right to conscience, employees of Alberta Hospital could be censured for speaking out about the cuts. In the face of this, a number of employees gave their names, expressed their opinions and defied the government to try to muzzle them. It was pointed out that those who are speaking are not just speaking for themselves but for thousands of others. Those present made it clear that they will defend and protect any health care worker or professional who is censured by the government for speaking out or participating in the Save Alberta Hospital campaign.

Speaker after speaker provided information and insight into what was taking place and what needs to be done. One participant reminded everyone that a society must be judged by how it treats its most vulnerable and that by this measure the Alberta government was a failure. Another suggested that the treatment of the mentally ill in Alberta raised questions as to in what direction the government was steering the society. Another stated that the Alberta Government was disenfranchising and isolating the mentally ill and reminded everyone of how certain societies in the past such as Nazi Germany simply treated the mentally ill as non-persons. Another speaker affirmed that health care is a right and must be provided with a guarantee, including redress against those who try to block that implementation of that right. And as one person put it -- this is not just "your" fight -- this is our fight as a community.

Hundreds of people filled out sign-up sheets to participate in future actions to Save Alberta Hospital. Friends of Medicare is organizing a rally on September 25 at noon at Ed Stelmach's Constituency Office, 9925 104 Street, Ft. Saskatchewan.

Letter to the Editor

On August 26 the Alberta Health Services Board, the superboard which runs all health care in Alberta, announced the "second stage of deficit elimination." According to this statement, the superboard "entered the 2009/2010 budget year last April with a projected budget of $10.9 billion and a deficit of $1.3 billion. The announcement stated that "during the first phase of cost reduction, $650 million in potential annualized cost savings were identified. These are underway or can be implemented over the next two months."

"In the second phase, AHS will consult with staff over the next two months to identify a further three percent in annualized cost savings. Decision-making will take place in November and December this year, for implementation beginning in January 2010. This will lead to about $315 million in annualized savings.

In total $965 million is being cut from the budget. This does not include an additional 3 percent from contracted services - both to non-profit, voluntary providers and for profit private facilities. The cut to Alberta Health Services direct spending announced by CEO Duckett is approximately 11 percent of the total budget.

To put this in context, the biggest single year reduction in Alberta in the 1990s was 7.7 percent in 1994. Alberta's cuts were the deepest ever in any province. Duckett's 11 percent in cuts are starting later this year but the great bulk of them are planned for next year, 2010-11. All on the word of an unelected administrator, without even a token public planning process or discussion; and we have no way of knowing if this is all or if there's more to come.

Stephen Duckett says the whole $965 million (11 percent) will come out of administration and "efficiencies" like bulk purchasing. There will be no impact on patient care -- in fact, he's going to cut the average wait time in Emergency by half. This is propaganda on a grand scale. First of all, recall that the old regions publicly reported their total administration spending, and they were all around 2-3 percent. So a claim that 11 percent can come out of "administration" is nonsense. Sure, bulk purchasing may save a few million here and there -- but almost the entire old system was already buying at least non-clinical supplies together. The crucial thing is that 70 percent of the system's costs are people; perhaps 3 percent of all compensation is for people in "administration." Say Duckett lays off all the Human Resources, Finance, Information Systems people, etc. He still has to find 7 or 8 percent out of the remaining 25 or 28 percent of the budget which includes all the equipment and supplies. So he's going to cut about a quarter of everything that the health system buys? It's a ridiculous claim. And as for the claim about reducing emergency waits by half, that's 100 percent propaganda, nothing but a few words tossed out there to distract people with false hopes. How's he going to do it? Who's planning it? He has no idea; it's just a bullet on a list of spin points.

Duckett's a liar: 11 percent will be a disaster. But we don't have to wait to see the cuts: we already have a disaster, in the "deficit." This "deficit" is huge and it will be used to try and justify the demands for "reform" -- especially the tired old Ralph Klein/Fraser Institute claim that the system is "unsustainable." But the most essential thing about a deficit this large is that it's new -- we've never seen anything like it before. There was no deficit crisis in the system before Liepert took over: the whole story about a budget/deficit crisis that Liepert has told from the beginning to justify smashing the health system is a LIE. The net overall deficit of the health care funding allocated to regional health authorities under the old system in 2007-08 was $100 million. In 2008-09 it was announced as $156 million. For this year, it's TEN TIMES that - $1.3 billion.

