New research has robbed the BC right of one of its favourite tools to push privatization, dismantling a flimsy and flawed Fraser Institute report that claims to compare the work of health care support workers and hotel workers.
Economist Marjorie Griffin Cohen, a professor of political science and womens studies at Simon Fraser University, conducted the research for the Hospital Employees Union, CUPEs BC health services division. After examining the Fraser Institute studys methodology, Cohen concluded the think tanks three-page report exaggerated the wage differences between health care and hotel workers. She also found the report didnt look at the actual jobs of hospital and long-term care workers, making any comparison faulty at best.
Her analysis exposes the true agenda of BC politicians and pundits who have tried to carve out an artificial distinction between “hotel” services such as catering or cleaning, and other forms of patient care. The Fraser Institute paper provided ideological ammunition used to push privatized health care jobs and lower wages. While privatization pushers seek to hive off these services, the research shows these services are at the heart of healthy patient care.
Cohen took a close look at the skills, responsibilities and working conditions of hospital housekeeping staff, laundry workers, trades, food and clerical workers. She found the technical sophistication of hospitals and the responsibilities of support workers require a different set of skills and training than would be required in a hotel.
Health care support workers are often in front-line contact with patients, playing a significant role in well-being and recovery. Levels of responsibility are much higher in hospital work. Youre dealing with people who are sick, so there are strict protocols around food and cleaning. Operating rooms must be sterile and immaculate, says Cohen. The spread of antibiotic-resistant superbugs makes stringent cleaning routines the first line of defense against infection.
Cohens study cites evidence of lower standards of cleanliness in hotel rooms. My point is not that hotel workers do inferior jobs but that their roles are fundamentally different. she says. Key to any comparison is that healthy people require a different level of cleaning and care than already-vulnerable patients and residents.
Hotel workers dont confront the risks and dangers that are a day-to-day reality in health care support work. Laundry workers and cleaners come into contact with body fluids and parts, and are exposed to hazardous chemicals. Infection from needle stick injuries is another danger, along with exposure to diseases such as tuberculosis. Rising workloads compound the health and safety risks of health care support work. BC Workers Compensation Board statistics show cleaners and housekeepers in hospitals and long-term care facilities are injured four times more often than the average industrial worker.
Trades people and food service workers in hospitals and long-term care facilities have specialized training about patient and resident safety and care. In addition to their specific trade, maintenance workers need to know how to handle hazardous materials, and frequently work around patients. Food service workers are able to interact with patients and observe whether or not patients are actually eating the food given to them. This is an important function, particularly with elderly patients. Meeting patients dietary needs is a complex process that involves government regulations as well as constant monitoring and reporting.
Comparisons of clerical work dont stand up either. Admitting patients to hospital is vastly different from handing them a hotel room key. Health care clerical jobs demand a high level of technical accuracy to admit or discharge patients, create and maintain medical records, as well as manage and purchase supplies.
In all of these cases, lower pay and poor working conditions that come with contracting out would mean losing continuity in care. High staff turnover will make a dent in the on-the-job training and expertise that public health care providers have built up, says Cohen.
Cohens study concludes with a look at contracting out in other jurisdictions. She finds hotel-type services are not contracted out in most US hospitals. She also found the Toronto Hospital has brought back in house its contracted out housekeeping and material management departments, along with part of food services. The food service went to the Bitove Corporations cook-chill system of highly processed and packaged foods. Bitove is infamous for its rethermalized toast that was prepared in Toronto and flown to New Brunswick for reheating while hospital toasters sat idle.
Bitoves Toronto menu wasnt much better. Hot breakfasts and water delivery were eliminated, and there were delays meeting special needs of new patients. Over-packaged food, including toast, was difficult for weak patients to open without help. Supply and delivery problems were common. Now, the Toronto Hospital is building new kitchens and bringing the work back in house.
Cohen concludes contracting out may well be the cause of widespread dissatisfaction uncovered by surveys of patients and staff. The Toronto story is a cautionary tale for BC health institutions.
The push to discredit and undervalue health support work is the tip of the privatization iceberg, so its vital to challenge this first step says Cohen. The approach is to privatize health care incrementally, starting by picking off the easiest group the lowest paid and, to them, least visible workers in health care. Her report is a call to strengthen not fragment the network of support and care.
In BC, Premier Gordon Campbell has gone into hyperdrive, bypassing the incremental approach in favour of an all-out assault on public health care support workers. His bid to take away the job security of health care workers will pave a roadblock-free way for widespread privatization and contracting out of health care support services. Cohens paper provides hard evidence of the value of unionized, public health care staff and the services they provide.