The virus that’s wreaking such havoc is the privatization virus. CUPE members are being exposed to the virus every day – both as workers and as people who rely on public services for themselves, their family and their community.
The disease is spreading especially quickly in the health care system. And the race is on to cure the privatization fever that’s seized the minds of governments and administrators – before it kills our public hospitals, nursing homes and long-term care facilities.
Cost-cutting and restructuring are some of the early warning signs that the privatization virus is at work. Governments seized with deficit-cutting madness are cutting money from health care, leaving the system vulnerable to invasion by privateers.
Thanks to the tireless efforts of CUPE members and their allies, the public is more aware of the impact of these cuts. But it’s an on-going battle to get governments to take action to reverse the trend.
Across the country, the stories are chillingly similar: Workers are stressed to the limit and patients are paying the price.
At the McCreary-Alonza Health Centre in Manitoba, every department has been cut yet the workload continues to rise. Before the cuts started in 1990, there would be perhaps three or four patients in need of the most serious care. Now, there are 18 in a joint hospital/nursing home with just 33 beds.
“There’s a formula the government uses, but it’s almost like they change the formula to suit themselves,” said Dianne Unrau of CUPE 2283. “Because of the higher levels of care and decreasing staff, there’s more sick time, decreasing morale and more injuries.”
Unrau said the little things just don’t get done anymore. Little things like keeping patients, many of whom have no family, company. Perhaps reading them a book or writing a letter to a loved one far away.
A couple of provinces to the west, Mary Nicholls knows exactly what Sister Unrau feels. Nicholls is an activity worker at Mills Memorial Hospital in Terrace, B.C. She has seen the occupational therapist, social worker and ward clerk all disappear from her hospital.
As a result, “there’s less staff for patients. The staff is limited in terms of one-on-one with patients and groups.
“When I’m away, either sick or on vacation, I’m not replaced. This means no patient can even go out for a walk or go to the drugstore,” she said.
Patients are suffering the effects of a thousand cuts clear across the country. In Miramichi, New Brunswick, Beth Murray sees patients humiliated because a conservative politician somewhere thinks people can always do more with less.
Sister Murray, of CUPE 865, works in food services. Because staffing hasn’t increased while demand skyrockets in the Miramichi Hospital, patients refuse to eat because the food will be cold by the time a nurse arrives to move their tray.
“We’re not allowed to assist patients and when I’m delivering food trays, they say I may as well take the tray away. The food will be cold by the time someone arrives,” she said. “It’s also so stressful to see people sitting on a commode, with tears in their eyes. One had been left there for 20 minutes and wanted to get back into bed, but no-one was there to help her.
“People aren’t seeing or hearing what’s happening. Patients are even called customers now,” she said.
But customers at Canadian Tire are treated better than the system treats some patients.
At the Jewish General Hospital in Montreal, there are up to three times as many patients for each respiratory technologist (RT) as there should be. This means patients under anaesthetic are not checked as often as they should by RTs, whose job it is to monitor the ventilator that breathes for patients during operations.
“The number of patients has increased, but the number of RTs has not,” said Céline Tranquille, an RT at the hospital. “The patient who is on the ventilator should be checked every hour, but often that doesn’t happen. The care is not what it should be. Sometimes the operation is postponed or even cancelled because there’s no RT.”
In Northern Ontario, staff was laid off after beds were closed. Then there were bed shortages, so beds had to be reopened but the staff wasn’t in place. As a result, the new staff wasn’t given sufficient training and was forced to scramble as the patient-to-staff ratio grew.
Susan Piette, an RPN at the Sudbury Regional Hospital and member of CUPE 1623, said when she started a new job in x-ray she got just three days’ training. And throughout her hospital, services are being cut. Patients’ beds are not changed, sponge baths have replaced showers and little things such as tissues and shampoo have been abolished.
“Increasingly, we’re counting on family members to come in and bathe and feed patients,” said Sister Piette. This trend is seen across the country and is a burden that hits women especially hard. As cuts take away public services, women are overwhelmingly expected to fill in the gaps.
