With Bill 15 tabled by Minister Christian Dubé, Santé Québec, the new government agency responsible for network activities becomes the sole boss of some 331,000 employees in the health network, which currently has 34 employers. From 136 units, we would go to 4, which will transform the current system of local negotiations of working conditions.
From the outset, the central unions in the health network—the CSN, the FTQ, the CSQ and the APTS (Alliance of professional and technical personnel in the health and social services network), which form a common front , as well as the Fédération interprofessionnelle de la santé du Québec (FIQ) — have criticized Bill 15. Some have deplored the increased centralization it imposes and the lack of consultation that preceded its tabling. Others saw it as a mix of structures that do not solve the problems. But we did not hear them deny the need to reform the health system or oppose the minister’s general objectives, including improving the working conditions of nursing staff. This makes sense.
Of all the centrals, it is the FIQ, headed by Julie Bouchard, which has shown itself to be the most virulent towards the bill. “I’m still looking for the positive,” said the president. It is true that she represents nurses who are among the network employees most affected by the effects of the labor shortage: work overload, compulsory overtime and exhaustion. It will be necessary to see if the closure that it manifests and the surly style that it employs will pay off for its members. In the current context, one might wonder if this is the best strategy to adopt to rally public opinion to one’s cause.
As for the call for decentralization, the Minister must heed it, because several elements of Bill 15 lead to even greater centralization of an already highly centralized network. All the same, it must be emphasized that the central unions are not reluctant to negotiate with a single employer.
In the 1960s, that was their demand. Before the health network was formally constituted, hospitals, often founded by religious communities, were independent entities. At that time, the unions fought to negotiate directly with the State rather than with the management of each of the establishments.
In the early 2000s, the unions in the health network opposed Bill 30 by the Minister of Health, Philippe Couillard, a bill which, while reducing the number of bargaining units, forced the parties to negotiate locally the conditions related to the organization of work. “A return to the 1960s”, then denounced the president of the Federation of Health and Social Services, Pierre Lamy. The president of the FTQ, Henri Massé, had described the decentralization of the negotiations as a “farce”, the FTQ only negotiating with the real power, that is to say the ministry and the Treasury Board. Another time, other mores, one might say: what these union leaders denounced were the local tables that currently exist and that their successors want to preserve today.
The centrals of the common front fear that an intensive poaching will follow the changes in accreditations, as had happened after the Couillard reform. They do not want an inter-union war.
As Christian Dubé mentioned, the existence of a single employer will allow a staff member of a CIUSSS, for example, to change establishments without losing their seniority. This “network seniority” was demanded by the unions, but the centrals are now expressing reservations, stressing that the movement of personnel could disadvantage certain establishments or certain regions. This is a legitimate concern, but probably exaggerated.
Apart from the FIQ, which has the knife between its teeth, the other centrals are talkable, we argue in the government. During the last negotiations, the FTQ, for example, showed itself open to the introduction of differentiated salaries, a measure that is part of Minister Dubé’s Health Plan.
But for the centrals to remain talkable, the president of the Treasury Board, Sonia LeBel, will have to offer better than a salary increase of 9% over five years. Given the inflationary pressure of the past two years, this offer actually represents an impoverishment for network employees. After agreeing to a tax cut for the population totaling 9 billion in five years, the Legault government will have to find another leeway to adequately remunerate network employees. This is an essential condition for the success of the reform undertaken by Christian Dubé.