Heath care contract: adding and subtracting


Last week’s to-the-edge-of-the-ledge, past-the-last-minute contract settlement between Capital Health and its 3,600 health workers raises all sorts of difficult but intriguing questions.

The first, and most immediate, of course, is could the disruption—even without an actual strike, the anticipation cancelled 560 elective surgeries and emptied 172 beds—have been avoided?

The short answer is probably not. Both sides have legitimate, vital interests in the outcome and only the combined pressure of a looming deadline and smacking up against the real-life consequences of not settling creates the conditions necessary for compromise.

So long as there is collective bargaining, we will have brinkmanship.

But should we even have collective bargaining in health care? Let’s come back to that.

Is the settlement fair? We won’t know the full financial implications until an arbitrator picks either the union’s (nine per cent over three years) or the province’s (6.5 per cent) final position. The province’s finance department has undoubtedly already crunched both scenarios, so Premier Darrell Dexter should disclose them so we can discuss their merits now.

This year’s provincial budget includes a $199-million “restructuring” line item, supposedly to cover contract settlement contingencies above the government’s hoped-for one per cent salary increases, so the deal may not deflect the government’s goal of balancing the books by next year. But it will raise the bar for other public sector workers.

Other numbers also come into play when asking if the settlement makes sense. Nova Scotians’ cost of living increased by 3.7 per cent last year while wage settlements barely nudged 0.4 per cent. Even the union’s final demand just keeps pace with cost-of-living increases.

One more, different set of “numbers:” the settlement calls for an across-the-board wage increase, meaning those at the lowest end of the union’s 100 or so different job categories—those who need more most—will get the least. How fair is that?

Back to collective bargaining and essential services. Given that the final salary settlement ended up in the hands of an arbitrator anyway, why not cut to the chase and ban strikes in health care?

That, my friend, is a whole other discussion. What do you think?

  1. OK – Three points.

    1) IF (not that I agree) we are moving to binding arbitration and no strike option at all for those in health care (or maybe in the whole public sector, as some would have it) – then I suggest that we set a rate for each classification in health care through bargaining, and then start with automatic COLA (cost of living) clauses — the rates that we decide are fair this year will go on being fair, in subsequent years. For any another kind of increase (expansion of the responsibility of the classification, or shortage of workers, or need to stimulate retention, requests for better pensions or benefits) or changes to language about working conditions, leaves etc. then the employer and union would go to an arbitrator to decide the reclassification or the increase, if they cannot come to an agreement. And, although work load is not usually considered in classification decisions, if efficiencies are possible — meaning an increase in the work load — or getting more production from fewer workers – they should also benefit from that increase according to a decision made by an arbitrator. This probably sounds reasonable but is far more than folks in health care have been able to bargain for, WITH the strike option in the last couple of decades — their wages (like most workers in this country) have stagnated or been reduced in real dollars over the last 20-30 years. . .

    2) NO space here but the increase in health care spending is not because of worker wages and salaries but more because of wild investor demands from pharmaceutical and technology companies and the fact that they are making excessive profits. Applying austerity here means that they fall behind, and creates a lack of available skills/professions.

    3) Also I understand (though I cannot prove it is true, and its source is questionable) – that CDHA has 1 manager for every seven workers — a little less management is probably in order.

    Just a little PS – One way to have the low income workers get a better increase is to accept increases in dollar amounts rather than in percentages. A $1.00 an hour increase will be a higher percentage of the wage of a low paid worker than a high – narrowing the gap — but I am having trouble suggesting how that fits into the COLA system (that I don’t actually agree with as I prefer bargaining and the right to strike) I suggested above.


  2. Collective bargaining, including the right to strike, invokes a number of practical questions, but it IS a right. Would we not have to make a case more compelling than inconvenience, delay, or even a risk to health–our society is laced with these risks, few of them banned, and many encouraged–before we compromise a basic right?
    Can such a case be made? Doubt it, though we should be open to the discussion, of course–as we should be open to wondering why we obsess about the wage rates of highly-skilled technologists, but leave unquestioned the salary burden of less-competent administrators? Or, why we care so much about a raise that’s less than the cost of living offered to a $33,000 a year worker, and pay so little attention to a greater percentage raise given to a specialist who makes ten times the annual salary? (And, are both making a fair tax contribution in support of the public good, including the medical system?)
    With the cost of our medical system having risen to, what, 45% of the provincial budget, we should be thinking about a wide set of serious problems (not just wages and salaries and taxes, but about pharmaceuticals and those who grow rich off them, equipment, computers, consultants, etc.)
    If we remove the right to strike, are we also willing to defend the public good with a more egalitarian pay system across the board, legislating a more progressive tax system and controls on profiteering in the medical world?
    Your question about the effect of straight percentage increases within a collective agreement is a good one. Unionists like myself will be tempted to say, ‘Leave that to the local to sort out among themselves’. But we know otherwise: better-paid employees are often more active in a union, more influential in creating contract demands and more likely to be involved in negotiations. As our union movement fights to overcome the vandalism of the right (including threats to our collective rights), it may well rediscover its egalitarian roots. And then, will we be able to confront the difficult task of bringing this new fairness into our own practices?


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