October 11, 2018

Growing Demands to Increase Investments in Health Care
and Keep the System Public

Mass Rally in Ontario to Rebuild and
Improve Public Health Care



Growing Demands to Increase Investments in Health Care and
Keep the System Public
Mass Rally to Rebuild and Improve Public Health Care

Health Care Workers Fight for Immediate and Long-Term Demands, Against
the Wrecking of the Sector
- Interview, Jeff Begley, President of the Federation
of Health and Social Services

Health Professionals Protest Cutbacks and Deteriorating  Working Conditions
Shortage of Nurses Driven by Neo-Liberal Agenda

Manufacturing Yes! Nation-Wrecking No!
Talks Suspended Between ABI Workers and Alcoa-Rio Tinto Cartel

Growing Demands to Increase Investments in Health Care
and Keep the System Public


Mass Rally to Rebuild and Improve
Public Health Care

On Tuesday October 23, a mass rally is being held at noon at Queen's Park in Toronto to warn the Doug Ford government that the public health care system in Ontario needs to be rebuilt and improved and to say No! to cuts and privatization. The rally is sponsored by the Ontario Health Coalition and many unions including the Ontario Council of Hospital Unions/CUPE, the Ontario Public Service Employees Union.

In its September 21 press release, the Ontario Health Coalition writes: "The Coalition notes that Ontario has already cut and downsized its public hospitals for decades. In fact, no other province in Canada, and virtually no other country in the developed world, has cut as deeply as this province. Already Ontario has the lowest public hospital funding in the country. We have fewer hospital beds left than any other province. Ontario has the lowest level of nursing care per patient, occupancy [overcrowding] levels in hospitals that are unparalleled anywhere in Canada or Europe. Here, patients are pushed out of hospitals more quickly than in other provinces, and as a consequence, Ontario has the highest levels of hospital re-admission in the country. One in ten patients ends up back in hospital after they are discharged. As overcrowding has reached crisis levels, violence in hospitals has spiked. 30,000 people are waiting for long-term care placements and care levels are too low to provide for their needs. The Coalition is calling on government to rebuild and restore services, not cut and privatize. "

The organizers of the rally estimate that further wrecking of health care and public services through massive cuts and privatization is to be expected from the new Ontario government. They point in particular to its pledge to cut $6 billion in public service spending over four years through "efficiencies," to balance the Ontario budget in its first term and to offer massive tax cuts, mainly to the highest earners and to corporations, under the hoax of "protecting the taxpayer" and that "Ontario is Open to Business."

That is why the demands of the rally are aimed at rebuilding and improving the public health care system.

The demands are:

- Hospital funding must be set at a rate that will protect service levels and stop cuts. This means a 5.3 per cent/year funding increase for the next four years.

- A capacity plan must be developed to plan to meet population need for care.

- Closed hospital wards and floors must be reopened, closed operating rooms must be funded, and services that have been cut must be restored.

- Closed and privatized outpatient services must be reopened and restored in our local public hospitals to meet population need, including but not limited to outpatient physiotherapy, labs, day clinics and others.

- Patients must be protected from extra-billing and user-fees in private clinics. Canada's and Ontario's Medicare laws must be protected, strengthened and upheld.

- An immediate moratorium must be declared to stop the closures of local hospitals, consolidation of local services and the mega-mergers of local public hospitals.

- New hospitals must be financed using public borrowing rather than exorbitantly expensive P3 privatization, with sound management and public oversight. The substantial savings generated from this can be used to rebuild public capacity and improve access to care.

- Our public hospitals and health services must be governed democratically in the public interest by Boards of Directors that reflect the diversity of our communities.

- Services must be transparent, accountable and responsive to patients and communities. Legislation must be amended to provide full access to quality of care information in public hospitals. Staff should be protected when they advocate for quality and access issues in the public interest.

- Concrete steps must be taken to move public funding away from activities that do not add value and are not improving care.

- Curtail exorbitant executive salaries and the use of PR firms, unnecessary advertising and consultants.

- Cease the practices of shadow-billing and price-based procedures in hospital clinical care.

The Coalition writes:

"The best way to protect public health care is to push for what we know we need and to ensure that this government is afraid to cut and privatize health care. We need to set the agenda and make them respond to us.

