July 16, 2020 - No. 49

In the Name of Dealing with the Pandemic

Another Ministerial Dictate to Undermine Working Conditions of Health Care Workers in Quebec

Health care workers demonstrate against the use of ministerial orders,
Saguenay Lac Saint Jean, July 9, 2020.

Interview, Jeff Begley, President, Federation of Health and Social Services 
Quebec Government's March 21 Ministerial Order Challenged in Court

The Need to Enforce the Rights of Migrant Workers
Call to Reverse Ontario's New Guidance Allowing Some Workers Who Test Positive for COVID-19 to Keep Working

In the Name of Dealing with the Pandemic

Another Ministerial Dictate to Undermine Working Conditions of Health Care Workers in Quebec

Demonstration by health care workers, Mauricie, July 6, 2020.

The very first act undertaken by the new Quebec Minister of Health and Social Services, Christian Dubé, formerly President of the Treasury Board, was the publication of a ministerial order that cancels parts of the collective agreements of health and social services workers, like a previous ministerial order did.[1] The new order purports to deal with the influx of new trainee orderlies in residential and long-term care centres (CHSLDs). The Minister has imposed accelerated training which is truncated -- 375 hours of training instead of 870 hours which lead to the Diploma of Vocational Studies provided by the Ministry of Education. These trainees are to begin working in CHSLDs as of September 15.

The ministerial order imposes the following conditions on trainees and the unions:

"That the national and local provisions of the collective agreements in force in the health and social services network and the employment conditions that apply to non-unionized salaried personnel be amended as per the following conditions:

"(1) a lump sum of $5.00 per work shift, which may be divided into half shifts, is paid to the salaried person designated by his or her immediate superior to accompany candidates enrolled in training leading to an attestation of professional studies for health care facility patient service support. That salaried person holds one of the following job titles appearing in the List of Job Title classifications, wording, health and social services wage rates and scales: nurse; nursing assistant; orderly."

The ministerial order is unilaterally changing the duties of these workers which are outlined in their collective agreements. It is imposing an extra task on top of their normal duties and is forcing them to perform training which is normally done by professional staff whose job is to do training. There has been no negotiation, consultation or even discussion of this with those affected by the decision. Furthermore, orderlies are already overworked and suffering great stress due to their working conditions and the risk of contracting and spreading COVID-19. This order is bound to increase all these problems, putting the health and safety of the workers and of the patients further at risk. For all that extra work, they are getting an additional $5 a day per shift. This $5 is not considered a wage increase. It is a "bonus" which means it is not integral to the pension plan.

Who is going to take responsibility if accidents happen? Not the government, obviously. This order has nothing to do with dealing with the pandemic and everything to do with using the pandemic as a pretext for strengthening the arbitrary powers of the state. It is doing so at the expense of the working conditions of the workers and of their voice and therefore at the expense of the well-being of the patients.

Unions are happy to welcome the arrival of badly needed new staff, however they are opposed to the complete disregard for the workers' concerns and their right to a decisive say in their working conditions. Workers' Forum is publishing below an interview with Jeff Begley, President of the Federation of Health and Social Services (FSSS-CSN), which represents, amongst others, tens of thousands of orderlies.


1. For more information on the Quebec government's ministerial orders, read "Quebec Public Sector Workers Oppose Ministerial Use of Emergency Powers to Arbitrarily Set Working Conditions," Workers' Forum, April 7, 2020.

(Photos: FIQ)

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Interview with Jeff Begley, President, Federation
of Health and Social Services (FSSS-CSN)

Health care workers protest ministerial orders, Victoriaville, July 9, 2020.

Workers' Forum: The ministerial order issued on July 4 by the new Minister of Health and Social Services once again allows for the cancellation of workers' collective agreements in order to unilaterally change working conditions, this time with regard to the supervision of new orderlies. What is the position of the Federation of Health and Social Services on this issue?