“Our members are living with the psychological impact of this underfunding,” said Yvette Doire of CUPE 2805 at a Montreal nursing home. “We give the maximum that we can – but it often means five minutes to wash and a few more to eat. But we know it’s not adequate and so we take home with us feelings of guilt for not doing enough.”
At Doire’s facility, care for 25 patients should be delivered by five workers. The current ratio is two or three workers to 25 patients.
It’s the same story across Canada. In British Columbia, cutting jobs resulted in patients losing meal choices and being forced to take what’s given. In Manitoba, medical files were updated late, exposing patients to risk. In Ontario, operating theatres have been labelled “filthy” by health inspectors, courtesy of cleaning cutbacks.
At one Ontario hospital, the number of antibiotic-resistant infections has risen from five a year to five a month, partly attributable to fewer cleaning staff.
Luckily, there hasn’t been a similar increase in the number of fires at one of Canada’s biggest hospitals. At the Toronto Hospital, fire sprinklers and dampeners (barriers to fire that close if one is detected) are just not checked anymore as a result of cuts to the maintenance department.
When this is coupled with contracting-out to unqualified trades, the results are potentially lethal.
“People in maintenance had to go after contracted-out electricians and do it right,” said Richard Rollox of CUPE 5001. “Fibre optic cables were installed through firewalls without using conduits. We had to go in and re-route it properly because it’s a safety hazard. If a dampener closes [without a conduit], then it would cut all the services.”
Not only did the hospital have to pay people to redo a job they paid outside contractors to do, if there had been a fire and the unchecked system actually worked, vital, life-saving cables would have been cut
Restructuring Confusion
As the federal Liberals slashed transfer payments, the cost-cutting madness spread to the provinces and attacked health care. In the push to cut health care costs, Saskatchewan, Manitoba, Ontario and Nova Scotia have all gone through large-scale restructuring.
In Saskatchewan, Steve Foley of CUPE 4110 in Weyburn and president of the Health Care Workers Council, said restructuring has not been easy. Workers’ contracts had to be merged and there are fewer staff to meet patients’ demands than five years ago.
“The government tried to do the right thing, but much of their restructuring was driven by money – not service. But when you hear about health care reform in the rest of the country, [the Saskatchewan government] did try to do things right with partially elected health care boards,” he said. No other province has any elected representation on health care boards.
In B.C., community care for people with mental disabilities has borne the brunt of restructuring. Although funding has been improved, it’s still at meagre levels that don’t relieve the strain that restructuring has placed on facilities.
The Vancouver area, for example, saw the closure of the Riverview Hospital, which forced “intensely psychotic” patients into the community care system. As a result, community care staff were forced to deal with more serious, time-consuming problems with no extra training or staff.
“We [are handling] much more complicated symptoms,” said West Vancouver’s Graham O’Neill of the Hospital Employees’ Union. “So you’re spending all the time with one person and not with others. We also need training on violence intervention with aggressive residents.” O’Neill’s comments echoed those from across the country, with health care workers facing worsening assault from patients and residents with few policies in place to deal with it.
Fighting Privatization
Dwindling funding and growing demand are a dangerous combination, leaving health care services vulnerable to privatization. Huge health care corporations are ready and willing to take over once-public services, eager to turn a profit and expand their market share. Experience shows that jobs disappear and patient care goes down as privateers ensure that their profits go up.
Overwhelmingly, Canadians do not want private health care. Governments know this, so privatization is happening in secret, at a rate of 1 per cent per year. Piece by piece, service by service, privatization is spreading. No-one will announce that the system is being privatized, but unless CUPE and our allies continue to expose privatization, the announcement won’t be needed because it will be too late.
CUPE Alberta has been battling privatization ever since Ralph Klein’s Tories were elected. Alberta’s Bill 37 would have permitted privately-owned hospitals in the province, a clear violation of the Canada Health Act.
