October 15, 2020 - No. 70

Alberta Government's Mass Layoffs of Health Care Workers

The Need to Raise the Demand to
Stop Paying the Rich Becomes Increasingly Urgent

Health Care Unions Condemn Privatization and Mass Layoffs
Kenney and His Government Cannot Be Trusted with Our Public Health Care System - Friends of Medicare
How the Deals Are Made - Peggy Morton

Alberta Government's Mass Layoffs of Health Care Workers

The Need to Raise the Demand to Stop Paying the Rich Becomes Increasingly Urgent

The government of Jason Kenney in Alberta is using its majority to hand over as much of Alberta as possible to private interests in the most egregious way possible. On October 13, in the midst of soaring cases of COVID-19, Minister of Health Tyler Shandro confirmed that the government is proceeding with the layoff of 11,000 health care workers and that one sector after another of the health system will be privatized.

Laundry services in rural Alberta will be the first service to be privatized, eliminating 400 jobs in communities hard-hit by the economiccrisis. Medical labs across the province are to be contracted out to one of the companies comprising the global medical laboratory cartel, resulting in 2,000 layoffs. Alberta Health Services will continue reducing the number of nurses in the system through attrition during the pandemic and proceed with layoffs to eliminate the equivalent of 500 full-time registered nursing positions, affecting 750 nurses, once the pandemic is declared over. Apparently the contracting out of housekeeping and food services will be delayed because of the pandemic, but will also proceed with 4,000 housekeeping jobs and 3,000 food services jobs to be eliminated.

The United Conservative Party (UCP) claims that the privatization of these jobs will save $600 million but even Minister Shandro admitted that this depends on the contracts yet to be negotiated and signed with the private interests. The usual practice is to pay the private corporations even more while these narrow private interests pay the workers much less than the standards which currently exist. They do not adequately train workers and they downgrade the working conditions and services provided.

All of this is done during the COVID-19 pandemic which itself illustrates how the privatization measures and downgrading of services and treatment of the workers exacerbate the health care crisis. It is unconscionable.

What the Alberta government is doing is a good example of why at this time Canadians must not confer majority governments to any party seeking to come to power. They rule with impunity to push pay-the-rich schemes and simply run roughshod over those among the working people and population who are affected by their decisions.

Privatization is all about the rich seizing the decision-making power to take over the public domain. The state is restructured so that any public authority whatsoever is eliminated. This means the people have no recourse within the system to hold governments or the private employers, whose ownership is often not even known, to account.

The damage to Canada's social fabric is irreparable. As if the layoffs announced on October 8 are not damaging enough, a draft leaked to the CBC is said to contain many other draconian measures including legislated cuts to wages, elimination of physician clinic stipends and other additional cuts, increases to accommodation fees for seniors in continuing care, introduction of a co-pay for home care, and shifting more patients from long-term care to designated supportive living. It also includes potential consolidation of rural hospital services, including emergency departments and closure of some diagnostic imaging and laboratory sites, with more layoffs. This would force rural residents to travel longer distances for services. Once the government learned that the CBC had a copy of the draft, the Minister of Health called a hasty press conference, and produced a “new draft” in which almost everything but the layoffs suddenly disappeared. Not only have sweeping draconian measures been drafted under the direction of the corporation infamous for serving narrow private interests E&Y, but the government is now attempting to conceal its plans.

If people do not agree to submit to the decisions to privatize health care, they are threatened with violence. It is unsustainable. It shows that the people must take up the challenge of how to hold governments to account. The main battle at this time must take place in the court of public opinion with the workers themselves and their defence organizations and political formations speaking out against the announced measures and in favour of alternatives. This is courageously being done across the country and must be stepped up further.

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Health Care Unions Condemn Privatization
and Mass Layoffs

Unions representing health care workers in Alberta strongly condemned the United Conservative Party's (UCP) announcement that it would proceed with privatization of medical labs, laundry, housekeeping and food services in health care facilities and continue to reduce the number of nurses in Alberta hospitals.

Alberta Union of Provincial Employees (AUPE)

At a media conference immediately following Shandro's press conference, AUPE President Guy Smith said AUPE members will take whatever action is necessary to stop the cuts which include 9,700 jobs of AUPE members providing laundry, housekeeping and food services.

