The Government Is Reneging on Its Commitments to Health Care Professionals

Nathalie Lévesque is the interim president of the Interprofessional Health Care Federation of Quebec (FIQ)

Workers' Forum: The organizations representing nurses are critical of Ministerial Order 2021-071 issued by the Minister of Health and Social Services on October 16, on attraction and retention premiums for full-time nurses. Can you tell us more?

It’s not negotiated, it’s an order, your rights
are threatened
Unions’ solutions: Minister Dube must cooperate and respect the collective agreement to meet the objective of recruiting and retaining health health care professionals. That’s the law! 

Nathalie Lévesque: During his press conference about two months ago, the Minister of Health and Social Services announced that he was releasing a budget containing attraction premiums for personnel in the network that were also retention premiums for personnel already employed there. He described this as a stop-gap measure pending the coming into force of the collective agreements signed with the unions representing nursing and cardiorespiratory personnel. That measure became a ministerial order.

What we are critical about, amongst other things, with regard to the management of the health network through ministerial decree, is its unilateral application, which often does not factor in the working conditions of the members we represent.

Through this ministerial order, the government is reneging on its commitments to health care professionals.

For example, there are several measures in this order that contravene what was negotiated in good faith with the Ministry in our new collective agreement. This is inconceivable. How can a stop-gap measure violate agreements negotiated in good faith?

Let me give you an example. We have pregnancy leave in the collective agreement. To have access to the $15,000 premium without being penalized, you must not take any time off. So if a young health care professional who has recently become pregnant goes to see her doctor, she will not be eligible for a certain part of the premium proportional to the time not worked. This is leave provided for in the collective agreement that was negotiated with the Ministry.

You have a family emergency and you have to take an unpaid leave? A single day without
pay means you lose your bonus.
Unions’ solution: no unpaid leave or leaves in the contract can make you lose your bonus. You must have access to the premium based on your hours worked.

Continuing with the example of the pregnant woman, let's say she returns from maternity leave on December 26. She comes back to help out the network in the middle of the holiday season. Because the deadline for signing the contract for the premium is December 15, she will not be able to sign. The same thing happens to a worker who returns from disability leave after December 15. We are saying that offering a year-round eligibility period would be of interest to those returning from different types of leave.

Also, single parent families are part of today's reality and are becoming more numerous. In this period of the resurgence of colds, then of the flu in January, parents are sure to be absent some times. For example, if a parent has to leave work because the daycare has called to say that a child is sick, the worker will lose a part of the premium on a pro rated basis because they have to pick up their child at the daycare and will return to work the next day.

I also understand that full time work is being encouraged. So why, for example, is a person who is part-time and is willing to work an extra shift or two, not considered eligible for a premium?

It's one-sided. Either you go full time or you get nothing, if you take time off, you lose some of the premium.

We have asked that we be heard by the Ministry, to provide them with potential solutions, based on what our members in the health network are telling us, on what their day-to-day experience is. We want to work together. There are ways both in the medium and long term to make changes together in the network. The day after a meeting with the ministry, we were told 'thank you very much, see you next time.' It's like talking to deaf ears, it's unidirectional, there is no openness, as promised, that should take place in a discussion. They simply shut the door on us.

Now the Minister of Health is saying that the unions are impeding the hiring of 3,000 full time nurses because we are calling on our members to pay attention to the details that may disqualify them.

You know, there have been 155 ministerial orders since the beginning of the pandemic, 105 of which have violated the working conditions of health care professionals and all the people who work in the health system. It is clear that we will never agree to be associated with such a ministerial order. The measures in the order are imposed unilaterally and have never been negotiated.

If you sign you become full-time and the employer can move you and change your schedule at will!
Union solution: You are not a robot! This provision must be eliminated in order to respect the collective agreement. You do not have to give up your rights!

WF: In one of your communiqués, the FIQ says that the ministerial decree reintroduces staff mobility and encourages the acceptance of rotating shifts, which must be stopped in order to stabilize the work teams. Can you give us an example?

NL: Let's say a nurse has a part-time position on a medical floor and she is three shifts short of full-time. To be able to sign the contract under Order 071 that would make her eligible for premiums she has to agree to the additional three shifts, but on those three shifts she could be sent to work anywhere. She could be sent to Geriatrics one day, to the emergency room another day and on the third day to the CLSC [Local Community Service Centre]. This is not optimal quality care. We want to guarantee quality care to the population, but this is not the way to do it.

WF: Under these conditions, what are the FIQ's priorities with regard to changing the situation in the health care system?

NL: We must be able to work cohesively with the ministry, put an end to the management of the health care system by ministerial order and implement our collective agreements in a sustainable manner. For us, the priority right now is to implement what we have negotiated in our collective agreement. This includes financial measures, incentive bonuses, a FIQ-bonus, and negotiated hours of care, which are the basis for the health care professional/patient ratios that we want to implement. This is what will end mandatory overtime and close the door to private hiring agencies for nurses. Our collective agreement also includes a form of work schedule self-management by the care units, which includes taking into consideration the opinions and daily experience of health care professionals. All of these measures, once implemented, should help our members work in an environment that is safe and respectful of our working conditions.

We want to remind everybody that we are not in confrontation mode with the government. We must work together to optimize the health care system and be able to provide quality care to the population.

This article was published in

November 19, 2021 - No. 109

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