Jeff Begley: It is very disappointing. Once again, the government does exactly as it pleases. There is nothing in this order that will eliminate the overburdening of the people who will have to supervise the new orderlies. There are 10,000 people who, so far, have had three weeks of training, or 120 hours. At the moment, the trainees are doing half internship, half training at school, until September 15. Normally, when an orderly arrives at work, he has had 870 hours of training. What we are being told about the training that is being given right now is that it is very much focused on COVID, which is fine. However, there are indications that in some places, for example, there is no training on how to move patients in a safe way. For orderlies, especially those in CHSLDs [residential and long-term care centres] where many patients are not mobile, this is a real problem. It is a major problem because moving patients is at the heart of the work they have to do.

The order was published yesterday, Sunday, July 5. On Saturday, the FSSS-CSN was at the table with the Ministry of Health, at our request, regarding orderlies. We told them that there were concerns about overload because the existing orderlies have their usual duties and, in addition, they will have to train and supervise newcomers. The Ministry told us that it is the teachers who are responsible for supervision. But these teachers will not be there! The Ministry added that what they expect of experienced staff is not that they coach or teach the newcomers, but that they "observe" the newcomers. Imagine a new attendant who has not learned how to move patients safely and an old attendant saying, "Go ahead, try it and I'll just observe you." This is a danger to both the patient's safety and the new employee's safety because he has not mastered the technique. So of course, the experienced colleague will have to help him to do these essential tasks correctly! It is therefore nonsense that, in addition to their usual duties, orderlies will have to supervise new employees for $5 a day, regardless of the number of trainees they are responsible for.

WF: What is the way of receiving these new employees safely and professionally?

JB: The experienced orderly or health care worker would have to be relieved of part of their duties so that they could guide and supervise the new employees. Even after taking a course, the first few times a person does something, like moving someone, they need assistance to do it properly. This is why we are concerned about the overload of work on existing employees, who are in a great state of fatigue and whose vacations have been reduced, in some cases by half.

The other thing we are concerned about in the new order is that it says that it is the employer who chooses the people who will be responsible for observing one or more new employees. We are saying that it should be volunteers, and based on seniority first. They have to be volunteers -- not people to whom the employer is going to say: 'you're good, I want you to do this.' I would hope that there are employers who will choose to take volunteers, but the ministerial order does not require it.

I reiterate that there is no problem with this type of training, but only if the experienced orderly, the licensed practical nurse, or the nurse is relieved of part of his or her duties to ensure that the newcomers are properly trained, and especially to help them put into practice what they have learned and the actions they must perform. It's perfectly normal not to have everything under control when you arrive at your workplace. It is with the help of experienced workers that they gain confidence.

When the government made the first announcement [of accelerated training to attract new orderlies -- WF Ed. Note], we told the government: "We are getting on board. If you want to sit down with us, we'll work together to make sure it goes well by looking at the conditions necessary for things to be done well." A month later, there is still no exchange. The Ministry imposes. It only informs us of the decisions it has taken.

WF: It's striking how unions and negotiated settlements are being targeted with ministerial orders and Bill 61 on restarting of the economy.

JB: Yes, in the name of the health emergency, the government has given itself the right to impose. We understand that in extreme situations, a government can give itself this type of right so as not to find itself in a situation where services are disrupted. But this is not being used sparingly. The measures it imposes are very broad and affect the vast majority of workers.

What is obvious is that the government's target is the unions. And that allows it to say: "I have done everything right without unions, they are not necessary." The new Minister of Health, Christian Dubé, told us just recently that he considers the unions to be important partners, and that he wants to work with us. So we said that was perfect, that we were ready, and that there were two urgent things: the arrival of a massive number of new orderlies and health and safety in the event of a second wave of COVID-19. But no action was taken on what the Minister told us.

This is a power grab by the government. It expresses a refusal to talk to the unions.

And this is happening at a time when we are very concerned about a second wave of COVID-19 that could happen soon.