So where did it come from? The first point is that the announced budgets and actual expenditures in Alberta have little in common. Government can declare a "surplus" or a "deficit" -- it is all an artificial construct. For example in both 2008 and 2009, the actual revenues of the Alberta government were $3 billion more than the budgeted revenues. As for the health care budgets, according to the Alberta government Consolidated Statement of Operations, in the fiscal year 2008-2009, the total health care budget was set at $13.46 billion. Actual spending was $13.1 billion. This means that the "deficit" which was used to justify reduction of services in the last quarter of 2008-2009 was entirely fictitious. There was a "surplus" in the health care budget. Then for 2009-2010, the government announced that "health care funding will remain at $12.9 billion, a cut of $500 million from the previous year's budget.

Health Minister Ron Liepert is not "fixing" a deficit crisis. He created it. So what is the agenda which he has publicly stated he's enacting over the government's full four-year term. Liepert has given one interview after another where he says the Third Way failed because Ralph Klein made the dumb mistake of saying up-front what he wanted to do. Liepert has learned, the only way to make "fundamental changes" is by stealth: he's going to work methodically to lay the foundations for the changes he has in mind and never say what the goal is.

So let's say it for him: Ron Liepert is driving the system into crisis to make people accept a two-tier parallel private system. That's not the health system we want, and Ron Liepert is not the health minister we want.

Nurses Say It's Outrageous to Claim Improved Services with Less Staff and Resources

Nurses and Albertans should be outraged that Alberta Health Services (AHS) is saying it will improve services while it is actually making more drastic cuts to staffing. "They have announced less money will provide more and better services. Less people and they're going to provide more and better services. I don't think so," says UNA President Heather Smith. "It's going to make access and quality of services less."

Today AHS CEO Stephen Duckett announced a 3 percent across the board budget cut, which includes AHS partners and voluntaries like Covenant Health. Part of the announcement was negotiating voluntary severance for early retirements.

"It looks like phase one of Duckett's cuts was the NON hiring freeze, which we notice AHS now calls "not filling vacant positions." That aggravated the shortage situation in many areas. It was a severe staffing cut. Now, phase two looks like 3 percent more staffing cuts," Heather Smith said.

AHS Financial statements for 2008-2009 showed total spending of $9.9 billion (not including ambulance services). Now, if Duckett cuts the complete deficit, the $10.9 billion budget for this year would be reduced by $1.3 billion to about $9.6 billion, presumably including ambulance services. "That's a significant cut in our health services," says Heather Smith. "How that's going to make things better is a calculation I don't understand."

Duckett mentioned the closures at Alberta Hospital Edmonton as a new example of their transparency with Albertans. But he did not clarify how more cuts would be made. Are they going to close further facilities? Or are they going to spread the pain and make short staffing worse everywhere?

"We will enter discussions with the Employers about severance, but it seems almost absurd," Heather Smith said. "During all the recent years of negotiations, the top priority has been retention of senior nurses. This severance is an attempt to cover up the elimination of positions, reducing services. This can't be good management."

Nurses Speak Out about Acute Nursing Shortage

Alberta Health Services (AHS) chieftain Stephen Duckett has announced that AHS will enter into discussions with health care unions regarding a "voluntary early retirement program for health care staff to help cut costs."

In June 2009, the United Nurses of Alberta (UNA) asked nurses to report current examples of how the nursing shortage is affecting their work and their patients. Some of their responses were published on the UNA website.

"We have both an acute care and a Long Term Care unit which are very separated. Both units are staffed with one RN [registered nurse] 24 hours a day so whenever someone is off they need to be replaced. Our full staff complement is 8.82 nurses, and with our present vacancies of 2 FTEs that means we are short over 22% of our RN staffing. All these empty shifts always have to be filled somehow."

"I took a peek at my phone and I was called every day for overtime from the 21st-28th of May....I didn't go back much farther in the caller ID."

