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1998
Health Care Reform
At the 1997 UNA Annual General Meeting the number one concern of the delegates was the privatization of health care. In a UNA survey, 94% of nurses rated the increasing privatization of health care as “a very important issue for UNA action”. Consequently much work was done in 1998 to support and extend Canada’s public health care system and to oppose encroaching privatization.
UNA sponsored a national postcard campaign calling for a Royal Commission on health care. Thousands of postcards were distributed by UNA members and supporters and received by the federal Minister of Health.
Bill 45, the Health Professions Act, remained the target for UNA scrutiny and action. This omnibus Act will replace 15 separate statutes (including the Nursing Profession Act) and combine the regulation of 28 health care professions under one piece of legislation. The Bill received second reading in April of 1998 and was left at that stage in order for the government to engage in extensive discussion with the affected parties. After these discussions, a final version of the Bill will be introduced in the 1999 Spring session of the Legislature. Due to the fact that the legislation affects such areas as governance of a profession, and the standards of practice and licensing, the Alberta Association of Registered Nurses was particularly interested in the Bill and was very disturbed about some of the proposed pieces of the legislation
regarding governance, registration and continuing competency. They mounted a provincial campaign which UNA Locals actively supported, and when AARN officials met with the government to point out their areas of disagreement they came away feeling that the final draft would address their concerns satisfactorily. The final version of the Bill came out in December 1998, and did not contain all of the changes that the AARN expected. The AARN wrote a responding brief identifying all of the deficiencies in the Bill including technical and administrative difficulties, governance and membership problems as well as scope of practice issues. The new legislation would let unregulated people perform regulated activities. When the Bill comes forward in the 1999 Spring session both UNA and the AARN will be active in challenging many of the problems and deficiencies of the proposed legislation.
On April 2,3,4, 1998, UNA co-sponsored a health care conference with the Parkland Institute. This conference was titled: “The Canadian Advantage—Public Health Care”, and had as keynote speakers, Ralph Nader, Maude Barlow, Colleen Fuller and Richard Plain.
In 1998, federal statistics were released showing that Alberta has fallen from first to tenth place in the per capital expenditures on health care. Alberta spends less per capita on health care than does any other province. B.C. spends the most—$1,955 per person, while Alberta spends only $1,588.
Bill 37, the Health Statutes Amendment Act, was a major focus of activity for UNA in 1998. This, you will remember, was an issue in 1997 and focused on the Health Resources Group (HRG) which wanted to operate a full acute hospital on a private for-profit basis. All the disclaimers about it not being a hospital were referred in 1997 to the College of Physicians and Surgeons but in December 1997 the College declined to approve the HRG as a hospital, thus putting the hot issue squarely back into the government’s hands. The government’s response was to introduce Bill 37 and it tried to pass the Bill without public debate saying that it was a piece of legislation that would protect the public health care system.
In fact, Bill 37 would have given the Minister of Health the power to approve private, for-profit hospitals in Alberta. Not only would Alberta have become the first province allowing for-profit hospitals, these same hospitals would receive tax dollars via contracts with the Regional Health Authorities. There would be no advisory body to the Minister, no regulations or guidelines to moderate his decisions—in fact no controls at all. Bill 37 would in fact allow a two-tier health care system where fast, effective and first-class services would be available for those who could pay, and the public system would become a second-class and less effective system with decreasing access to skilled doctors. Bill 37 would also create downward pressure on the wages and working conditions of health care providers in the constant demand to create
increasing profits. UNA, along with a number of supportive community groups, set up a provincial lobby action to put pressure on the government to withdraw Bill 37. Public pressure worked—at least to the extent that Bill 37 was withdrawn but with the government’s plan to revise it and bring it back to either the 1999 Spring or Fall sittings of the Legislature. Hon. Allan Rock, the federal Minister of Health, wrote a letter to UNA outlining that it is his understanding that “an independent panel of health care experts was to conduct a detailed review of this legislation to ensure that it is consistent with the principles of the Canada Health Act”. He went on to say that the panel was also “to make certain that the content of the bill meets the government’s stated objective of protecting the public health care system from the possible adverse impacts of private treatment facilities”. And Mr. Rock said: “I believe that an assessment of the legislation and the regulations to
which the bill refers, is needed”. The Blue Ribbon Panel is to report back to the government in early 1999.