Again, there is no discussion with the government. People's lives are at risk. And even if someone does not die, we have the example of workers who have been infected with COVID who continue to have significant after-effects a month, a month and a half later. We have more than one testimony on that. They are still not back to their optimal health.

It is my interpretation that the pandemic and the economy are being used as an excuse to attack the unions. The members are exasperated by all these orders that impose working conditions on them.

That has to change.

Health care workers protest at assisted living facility in Drummondville, July  6, 2020.

(Translated from original French by WF. Photos: FIQ)

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Quebec Government's March 21 Ministerial Order Challenged in Court

May 27, 2020 health care workers day of action.

It its press release dated July 13, the Interprofessional Health Care Federation of Quebec (FIQ) informs that, together with the FIQ-Private Sector (FIQP), it has filed a motion before the Superior Court to put an end to what they call a violation of democracy. The FIQ and FIPQ object, specifically, to the renewal of ministerial order 2020-007 of March 21 which violates their members' rights and continues to suspend several provisions in their collective agreement.

The press release states in part:

"Since the beginning of the pandemic, this order has given Quebec health institution managers exceptional powers, in particular over health care employees' schedules, work locations, vacations and leaves. The use of these powers should change based on how the situation evolves, but there has been an abuse of power. While restrictions are being eased throughout Quebec, health care professionals' working conditions are still under siege, even when the number of cases has been dropping significantly in Quebec health care institutions, and some don't have any at all.

"While we must all remain careful, it is clear to the FIQ and FIQP that the pandemic has usurped too much leverage when it comes to their members' working conditions. 'It's clear that these orders are no longer needed to deal with the public health emergency but instead to manage problems in the network that existed long before COVID-19. The government isn't protecting the public's health anymore, instead it's keeping measures in place that make the managers comfortable. It's an abuse and violation of democracy. We sent letters, we demonstrated, we used every platform to get our message out... Now we are going to court,' writes Nancy Bédard, FIQ President.

"Four months to the day after the public health emergency was declared, the FIQ and FIQP went before the Superior Court with this motion, requesting that the order not be renewed. 'Nurses, licensed practical nurses, respiratory therapists and clinical perfusionists showed up, collaborated and coped with the crisis in an exceptional way. To extend this order is to extend their distress. There's no logical reason that can justify maintaining these measures: our members have a work contract that contains countless ways to find solutions as needed. Let's use it!' writes Nancy Bédard.

In their motion, the FIQ and FIQP maintain that the government is overstepping its powers, as conferred on it by the Public Health Act, and is abusing its power for enforcing exceptional measures. They also assert that ministerial order 2020-007 is violating their members' fundamental rights, and the rights of all health care workers." It is unfairly stepping on fundamental rights that are protected by the charters, in particular the right of association," states the press release.

(Press release translated from original French by WF. Photo: FIQ)

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The Need to Enforce the Rights of Migrant Workers

Call to Reverse Ontario's New Guidance Allowing Some Workers Who Test Positive for COVID-19
to Keep Working

On June 30, a group of medical professionals published an open letter to the Chief Medical Officer of Health for Ontario, calling for him to use his powers under the Health Protection and Promotion Act to immediately reverse the new public health guidance announced on June 24 by Premier Doug Ford.[1] They are inviting other medical professionals to add their names to the letter. The letter can be signed here.

Dr. David Williams
Chief Medical Officer of Health

Re: Public health guidance on testing and clearance

Dear Dr. Williams,

We are health care professionals writing to express our concern at the guidance provided by your office on June 24th that asymptomatic workers who test positive for COVID-19 may continue to work if they are deemed "critical to operations." In particular, we are concerned that this guidance puts migrant agricultural workers at specific, preventable risk of harm. We urge you to act in your capacity as Chief Medical Officer of Health (CMOH) as outlined in the Health Protection and Promotion Act (77.1) to immediately reverse this guidance.