"Please join us. A show of strength is vitally important at this juncture. We know that the people of Ontario are with us. No one wants more cuts. The overwhelming majority of Ontarians oppose health care privatization. We need to mobilize, to make visible the public demand to improve our public health care. We need to inspire people to stand up and make cuts and privatization impossible. We can do this. We've done it before. But we need your help."

Buses are being organized from local communities across Ontario so that people can attend. To fill a bus registration form, click here.

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Health Care Workers Fight for
Immediate and Long-Term Demands,
Against the Wrecking of the Sector

In a press release issued October 4, the Federation of Health and Social Services (FSSS-CSN) called for an emergency investment of $50 million from the new Quebec government to avoid what it calls a breakdown in the health care and social services network.

Workers' Forum recently spoke with federation president Jeff Begley about the demands of health care workers.


Workers' Forum: Can you tell us more about the federation's assessment that Quebec's health care system is at a breaking point?

Jeff Begley: Several things show that the breakdown is actually happening. One example is the significant crisis in the ability to retain and hire staff. The Ministry is well aware of the problem of the movement of labour in the sector. There are people in the Ministry who have assessed the situation and found that we are facing a crisis. Added to this is the fact that given the shortage of manpower, those who remain are more stressed and end up in situations where they always have to give more.

In the last four years, there has been a 25 per cent increase in the number of people on short-term disability insurance, which can be up to two years. At the same time, there is very little hiring being done in the health care sector because the conditions have become extremely bad. People are asking themselves why they would go to work in the public sector that looks like such a chaotic place. We are no longer able to hold onto our people. On average, new hires stay in the sector a maximum of three years. It was not like that before. Attendants with 20 to 25 years of experience were common in the past. There are still some, for example, those who must stay and work until retirement. If they had other choices, there are many who would leave. But there are more and more young people who start and then say after a short period of time that it is enough, and begin looking for something else.

The shortage of workers in the health care sector is very real and it does not affect only nurses and attendants. It also affects people who work in administrative, professional and maintenance positions, and skilled workers. It is clear that there is a direct link between this shortage and the deterioration of conditions. It must also be remembered that when there is a shortage of people who ensure the cleanliness of institutions, there is a recurrence of infectious diseases and increased risk that workers and patients will contract these diseases.

WF: What work is the FSSS doing to change this situation?

JB: We think that at the same time that permanent solutions are needed to repair the damage of the four years of Liberal Party rule and the Barrette reforms, we need immediate measures to ensure the retention of the staff still in the sector. That is why we are asking for an immediate investment of $50 million while we are preparing for the next round of negotiations and for permanent solutions. The next round of negotiations is in 2020. If we wait until then before taking action the situation will continue to worsen and the public health care system will be totally wrecked.

Our people who are at work must receive the message that the fundamental problems in the system will be dealt with, while immediate measures are going to be taken to retain the people who are already there, so as to stop the decline in the sector. For example, money has to be injected immediately to replace people who are on short-term disability. The harassment of the people on short-term disability to force them to come back to work before they are well must be stopped. When they come back, they must be able to stay. Since there is currently a significant increase in the number of people on short-term disability insurance, they are being harassed to return to work and then they become sick again a few months later.

Solutions may vary with regard to retention according to the sector. Attendants, people assigned to home care, maintenance workers are not facing exactly the same conditions. We are ready to sit down tomorrow with the employers and the government to review the application of emergency measures, while knowing that those measures are not a permanent solution.

With regard to permanent solutions, we are in the process of preparing consultations with our members. We strongly believe that our members are able to identify solutions and we will be consulting widely with all our members. The people who work and operate the system against all odds, have solutions to the problems of the sector and will be involved in identifying them so that this is reflected at the bargaining table.

Among other things is the health and safety of our members. Our demand is for the health and social services sector to become a priority sector in the Occupational Health and Safety Act. At present, the health and social services sector is not considered a priority sector. Yet, we have one of the worst records in terms of health and safety of the workers. It is necessary that there be prevention in the sector instead of waiting for people to become sick. There is no prevention being done right now. If we were considered a priority area, we would have prevention representatives and joint health and safety committees.

This is the work we are doing at this time to press for immediate emergency measures and permanent solutions.

