The Minister of Health and Social Services, Christian Dubé, tabled Bill 10 on Wednesday, which gives him the power to regulate and prohibit the use of independent labor (MOI) and agencies. shift. It’s an “enabling” bill that basically allows the minister to do whatever he wants by way of regulation.
To understand the government’s intentions, reading the bill is of little help. It is in a document prepared by the ministry that we learn that Christian Dubé is aiming for a timetable for the abolition of the use of the MOI with variable geometry, all the more variable as he can modify it as he pleases. In Montreal and Quebec, abolition is scheduled for 2024; in medium-sized agglomerations, it is in 2025; and in remote areas where the use of agencies is most widespread, eradication is envisaged for 2026.
During a technical briefing, the department presented data showing the exponential growth from 2016 to 2022 of this recourse to this independent workforce, which is often made up of former nurses from the network or other members of the nursing staff who thus obtain flexibility in the choice of their working hours that the network is unable to provide. It’s unfair for the permanent nurses who keep the network at arm’s length.
Thus, in six years, the use of MOI, integrated into the network management model, has doubled in number of hours. Costs to the healthcare system nearly quadrupled to nearly $1 billion. This gap of one to two between the growth in the number of hours and that of costs shows that the agencies have the big end of the stick and are aiming for the blessed bread. Their rates can reach $100 per hour or more for the services of a nurse. In addition, with the bill, the Minister gives himself the power to set a maximum hourly rate per job title.
It is a “vicious circle”, said the minister: the agencies encourage departures and aggravate the lack of manpower by recruiting staff. Year after year, 20,000 people leave the public network, or 6% of its 350,000 employees. That’s twice the number of employees retiring. The network not only has a problem of attraction, but a problem of retention, says the minister.
A “change of culture” is needed and it requires a significant improvement in the working conditions of unionized nursing staff. This rests on the shoulders of the President of the Treasury Board, Sonia LeBel, who must negotiate the renewal of the collective agreements of network employees. And on those of the unions which are called upon to be open to this flexibility in the local management of working hours and to these differentiated offers for nurses, which repels them. They will also have to agree to the rules that will govern the seniority of nurses from agencies that will return to the network. It’s not win.
The implementation of Christian Dubé’s Health Plan largely depends on these negotiations. They promise to be difficult if we rely on your employee, in particular, by the president of the Fédération interprofessionnelle de la santé du Québec, Julie Bouchard. Improving the working conditions of nursing staff and changing a management model that relies on placement agencies and on the obligation, imposed on too many nurses, to work overtime are objectives that should nevertheless be subscribed to trade unions.