Nurses and other health care workers across Quebec have taken action to protest against draconian working conditions and a drastic decline in patient care due to years of austerity. They are demanding an end to compulsory overtime, the hiring of more nurses and other health care professionals, and a reduction in workloads through reduced, and strictly enforced, patient-nurse ratios.
In recent weeks, nurses at hospitals in Laval, the province’s third-largest city, Sorel-Tracy, and Trois-Rivières have resorted to job action, refusing to start their shifts and holding “sit-ins” until additional staff were called in, to protest the chronic lack of personnel.
Thousands of nurses and other health care workers have also taken to social media to voice their outrage at the state of Quebec’s public health care system. Facebook messages posted by two nurses have been shared tens of thousands of times and have attracted an avalanche of supportive comments, many from other nurses with similar experiences.
In the first message, Emilie Ricard, a young Sherbrooke nurse, explained that she had been responsible for more than 70 patients throughout her shift with just two aides and a nursing assistant to help her. In the other message, shared more than 75,000 times, Joanne Leclerc, a nursing assistant from Sorel-Tracy, denounced the fact that when she refused mandatory overtime she was suspended.
Forced overtime is increasingly the norm in hospitals across Canada. In Quebec it mushroomed in the wake of the hospital closures, massive budgets cuts, and elimination of 12,000 nursing positions that the Parti Québécois (PQ) governments of Jacques Parizeau and Lucien Bouchard imposed in the 1990s. It has increased further in recent years due to another savage round of budget cuts, this time administered by the PQ’s federalist opponents, the Liberal government of Philippe Couillard.
According to a study, when nurses’ overtime hours increase 5 percent, the patient mortality rate increases 3 percent. Many Quebec nurses are routinely forced to work double shifts,
The nurses’ protests have forced the corporate media, which has enthusiastically supported Couillard’s austerity drive, to report on the deplorable conditions that prevail in Quebec hospitals, though in a very limited way. Articles have appeared on out-of-breath and harried health care workers—not only nurses, but also doctors in residence, who work an average of more than 70 hours per week, respiratory therapists, social workers, and nursing aides. According to a recent survey conducted by the Fédération interprofessionnelle de la santé du Québec (FIQ—Interprofessional Health Federation), the union that represents the majority of Quebec’s nurses, 30 percent of its 75,000 members are considering quitting their jobs.
However, FIQ has come to the help of the provincial Liberal government in seeking to prevent the incipient rebellion among the nurses from becoming the catalyst for a broader mobilization of public sector workers and the working class as a whole against the ruling elite’s drive to dismantle public services and gut worker rights.
At the conclusion of one of the many emergency meetings between FIQ leaders and Health Minister Gaétan Barrette, the architect of the latest wave of health care cuts, FIQ President Nancy Bédard described the meetings as “very positive.” “We have a [government] commitment to pilot [patient-nurse] ratios in 16 regions of Quebec,” she gushed, adding, “I am confident the Treasury will put up the necessary funds [for the hiring of staff].”
Bédard represents an organization that, in conjunction with the larger Quebec Federation of Labour (FTQ), Confederation of National Trade Unions (CNTU) and Centrale des syndicats du Québec (CSQ), has repeatedly isolated and sabotaged militant nurses’ struggles, while politically harnessing them to the big business PQ.
FIQ’s latest maneuver is aimed at dissipating and derailing their challenge to chronic understaffing. Barrette has made it clear that there will be no law regulating patient-nurse ratios. These will continue to be decided by health care institutions whose budgets have been ravaged by years of austerity.
As for the “necessary funds” to improve public services, the true attitude of the Liberal government was revealed in the cynical statement of Premier Couillard that “We are in a public health system where, all the time—in the future too—resources are never at the same level as needs.”
The conditions experienced by nurses and their patients are the product of decades of cuts administered by successive provincial PQ and Liberal government to health care and all public services, and of the massive cuts federal Liberal and Conservative governments have made in the funds that Ottawa provides the provinces to fund Medicare, post-secondary education and welfare.
For the ruling elite, the ravaging of health care budgets is not only a means of slashing taxes for big business and the rich. It is meant to erode the strong popular support for a universal, state-funded health care system and thereby politically prepare the wholesale privatization of health care.
In this regard, Quebec is very much in the lead. Over the past decade, Liberal and PQ governments have fostered the growth of privately-owned diagnostic clinics and, in the name of efficiency, have given the green light for various medical procedures to be administered by for-profit clinics, although the cost is still borne by the state.
Under Bill 20, the health “reform law,” Barrette and the Liberals pushed through two years ago, not only did the government fuse health care institutions, eliminating large numbers of administrative jobs. It took an important step toward privatization by establishing the principle that every medical service should be “monetized,” with a price, determined with the aid of private health providers, attached to it.
The turn by the nurses to spontaneous job actions and Facebook protests, independent of the unions, is an indictment of the FIQ and the whole trade union bureaucracy. Time after time, the union leaders have torpedoed struggles of health care and public sector workers—most infamously in the case of the nurses in 1999, when they rebelled against the disastrous consequences of the austerity measures of the Bouchard PQ government and mounted an illegal strike, only ultimately to be forced back to work under the threat of severe sanctions. (See: Unions strangle Quebec nurses’ strike)
Régine Laurent, who headed the FIQ from 2009 until last December, revealed in a recent interview the essential role that the unions have played in quelling the opposition among workers and enabling the ruling class to move forward with its plans for social demolition. “I was here in both strikes, in 1989 and 1999,” she explained. “And in the last two negotiations, in my head there was something that was clear. I never said it publicly, but for me it was clear that we had to use every means except strike action.”
In 2015 more than half a million Quebec public sector workers repeatedly demonstrated their determination to fight the latest government assault on their working conditions. But the Inter-union Common Front—in which the FIQ decided not to participate, the better to isolate the nurses—dissipated this anger in futile protest actions and steadfastly opposed linking the contract struggle over the workers’ terms of employment to any broader mobilization against the government’s austerity measures.
For months, the union bureaucrats refused to discuss, let alone warn workers, about the government’s plans to enact an emergency law illegalizing job action and imposing concessionary contracts by government decree. Such a discussion would have raised the need for workers to launch a political struggle against the Couillard government on the basis of a broad appeal to workers throughout Quebec and Canada for the defense of all jobs, wages and public services.
Then, as support for a province-wide unlimited strike developed, the union leaders, working according to a now familiar script, abandoned the workers’ demands, signed sellout agreements, and invoked the imminent threat of an emergency law and government-dictated contracts to force through their ratification.
Québec Solidaire (QS), the pseudo-left party that has three seats in the Quebec legislature, organized a demonstration in February of a few hundred people in Montreal to “support” the nurses. Their main demand, however, was for Barrette’s resignation. The purpose of the rally was thus not to prepare the mobilization of the workers against the austerity program of the Couillard government, but to help the union leaders defuse the crisis. QS played a similar role in 2015, when it lent support to the anti-worker maneuvers of the union bureaucrats, and in 2012 when it helped the unions politically harness the Quebec student strike to the big business PQ.