(Chantier politique. Translated from the original French by Workers Forum)

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Health Professionals Protest Cutbacks and Deteriorating  Working Conditions

On October 9, Nurses, Licensed Practical Nurses and Respiratory Therapists from the Outaouais and allies held a march to say loud and clear that in order to retain staff, the employer must improve working conditions, starting with the elimination of mandatory overtime whereby nurses sometimes have to work 12 hours or more without a break.

The march, organized by the Outaouais Care Professionals Union (SPSO), symbolically gathered at La Pieta Hospital in Hull and then crossed the Alexandra Bridge to Ottawa to underscore the exodus of nurses from the province that could occur if their working conditions continue to deteriorate.  Throughout the march, the healthcare professionals chanted slogans denouncing different aspects of their grueling working conditions that their employer, the Integrated Health and Social Services Center of the Outaouais (CISSSO), wants to further aggravate. Among the requests for concessions made by CISSSO during the current round of local negotiations for the renewal of the collective agreement are compulsory overtime, the abolition of a weekend off every two weeks, to force the professionals in care to be available every weekend, and the ability to change the work schedule to less than 48 hours without notice. There is also the demand for nurses to travel several kilometers to work in different locations at the employer's discretion.

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Shortage of Nurses Driven by Neo-Liberal Agenda

Demonstration by health care workers, in Levis, December 1, 2017.

In a guest column published in the October 1 issue of Le Devoir under the title "Lack of nurses: real or structural shortage?", Mia Laberge, a union advisor with the Interprofessional Health Care Federation of Quebec (FIQ), criticizes employers in the health network who invoke the argument of the shortage of nurses to block the implementation of ratios of health care professionals to patients. These ratios, she points out, are an essential remedy for nurses' collective exhaustion.

She writes: "It is very convenient to blame the problems on the shortage of labour. Employers can no longer hide behind this fairy tale. The well-being of thousands of Quebec workers and the quality of care for patients are at stake here."

The author cites statistics showing that from April 1, 2016 to March 31, 2017 more nurses were joining the profession than leaving, and that the number of nurses retiring was almost the same as in the previous year. Meanwhile, for the past fifteen years, she writes, nurses have experienced full employment, at 95 per cent. The rate of full-time employment is decreasing. It has decreased by one percentage point in most regions of Quebec since the 2015-2016 statistical report. In 2016-17, 58.4 per cent of nurses worked full-time, 33.3 per cent part-time and 8.3 per cent on an occasional basis. As the nursing workforce is growing steadily, particularly since 2012-2013, the problem lies more in the planning of the workforce, planning which is ideologically driven by neo-liberal management of the health care sector.

Thus, according to the author, despite real needs and a context of full employment that favours the increase in the number of full-time positions, nurses are still confined to precariousness. She describes the nursing shortage as structural, driven by neo-liberal policies, because part-time jobs proliferate to the detriment of full-time positions. While precarious employment is prevalent among nurses, there is a constant reliance on overtime, including mandatory overtime, and contract workers hired from private placement firms. The deficit of full-time positions, she writes, inevitably leads to a lack of staff and an overload of care professionals. The consequences are serious for the entire network, for patients, but especially for the working conditions of thousands of workers, most of whom are women.

She adds: "The neo-liberal management of the health care network is thus more and more openly interfering with care. Nurses experience constant organizational violence. They are the ones who must constantly overcome the failures of managers and face abuse from some doctors who are always asking for more. They face the "Toyota" reforms, the "Lean" programs, the lack of political will, and the underfunding of the public health system. They are always asked for more flexibility, more mobility across huge territories, more conciliation, and they are constantly confronted with abuse of their dedication to their profession.

The author concludes that adequate ratios of care professionals to patients are an essential and urgent remedy for nurses' collective exhaustion and must be implemented immediately.

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Manufacturing Yes! Nation-Wrecking No!

Talks Suspended Between ABI Workers
and Alcoa-Rio Tinto Cartel

General membership meeting, USW Local 9700, October 9, 2018.

USW Local 9700, which represents the 1,030 employees at the ABI aluminum smelter in Bécancour, Quebec who have been locked out since January 11, confirms the mediator's announcement that negotiations with ABI have been suspended. In an October 5 press release, Local 9700 says the gap is too great between the workers and the Alcoa-Rio Tinto cartel, which owns the smelter, for any talks to proceed at this time to reach a collective agreement acceptable to the workers.