In June 1998, the government’s provincial steering committee tabled a report and recommendations regarding a new piece of proposed legislation called Health Information Protection Act, Bill 30. This Bill was designed to ease public fears about an electronic health information system which would include a record of every Albertan’s personal health history. The proposed purpose was “to improve medical care, aid research on outcomes and assist with better system management”. No public consultations were held and the government announced that it was proceeding with the design of the system. The problems identified by UNA and other community groups include such broad exceptions to the use and disclosure of personal health information that confidentiality is all but made impossible. The registration information required by Alberta
Health under this Act included “authorization to access your income tax records.” UNA continued to oppose and lobby against Bill 30 because it gives the government too much access to personal identifiable information and makes that information too accessible to other interested parties.
The government announced a Health Summit to take place in February 1999—presumably to consult with all Albertans on the state of health care in the province. However, as 1998 ended, UNA became aware that the Health Summit delegates would all be handpicked by the government.
Regional Health Authorities
The Capital Health Authority (Region 10) and UNA Locals at the Royal Alexandra, the University of Alberta, the Glenrose, the Sturgeon, and the Caritas Health Group signed an agreement which outlines the process for hiring when a posting goes up. Nurses in the bargaining unit of the hospital posting the position get first preference; if there are no applicants, then other hospitals under the Capital Health Authority get next preference; if there are no applicants then it goes to the Caritas bargaining units; and finally if there are not applicants, it goes outside of the current bargaining units. If the vacancy or posting is at a Caritas hospital, that bargaining unit gets first preference; then the other Caritas bargaining unit; then the Region’s bargaining units; and then it goes outside.
The successful candidate for a position may transfer her seniority and other entitlements if she chooses, however she must resign from her original site and lose her seniority and entitlements there.
When the obstetricians in the Calgary Regional Health Authority threatened job action, the response of the employer was to advise all obstetrical nurses that all obstetric services would be centralized in one site and obstetrical nurses from all Region 4 hospitals would be expected to attend that one centralized site despite the fact that they were not hired for that site nor were they members of that bargaining unit. UNA filed an unfair labour practice at the Labour Relations Board and then the two parties began negotiations for an agreement.
After months of on-again off-again negotiations, the Calgary Regional Health Authority (Region 4) and UNA Locals at the Peter Lougheed, the Alberta Children’s, the Foothills, the Rockyview and the Colonel Belcher hospitals agreed to a Letter of Understanding that allows nurses to transfer their seniority if they move from one hospital to another in the Region.
The agreement restricts the employer’s rights to transfer employees to other sites unless it is for the purpose of skill maintenance, education or for emergency situations. The agreement sets out a process for regional recall and the filling of vacancies that provides nurses with more employment options.
Members covered by this agreement will have a single seniority date regardless of how many sites they work and they will be able to carry their seniority and other entitlements with them to other CHRA sites.
Emergency Room nurses in Edmonton hospitals reached their limit in 1998 and Heather Smith, UNA President, met with Local Presidents and emergency room nurses to hear their complaints and to strategize how to take action on prioritized issues. Amongst the many issues were concerns around short-staffing; the holding of admitted patients in the emergency room for up to seven days; region-wide shortages of ICU and CCU beds; physicians using emergencies as clinics because lab tests are done more quickly through emergency; IV therapy patients: patients being accepted from outside the Region without beds being available; hallway nursing; red alerts; and the lack of value put on the staff’s concerns or input.
Once these concerns were outlined and addressed, UNA applied to make a formal presentation of these concerns to the Capital Health Regional Health Authority. A meeting was held with Sheila Weatherill, President of Capital Health, and other RHA representatives on July 20, followed by a public meeting with the entire Health Authority on August 26 at which UNA had about five minutes to raise concerns. This meeting was followed by a UNA presentation to the Capital Health Board on September 23. This written presentation was entitled Emergency Nursing Care in Crisis and it was well received by Capital Health. If anything, they seemed overly solicitous re UNA’s concerns.