"Last Thursday, May 28th, the nurses scheduled to work the 12 hour night shift starting at 1900 hours were called in the mid-afternoon and asked if they could go in early at 1500 and work a 16 hour shift."

"New staff that were still being precepted were told that they were to take a full assignment because we were so short. Thankfully, their preceptors put their foot down and threatened Professional Responsibility Complaints. A few staff worked 16 hour shifts to make do. Even with the 16 hour workers, we were still short!"

"We've been short a Full-time RN in Long Term Care as well as a .58 part-time position for several months now. Contract workers and current RNs (often on overtime) and sometimes managers have been filling these positions. Yet the job postings went down and haven't been reposted. Since we only ever have one RN per shift, they absolutely need to be replaced. The current practice of using overtime and contract nurses is very expensive. We also need casuals for both units, as almost all sick time now is being covered by overtime. Current nurses are pretty good at picking up extra shifts at straight time, or changing around their shifts to allow for vacation coverage when they have lots of forewarning, but last minute call ins usually result in overtime. Don't tell me we don't need more nurses."

"But now vacancies don't seem to be getting posted (our manager has sent in the request but as of a couple of days ago it was not on the web). We are losing a nurse to Saskatchewan, home of the signing bonus. So once again we have some shifts with only one nurse to assess and treat up to 50 plus patients in the ER [emergency room] department. You would think with all the cutting in all areas (and of course I speak for rural where we are 2 hours from tertiary care) Mr. Liepert might worry if he should get chest pain out touring this great province. Is there a nursing shortage ...you bet there is!"

"June 1 and 2, 2009 The surgical unit worked one RN short, no one could be found to work. Four medical beds have been closed. We are not utilizing OR [operating room] and procedures to their full potential. We are not rescheduling OR time, decreasing colonoscopy and gastroscopies."

"On nights we have one RN in the ER. On the May long weekend she had someone on a nitro drip in ER waiting for a bed and then was chased by a drug addict and had to lock herself in the admitting area and wait for the RCMP to come. Rural nursing is extremely short and it is not looking good for us. No one is safe out here patients or staff."

"On May 31 there was a sick call that was not replaced so four beds on Unit 28 were closed instead. We also had 9 patients in our Cardiac Care Unit awaiting angiograms because the Diagnostic Imaging department is now closed from 4-8pm when they used to be open."

"In our hospital this past weekend 2 RN's and 1 LPN [licensed practical nurse] each worked a 16 hour shift. All job postings have been taken down. We have at least 3 RN's who want positions."

UNA pointed out that the government's own health care plan, "Vision 2020, stated: There are critical shortages of health service providers. Alberta needs more than 1,500 nurses, and by 2020 the province may be short by more than 6,000 nurses."

In the face of this, Health and Wellness Minister Ron Liepert said on Global News on June 3, 2009 that "I have never been prepared to subscribe to the fact that we were short several thousand nurses."

Friends of Medicare Launches Website and Campaign

Friends of Medicare in Alberta has announced a new website and a campaign to oppose the new round of health care cutbacks which the Alberta government has announced. In explaining what the campaign is about, Friends of Medicare states:

"Albertans should brace themselves! The Alberta government has begun a new round of health care cutbacks. In recent months, the government has announced a series of cutbacks to crucial health services including:

- A hiring freeze leaving thousands of desperately needed health care jobs vacant

- Cancelled and delayed surgeries, including postponing cancer surgeries for weeks

In response to overwhelming popular input from Albertans, Friends of Medicare has launched an aggressive campaign to urge the government to cease and desist from further dismantling of our public health structure in this province.

It is urgent that we mobilize together so we speak out in a unified voice against more cuts!"

Health Care Is a Right!

Health Care Is a Right!

Diversions

Divide and Rule Tactics

The Need for Redress

Why I Am A Worker Politician

More than 500 People Attend Meeting to Save Alberta Hospital Edmonton

Letter to the Editor

Nurses Say It's Outrageous to Claim Improved Services with Less Staff and Resources

Nurses Speak Out about Acute Nursing Shortage

Friends of Medicare Launches Website and Campaign

More than 500 People Attend Meeting
to Save Alberta Hospital Edmonton