Following a meeting between the union and Alcoa's senior management in Pittsburgh on September 6, some smaller committee meetings have taken place between representatives of the two parties to see if negotiations could resume. The talks were unsuccessful due to the refusal of the company to reconsider its demand for concessions.

The union updated its members on the situation at a general meeting on October 9, attended by over 700 workers. The following day, the union held a press conference to report that the ABI executives have now made additional demands for concessions regarding the pension plan, short-term health insurance and union leave time.

"This is an even worse offer than in last December," said the President of the Local Clément Masse to Workers' Forum. "Instead of getting closer to a settlement, we are moving away from it. Workers understand that there can be no negotiations if one of the parties does not want to negotiate. The workers want a settlement and to get back to work, but not by going backwards on their conditions. We are still strong and determined to go back to work with a negotiated agreement that is acceptable to us."

The union has been consistent in saying that the dispute is focused on respect for seniority in job postings and movement of workers inside the plant, and on funding for the pension plan. The owners had submitted an offer last December that the workers rejected. At the same time, the workers made it clear that the employer's offer could serve as a basis for further negotiations and agreement. The company ignored this positive sentiment and locked out the workers and began demanding even more concessions.

The workers and their union do not accept that the owners are now putting other issues on the table. This is similar to what the company did in March when it announced that it now wants a complete restructuring of the company's operations in the name of flexibility and competitiveness. In this context, it demanded the abolition of 20 per cent of the unionized positions at the plant and their replacement, if it chooses to replace them, with non-union positions at terms and conditions worse than those of the current unionized workers.

The union recognizes these actions as attacks on both the living and working conditions of the workers in the factory and, by extension, on the community and the region. The concessions demanded and the brutal lockout are aimed at diminishing the ability of workers organized into their union to wage effective struggles in defence of their rights and of the regional economy, now and in the future.

Wall outside ABI plant thanks all those who have financially supported USW Local 9700
throughout the lock-out and who continue to do so.

The workers do not accept this state of affairs and continue to request government intervention in recognition of the fact that the company refuses to bargain in good faith as it is required to do under the agreements in place. The workers want the new CAQ government, which came to power in the Quebec election on October 1, to  pressure the company to stop its provocative activities and insistence on dictate, and to negotiate seriously with the workers.

Force Majeure

ABI workers participate in rally outside "Leaders Debate" during Quebec election,
September 13, 2018.

The union is calling for the immediate end of the force majeure clauses in the hydro-electric agreement among the owners, government and Hydro-Québec. According to a one-sided interpretation of these clauses, the company-authorized and controlled lockout has become a  force majeure, which releases Alcoa-Rio Tinto from its obligations to pay Hydro-Québec for the energy block reserved for it at preferential rates. Quebeckers through Hydro-Québec have lost almost $160 million to date because of this agreement and opportunistic bogus interpretation of force majeure.

Under a reasonable and not one-sided definition, a force majeure is due to an event or effect that the parties to a contract could not have anticipated or controlled. The Alcoa-Rio Tinto lockout of its workers is under the control of the company and invoking the clause could only have been planned in advance with a very specific aim to allow the company to weather the lockout with less monetary damage and put maximum pressure on workers to make concessions.

The lockout does not constitute an "act of god" or uncontrollable event that is not the fault of any party to the agreement. The lockout was completely company instigated to serve its narrow private interests in opposition to the interests of the workers and their community. The government and Hydro-Québec should not agree to the company's one-sided definition, which grossly favours the company in its fight to impose concessions on its workforce, the regional community and Quebec generally so that it can take out of Quebec even more of the value workers produce.

The anti-social dictate of the company for concessions, along with its refusal to negotiate and the force majeure, are also meant to weaken the organized resistance of workers in the long-term. They constitute wrecking of Quebec and an attack on the dignity of working people and cannot and should not be tolerated by any Quebec institution, the people or government.

Meanwhile, workers in Quebec and elsewhere in Canada are stepping up their support for the locked out ABI workers, including financial support. On October 5, USW Local 8897 workers at ArcelorMittal Longueuil announced a doubling of the financial assistance they provide every week to ABI workers and have called on other USW locals to do the same.

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