Further to that meeting, UNA representatives met with the medical directors of these same emergency departments on September 29th and again all agreed that the issue was lack of beds, lack of resources and funding cuts.
UNA asked Capital Health to attend a meeting regarding emergency services with the Minister of Health and these two groups attended a meeting with Halvar Jonson on November 2. The Minister listened to the concerns but did not seem to grasp the enormity of the problems.
Subsequent to these meetings, 16 medical, 20 surgical and 6 ICU beds were opened at the Grey Nuns and the CHA did adopt some of UNA’s recommendations, but the major concerns of emergency room nurses continued into 1999 with only a promise of new funding in the next provincial budget.
Hallway nursing, short-staffing and burnout continued to compromise patient care, and retention and recruitment problems remained acute.
UNA Local #115 at the Foothills Hospital distributed a petition calling for the government to proceed with their announced promise to hold Regional Health Authority elections in 1998. Instead the government extended the current appointments into the next century.
October 4, 1998, saw the sad destruction of the Calgary General Hospital leaving Calgary the only city of its size in North America without a full-service hospital in its downtown core. And in a time when the government purports to care about the confidentiality of health care records, imagine the surprise when in the midst of the demolition, rooms full of patient records——boxes and boxes of them were found sitting out in plain view.
Locals in the Capital Health Authority (Region 10) concluded talks on a Letter of Understanding which allows members in the Region to apply for sponsorship in a full-time, 14-week training program in Advanced Critical Care Nursing offered through Mount Royal and Grant MacEwan Community Colleges. Capital Health will pay the full course registration (fees and textbooks) and, in return, participants will commit to applying for regular and temporary vacancies in Adult Critical Care areas. Employees must also commit to remain working for Capital Health for a nine-month period after the completion of the program.
Even though it is clear that the Regional Health Authorities were appointed to be the front for the health care cuts and staff layoffs, many of these tried-and-true Tories are saying that they cannot carry out their mandates on the resources they have been given. They say that health care is seriously under-funded and that the government must divert monies into health care.
Organizing
UNA organized a new Local at the Extendicare long term care facility in Mayerthorpe. This group of nurses became UNA Local #209.
UNA Local #126 which used to be the Big Country Health Unit was seriously divided up through the process of Regionalization and only a small number of nurses from that Local ended up in Region 2, the Palliser Regional Health Authority. In 1998, UNA was successful in winning a vote that resulted in about 65 nurses being placed in Local #126. These nurses were formerly with the Medicine Hat Health Unit and were represented by an all-employee staff association. Now all the community nurses in Palliser Region are members of Local #126.
Bargaining
Most UNA Collective Agreements expire in 1999 or 2000 so 1998 was not a big bargaining year.
Some contracts, however, were negotiated throughout most of 1998. Central Park Lodges in Calgary and Medicine Hat were in negotiations and ended 1998 without a Memorandum of Agreement. Instead a mediator was appointed—a Mr. Steve Morrison—who was to meet with both sides and agreed to present a mediator’s report sometime in early 1999.
In January, 1998, the Capital Health (Region 10) community nurses in UNA Local #196 completed their negotiations two and a half years after the expiry of their last contract. When presented with the employer’s “last offer” 98% of the members rejected it and the Union went on to win substantial improvements to scheduling provisions; to establishing shift and weekend premiums; to winning both a Professional Responsibility Committee and an Occupational Health and Safety Committee; to improving their vacation provisions for part-time and casual employees; to winning benefits for part-time employees; to getting better recognition of previous experience; and in improving severance provisions.
Extendicare bargaining was completed in May 1998, with hospital rates being agreed to and the employer’s portion of RRSP contributions moving from $.10 per hour to $.50 per hour. This contract expires July 31, 1999.
The new UNA Local #209, Extendicare Mayerthorpe was organized in July 1998, and we reached a contract settlement in October. In effect, they were rolled into the standard Extendicare contract with a few transitional issues included. This contract also expires July 31, 1999.