In response to Bill 37, CUPE Alberta went all-out. Even after the pasting Klein took over the Calgary laundry workers, he refused to back down until a province-wide mobilization campaign cemented public opposition to private hospitals.
When withdrawing his bill, Klein singled out CUPE for making private hospitals political suicide for the politician who dared favour them. Klein then handed the bill to a hand-picked review panel, which has dutifully returned a report favouring even more privatization of the health care system.
Most politicians, though, are smarter than Klein. They know it’s unpopular to call it like it is, so they hide privatization behind terms such as “partnership”. But CUPE members know partnership is just code for more cuts, limited access, fewer jobs and less service.
In Nelson, BC, Eleanor Schmidt of HEU has been leading a long campaign against a public-private partnership (P3) for a combined acute and long-term care facility in her community.
“We know the federal government has pulled money back,” said Schmidt. “It’s as if they’re leaving the door open for more corporations to come in and fill the gap.”
But she’s mobilized the community against a private facility and is winning. She said people simply do not trust private money in the health care system and want to keep it out – with good reason.
“One woman spoke about her fears for a two-tier health care system because she was forced to put her husband into a private facility and it was costing her $4,000 a month,” said Schmidt. “People can identify with it.”
The situation is worse in Ontario, where the provincial government has launched a massive advertising campaign about opening 20,000 new nursing home beds. What they don’t say is that two-thirds of all new beds in Ontario will be privately-owned, many by large American operators.
The privatization virus is infecting every aspect of the health care system and often gets its start in non-medical services such as laundry or food services. In New Brunswick, Quebec and Manitoba, CUPE fought hard against private food services, consistently predicting lower food quality and consistently being proven right.
No matter how they sell it, re-heated, frozen private food is not as good as food prepared on-site by
qualified CUPE members. Patients know it, too – after private food was introduced in Winnipeg, every patient at one hospital lost weight with an average weight loss of more than 6kg.
Although re-heated, private food has only been reversed in BC, CUPE continues to expose centralization hypocrisy.
In Newfoundland, the St. John’s Nursing Home Board wants to centralize laundry services for its six homes, four of which have no in-house laundry capacity. They have two choices: Close the two unionized laundries and save $132,000 or bring all laundry services in-house at St. Patrick’s Nursing Home and save $313,000 – even according to the board’s own figures.
Kelvin McDonald, a member of CUPE 879, and his co-workers at St. Patrick’s are trying to convince the board to keep the laundry public: “Residents right now enjoy quality laundry services. People have praised the service, but if it’s contracted out, who knows what type of service they’ll receive?”
The Federal Budget Boondoggle
The provinces have very different levels of health care funding, but they do share one thing in common: A federal government that does not get it. Nowhere was that more clearly demonstrated than in the most recent federal budget.
Despite cutting $22 billion since coming to office, the Liberals returned barely 10 per cent of that in the budget. It’s hard to thank someone for giving you back a loonie after stealing $10.
In 1995, the Canada Health and Social Transfer (federal payments to provinces) stood at $18 billion a year. Even after the so-called health care budget, it will only rise to $15 billion a year.
It’s unthinkable that anyone should call the last federal budget the “Health Care Budget” when not a word was mentioned about national homecare or pharmacare, despite Liberal promises to introduce these much-needed programs. Likewise, not a word on lowering the private share of Canada’s health care system from its current level of 31 per cent of spending.
Both the Alternative Federal Budget and the Canadian Health Coalition have called for federal spending to be 25 per cent of health care spending. Paul Martin’s 1999 budget fell far short. It will increase to a maximum of 12.8 per cent before falling to 11.2 per cent in 2003.
That’s far from the strong medicine needed to stop the spread of the privatization virus. CUPE members know that only swift and far-reaching action will save our public health care system.
Health care professionals tell us one of the easiest ways to stop the spread of disease is frequent hand washing. Governments can halt the privatization virus in its tracks by washing their hands of greedy corporations and their destructive plans.
Jamey Heath