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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
 
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.
Note
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.
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.
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.
The Need to Enforce the Rights
of Migrant Workers
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.
Note
1. Test
Clearing Cases Guidance Version 8.0, June 25,
2020. Relevant section is titled Work
Self-Isolation in Non-Health Care Settings
(To access articles
individually click on the black headline.)
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