By now it is clear that the COVID-19 pandemic has disproportionately harmed migrant agricultural workers, with large outbreaks on farms across Southern Ontario and the deaths of three workers: Bonifacio Eugenio-Romero, Rogelio Muńoz Santos, and Juan López Chaparro. The public health response to these outbreaks must be grounded in their root causes: poor working and living conditions. The guidance provided by the CMOH cannot be safely followed or consistently applied, and does little to address the root causes of these outbreaks.

The guidance states that asymptomatic workers may continue to work if they "adhere to public health measures." However, migrant agricultural workers consistently report that physical distancing is difficult in the fields, greenhouses, and bunkhouses of Ontario. Media reports describe poor access to the necessities for hygiene and personal protective equipment on some farms. In the absence of change to the material conditions of these workers, it is unlikely that workers can adhere to the recommended public health measures.

As a result, the guidance poses a specific and demonstrated public health risk to migrant agricultural workers and the communities in which they live. It is well-established that a large proportion of individuals with COVID-19 who are asymptomatic at the time of diagnosis go on to develop symptoms. In addition, we know that individuals can infect others while asymptomatic. We are not aware of another sector that routinely permits asymptomatic workers to return to work immediately following a positive test result. Given the working and living conditions of migrant agricultural workers, we are concerned that asymptomatic spread of COVID-19 will result in further outbreaks and additional deaths.

The guidance also places the burden of risk and adherence on migrant agricultural workers -- a population with minimal workplace protections or autonomy, while failing to ensure that employers directly address the conditions which exacerbate the spread of COVID-19. Workers may not feel safe to disclose symptoms if they fear loss of income or retribution from employers, including the fear of removal from Canada. Workers who wish to report symptoms and seek health care often have limited or no access to language-concordant care. The guidance does not clearly outline the responsibilities of employers to ensure that recommended public health measures are enacted or to improve the working and living conditions of their employees. Public health guidance stating that asymptomatic workers can return to work may also undermine their ability to make legitimate workplace insurance claims.

Moreover, we are deeply concerned by your statement suggesting that this guidance was prompted, in part, by employers' concerns that mass testing of workers could lead to the detection of a large number of asymptomatic cases of COVID-19. This argument clearly trades the health and safety of employees for the interests of their employers. We are troubled by media reports that the guidance was constructed to garner buy-in from employers and designed to be a compromise. It is clear that the voice, autonomy, and dignity of workers were not considered in this guidance. Our public health leaders are entrusted with a broad range of powers which they must exercise in service of the health of all those who reside in Ontario. We are concerned that the guidance was informed by considerations other than sound public health principles and that the independence of the decision-making process may have been compromised.

We ask you to focus your efforts on establishing the workplace conditions and protections required for migrant agricultural workers to protect their own health and that of their communities using your powers under Section 77 of the Health Protection and Promotion Act. These efforts should at a minimum include:

1. Revoking the guidance that permits migrant agricultural workers with COVID-19 to continue to work if they are judged to be asymptomatic;

2. Expanding access to testing for all workers;

3. Ensuring access to paid sick leave for all essential workers at high risk of experiencing outbreaks (including migrant agricultural workers and undocumented workers);

4. Providing specific mechanisms for self-isolation through funded programs of voluntary self- isolation in hotels or other temporary housing and advocating for long-term improvements in living conditions;

5. Protection from employer retaliation for missed work due to these precautions.

The growing season is long, and we have already borne witness to the deaths of three migrant workers. The immediate return to work of any person with COVID-19 threatens the health and safety of workers and the entire community. We therefore ask that you exercise your powers as Chief Medical Officer of Health and reverse the guidance to help ensure that we see no further outbreaks or deaths among migrant agricultural workers.


1. Test Clearing Cases Guidance Version 8.0, June 25, 2020. Relevant section is titled Work Self-Isolation in Non-Health Care Settings

(Photos: J4MW)

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