"Today [Tuesday, October 13], Health Minister Shandro confirmed his duplicitous plans to cut more jobs after promising to create more. The UCP is downgrading Alberta's public health care system by forcing already over-worked staff to do more with less. The job cuts for nursing care staff and doctors, and the mass privatization ploy, are all recommendations from the government's $2-million Ernst & Young report, which it commissioned back in 2019 to help them find ways to cut corners in AHS [Alberta Health Services].

"Now that we know exactly what the damage is, we can keep prepping ourselves for the biggest fight of our lives," says Smith. "Our AHS members are already fighting for strong contract language to stop the sell-off of housekeeping, food services and laundry jobs. We plan on winning this protection, but if we do not, strike action is on the table."

While the Jason Kenney government promised to create jobs in Alberta, Smith says it's actually "a job-destroying government. This brutal attack on jobs is going to hurt working Albertans and small communities across the province. This government kicks Albertans when they're down, exploiting a pandemic that they're failing to manage by killing jobs and endangering health care at the exact moment we need it most."

Smith adds: "It's disingenuous for the Minister to say privatization won't result in 'net reductions' and only a 'change of employer,' because we know the first thing private and for-profit companies do when they snatch up our jobs is cut wages, pensions and benefits for hardworking staff. And everyday Albertans are the ones who pay the price -- the patients, seniors and people with disabilities who are at the receiving end of a downgraded service."

Private companies will often resort to layoffs early in their contracts with government to boost their bottom line. Staff end up working short, run off their feet by demanding bosses who go after our first line of defence: union protections.

Rotting food, dirty linens, viral outbreaks, dangerous lab mix-ups: all are cited as a result of privatization in general support services across the globe. The media has also already confirmed Alberta patients will be paying more out-of-pocket for items like crutches and casts.

"There are no 'savings' in this botched plan," says Smith. "All I see are businesses profiting off the pain of patients and care-centre residents."

AUPE's licensed practical nurses and health care aides will also be impacted by Shandro's attack on the public care system, after he confirmed over 800 clinical AHS jobs will be eliminated through attrition, meaning even more short-staffed floors and longer wait times in the near future, AUPE said.

"Is this really how the UCP are repaying frontline health care workers after they risked their health and well-being to care for us through this pandemic, when we need them most?" adds Smith. "This is pathetic, and we're not going to let it happen."

Health Sciences Association of Alberta

"This government has decided to tear apart its best line of defence against the ongoing pandemic. To be clear, this is about privatizing health care. Money isn't being saved; it's being transferred to private pockets instead of being used for patient care," Health Sciences Association of Alberta (HSAA) President Mike Parker said.

"Privatization costs more and could very easily result in poorer health outcomes during this pandemic and the next one. Just days after again praising the work done by our lab professionals, the current Health Minister has targeted the very people he claims are protecting Albertans in his misguided drive to privatize health care. Support workers are clearly frontline workers. It takes a team to make health care happen. Docs and other health care professionals cannot do their work in dirty facilities or in unsanitary conditions.

"The Health Minister's announcement today is shameful. He has abdicated all responsibility for the health and safety of Albertans. He has instead decided his role is to fire highly-trained public health professionals in order to facilitate the transfer of our public health resources into private hands.

"These 'positions' represent thousands of Albertans who will be added to the list of the unemployed. That's thousands upon thousands who will no longer be contributing to our economy. And that's thousands and thousands who will no longer be there to 'protect' Albertans."

United Nurses of Alberta (UNA)

The Alberta government is once against throwing health care in Alberta into chaos, right in the middle of the largest health care emergency in a century, UNA Labour Relations Director David Harrigan said, calling the action dangerous and irresponsible.

"This morning's promise by Health Minister Tyler Shandro that there will be no layoffs of frontline nurses when it lays off 11,000 health care employees contradicts statements by Alberta Health Services in a letter received this morning [October 13]," said UNA Labour Relations Director David Harrigan. The letter from AHS stated clearly that it plans to proceed with its previously announced layoff of 500 nursing full-time equivalents, which UNA calculates will put 750 nurses out of work.