UNA Local #111 at Chantelle, Grande Prairie Care Centre had a Collective Agreement which expired September 30, 1996. Bargaining took place throughout the remainder of 1996, in 1997 and in most of 1998. These nurses received back their 5% wage rollback on October 1, 1996—a year before the hospital nurses received their 5% back. The bad news however, was that the Chantelle nurses are not at parity with hospital rates. However in the new contract which was signed in October 1998, these nurses get the same percentage increases that hospital nurses get in 1999, 2000 and 2001. In addition their premiums for shift differential, weekend work and charge responsibility move from $.50 to $.75 to $.85 over the life of the contract which expires September 30, 2001.
Membership in Local #126 was increased dramatically when the Palliser community nurses who had formerly been represented by an all-employee staff association voted to join UNA. Negotiations for a first Collective Agreement between Palliser and Local #126 have been rocky from the outset. Initially the employer refused to set bargaining dates and UNA filed a bargaining in bad faith charge at the Labour Relations Board. The Board ordered the employer to negotiate but bargaining soon reached an impasse over the issue of scheduled days of rest. Rather than attempt to resolve the outstanding issues with the UNA bargaining committee, the employer decided to file an application to the Labour Relations Board for mediation. October 20 and 21 were set for mediation between the parties. Finally an Agreement was reached which achieved
parity with other community health agreements. In addition, this Local will maintain its 5-5-4 day work agreement, superior vacation benefits, and wage rates for nurses with Master’s degrees are red-circled.
Although the majority of hospital, community and long term care contracts expire in 1999, preparation for bargaining got underway in 1998 with contract demands coming in from the Locals in July; the Negotiating Committees being elected by summer; the orientation for the Negotiating Committee taking place in July; the Negotiating Committee work week taking place from August 17-21; and the Demand-Setting Meeting taking place in Edmonton on October 26,27, 1998.
The hospital, community and long term care bargaining was combined for the first time into one large committee. A new configuration of representatives was decided by the UNA Executive Board. Given the fact that the former Staff Nurses Association of Alberta’s contracts were very different in both hospital and community sectors from the UNA contracts, it was decided that a larger committee was needed to represent all of the distinct contracts. Thus, the Board determined that there would be one hospital representative elected from each District; one representative elected from each of the Foothills and the University of Alberta Hospital; three community representatives elected from each of the three distinct community groupings in North District; three community representatives representing the three distinct community contracts in
North Central District; one community representative from South Central District; and one community representative elected from community Locals in South District. This created a 15-person Negotiating Committee which was prepared to split into two tables—one for hospitals and one for community—if that was the employer’s intent. 1999 ended with UNA knowing that there would be those two tables plus a number of long term care employers who would be seeking to negotiate separately.
In December 1998, Premier Klein announced that he wanted to meet face-to-face with the “Union bosses” to deliver the ugly truth about the province’s financial picture.
It is interesting to note that another Premier was also in the news about bargaining—the former Premier Peter Lougheed whose newly made public documents revealed that the government seriously underestimated the growing anger amongst nurses in 1980 and 1982. The then-Health Minister, Dave Russell, wrote a letter to Lougheed in May 1980 (after the successful April hospital strike) admitting that, “we did not identify the strength of feelings of the UNA building since 1977. We either missed or misread their signals.” Mr. Klein may be well advised to read the signs carefully in 1999.
Grievances, Arbitrations, Mediations and Hearings
In 1998, UNA members once again were vigilant in monitoring the application of their Collective Agreements and filed grievances when those contracts were violated. UNA Local executives, grievance committees and labour relations staff filed grievances, represented grievors in meetings, mediated settlements and, when satisfactory settlements were not achieved, presented the issues before arbitration boards.
UNA filed 597 grievances in 1998, 144 of which were advanced to arbitration. United Nurses of Alberta was awarded 9 Arbitration Awards in 1998. In addition, UNA represented members at WCB appeals, 20 AARN hearings and in 5 Short Term Disability and 5 Long Term Disability cases.
Education
1998 was a year in which District and Local requests for education continued to increase. In 1998 UNA provided 76 workshops for 1654 participants.
The basic workshops which form the base of any union continued to be provided—Local administration, professional responsibility, occupational health and safety, grievance, contract interpretation and ward/office rep workshops.
In addition, UNA provided workshops on the new Protection for Persons in Care Act; on the new Freedom of Information and Protection of Privacy Act; on nurse abuse; on the changes to the LPN Regulations; on the orientation of new Executive Board members and a two-day workshop for the facility, community and long term care Negotiating Committee.