Shandro was careful to say that there would be no layoffs during the pandemic, Harrigan said.
"There is nothing to prevent this government from prematurely declaring the pandemic to be over whenever it pleases, so this is a relatively meaningless promise," Harrigan said. Moreover, he noted, Shandro referred several times to eliminating nursing positions through attrition, so nursing positions will continue to be lost.

Last week, Harrigan added, AHS responded to UNA's request for clarification about the Ernst & Young report by saying that AHS was continuing to work with the Health Ministry on implementation of the Ernst & Young report's recommendations for changes to AHS operations and that no response from the government was expected until later in the fall. "So it sounds like they came up with a 79-page implementation plan over the long weekend," he said.

"Stability in the midst of a pandemic won't be achieved by short-staffed hospitals and burnt out health care workers," Harrigan concluded, noting that positions are already silently disappearing in the midst of the pandemic, and have been for months, leaving nurses short staffed and overworked and patient safety compromised.

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Kenney and His Government Cannot Be Trusted
with Our Public Health Care System

Today's release of the AHS Performance Review Proposed Implementation Plan is, in short, the biggest betrayal of Albertans by any government.

"Once again, this Premier and his government are callously advancing plans to suit their aggressive privatization agenda in health care," says Sandra Azocar, Executive Director of Friends of Medicare. "Kenney's UCP government continues to demonstrate nothing but disdain for the women and men working on health care's front lines. Considering how central they have proven themselves in the province's pandemic response, this whole plan is an insult to health care workers, and it's a betrayal of the patients who depend on them."

The aggressive changes outlined in the proposed implementation plan are not unexpected, but are yet another step in this government's plan to privatize our health care. We saw them take a step with the release of the MacKinnon report back in September 2019, and another big step with the release of AHS Performance Review in February. Both reports recommended massive restructuring of our health care system through major privatization, and both rely heavily on Fraser Institute data, the reliability of which was most recently called into question by the BC Supreme Court in their landmark Cambie Case ruling:

"It is unclear whether any general conclusions can be drawn from the Fraser Institute surveys, even if these surveys could generally be relied upon as providing reliable data (a proposition I seriously question)."

Despite the major questions as to the reliability of the two reports remaining, the Alberta government has not hesitated in capitalizing on them as the ideological fodder they need to accelerate the process of privatizing our health care system through contracting out and reducing the health care services available to Albertans.

The AHS review, contracted by American accounting firm Ernst & Young for over $2 million, was intended to find inefficiencies in the system. This report contained 57 recommendations that, by their estimate, could result in $1.9 billion in savings, though Ernst & Young cautioned those figures don't represent expected, or even achievable, actual savings, and Health Minister Shandro indicated at the time that not all recommendations were feasible, or would be implemented.

Following its release, Health Minister Shandro turned the AHS review report over to an AHS implementation team, which was tasked with reporting on their own recommendations in 100 days. As this date was five months delayed by the province's pandemic response, nothing had been made public until today. The 82-page plan outlines extensive cuts across our public health care system, acutely in line with the recommendations made by the initial Ernst & Young review. While the Health Minister has publicly stated that the implementation will be determined by AHS and guided by Operational Best Practices, a leaked document acquired by CBC reveals that Minister Shandro had in fact directed AHS to produce plans to implement all of the recommendations in the Ernst & Young report, except for a few he determined were off the table.

Included in the proposal are plans to contract out in-hospital food, laundry and environmental services, removing nurses' collective agreement provisions, introducing home care co-pays, ramping up chartered surgical services, and reconfiguring rural emergency department, acute care and maternity/obstetric services -- among many others. This plan has the potential to turn our health care dollars, resources and staff over to private companies which will be subsidized by public health care funding. Most pressingly, the government has forecasted 11,000 health care job losses, affecting up to 16,000 workers across the province.

While in today's press conference, Minister Shandro said there would be no impact to nurses or frontline health workers for the duration of the pandemic, this contradicts the letter received this morning by the United Nurses of Alberta, which clearly states that AHS intends to proceed with its previously announced layoff of 500 nursing full-time equivalents, which equates to 750 nurses out of work, according to UNA's estimation.

"Rather than building upon the solid foundation that we have in our health care, this government is choosing to sell it off to the highest bidder without presenting Albertans with so much as a business plan to show how these proposed 'savings' would impact patients and the care they are able to access," says Azocar. "Rather than recognizing the vital importance of our health care providers, they are choosing to cut 11,000 good jobs at a time when many Albertans are already out of work. Albertans need to ask themselves if this is the recovery they envisioned for their province. Frankly, we demand better."

AHS's plan, as directed by Minister Shandro, will see no less than the decimation of our public health care. Despite Minister Shandro's attempt to spin it, contracting out is not just a change in employers, it's a change in the way we deliver health care and a clear move towards private health care. As we continue to navigate the immediate and long-term implications of this pandemic, Alberta's government is trying to suggest that the path forward lies in laying off thousands of health care workers, and privatizing our health care. Albertans should know better than to trust them.

(October 13, 2020)

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How the Deals Are Made

In the lead up to Budget 2020, on February 3 the Kenney government released a "performance review summary report" of Alberta Health Service (AHS), conducted by the accounting firm Ernst & Young (E&Y). The report contained 57 recommendations and what the government called "72 savings opportunities to improve the quality and long-term sustainability of health services." In releasing the report, the government stated it had accepted the report, with two important exceptions: there would be no rural hospital closures or urban trauma centre consolidations.

Ernst & Young (E&Y) is one of the foremost masters of sucking dry companies -- and their active and retired workers -- that go into bankruptcy protection in the U.S. and around the world and then whitewashing the scene of any evidence of crime. It is notorious for its self-serving reports and recommendations which always declare a benefit to be gained from privatization and handing over all control of public services to private interests. Firms like E&Y who are in the business of developing public-private partnerships and other forms of privatization never mention that the benefits accrue to a tiny minority of ultra-rich parasites at the expense of the workers who produce added value and the people who need and have a right to the public services.

The process of using neo-liberal accounting cartels and "panels" chosen to produce pre-determined results is part of the restructuring of the state. Rich private interests are paid to extol the virtues of pay-the-rich schemes from which they as well as their clients benefit. The Alberta government has concentrated administration of health care in a single health authority, Alberta Health Services (AHS), but it is clear that the AHS is not directing this current restructuring, but has been reduced to implementing the decisions made by the global oligarchs and delivered through mechanisms like the E&Y report.

Consultants like E&Y are not hired by governments to find efficiencies so as to improve the delivery of health care. Their role is to provide a pretext for restructuring of the state and handing over public services to private interests. Their "reports" are completely predictable -- contract out services, attack workers' working and living conditions, reduce services, and impose additional user fees on the people. Workers are declared to be a "cost" which is to be cut to the bone in order to pay the rich, both by diverting funding from health care and by increasing the amount of the remaining funding paid to the parasites through lucrative contracts. The details of these contracts are never published, as the government says they are private business information.

Health care funding comes from the portion of the added-value created by workers claimed by governments. Privatization and cuts to health care funding are an attack not only on the health care workers but also on the living standards of the working people as a whole. To call this "savings" is nonsensical. To speak of the human factor, the workers who provide health and services as a "cost" is completely irrational when there would be no health care system without them. But this is how the rich see things -- anything that does not go directly into their pockets is a "cost."

The pandemic has provided yet more proof of the terrible consequences of private control over seniors' care residences, where the majority of deaths from COVID-19 have occurred. Study after study has shown the increases in infectious disease when housekeeping in hospitals has been privatized. Communities across Alberta have fought to get the food monopolies out of long-term care so their loved ones could have nourishing and culturally appropriate food. The conclusion that there should not be a penny of private profit in health care and seniors' care is clear. But governments accept no responsibility for the tragedies that occur as a result of their anti-social offensive, or the hardships the working people face. Jason Kenney declares that bringing COVID-19 under control is a matter of personal responsibility, although apparently not his own.

A health care "insider" told Workers' Forum, "E&Y doesn't know anything about health care; they don't know anything about Alberta. Other than that, it was a good report." Never mind patient suffering and staff burn-out, we just provide the numbers and are well paid for it is their refrain. But it is no joke. The pandemic has shown who can be trusted with decision-making and who cannot. It has shown that the Kenney government cannot be trusted. It has shown that private operators motivated by maximum profit cannot be trusted. And it has shown that it is the health care workers who can be trusted, who know what is needed, who are fighting for the conditions needed to bring the pandemic under control, and who put themselves on the line every day to care for the people. Who decides is the crucial question.

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