1998 education activity included researching and writing briefs on health care legislation—the Health Professions Act, the Protection for Persons in Care Act, the Freedom of Information and Protection of Privacy Act, Bill 37, Bill 30 (the Health Information Protection Act) and the Drug and Pharmacy Act.
Communications
The UNA NewsBulletin continued to provide all members with pertinent issues in contract interpretation, health care issues, bargaining progress, occupational health and safety issues, health care legislation and political action.
• Spotlight continued to be a popular contract information poster.
• The UNA Stat was sent electronically on a bi-weekly basis to the Locals for posting on their bulletin boards thereby informing members of current issues and bargaining timelines.
• Frontline was produced on an as-needed basis to provide the Locals with bargaining news, up-dates and timelines.
• The Professional Responsibility and the Occupational Health and Safety data bases have been kept up-to-date thereby providing the Locals and their committees with up-to-date information of what issues are being dealt with by UNA’s different Locals.
Computerization
UNA celebrated the amalgamation with SNAA at the end of 1997. The new Locals were all computerized and connected to the UNA*NET early in 1998.
UNA welcomed the addition of a new staff person to assist with the support and maintenance of the communications systems. Cindy Darby was hired during the spring and joined Rena Reid, who has been providing technical support to users and doing general network administration support duties for the past few years.
All members of the expanded negotiating committee have access to UNA*NET. Computers have been allocated to those who did not have a system of their own.
A number of Local computer systems have been upgraded during the past few months.
Network Users
District Reps 19
Locals 0n-Line 156
Neg Comm and other members 66
Labour Relations Staff 13
Administrative Services 9
Finance Staff 3
EOs, TO, and Senior Staff 8
Servers 9
Systems Admin Staff 2
All user Ids on UNA*NET 276
The office network was upgraded to accommodate TCP/IP protocol. It is a much faster and universal protocol which was required by the new finance software. It is the now the standard protocol used by the Internet.
UNA’s Internet web site was moved to a different service provider. We fully implemented the use of our own domain name: ‘una.ab.ca’. The web site is getting increased traffic, particularly to the downloading of copies of the Collective Agreements. The web site is maintained by our own staff rather than contracting it out.
Internet e-mail access was established for all users of the UNA*NETin 1998. The implementation of a UUCP gateway, (old reliable technology) allows a very secure exchange of e-mail between FirstClass and the internet.
A direct internet connection was established in both offices. Legal research, via an internet connection to QuickLaw, was made available to our Labour Relations Department. Quick and easy access to statutes, regulations, judicial and administrative decisions will facilitate the massive amount of research which is done by the Labour Relations staff.
The internet will become a more integral part of our communications system. Those who have internet accounts will be able to access our FirstClass system via TCP/IP by the end of 1998.
Communications between the offices will also be mainly via TCP/IP. This will allow high speed access to the information on our Edmonton servers.
Local Computer systems will continue to be upgraded as necessary and as new equipment becomes available.
PRC/Staffing
Patient, resident and client concerns were in the forefront in 1998. The cumulative effects of short staffing, budget cuts and rising acuity levels meant that Albertans in need of health care received a reduced level of care. Waiting lines for surgery lengthened; emergency rooms were nightmares of overcrowding and understaffing; and skilled health care practitioners left the province to practice elsewhere. The total effect was a drastic reduction in the quality and quantity of care.
UNA Locals responded with record number of PRC complaints and the Professional Responsibility and Staffing Committees worked ceaselessly to convince their employers that something had to be done to reverse the worsening situations. Many times UNA won concessions but often for only short periods of time and then the problem would rise again. But we also won some major staffing issues largely because of the persistence of our members and because management nurses often agreed with the assessment of short staffing causing patient harm.
Our PRC and Staffing Committees brought forth to management such issues as short-staffing; nurses working extended shifts from those scheduled; staff exhaustion as a result of mandatory overtime; staff being denied vacation; staff being brought back from vacation; supply and equipment shortages; the rationing of supplies especially in long term care facilities; the increased use of physical and chemical restraints—all of which eventually corrode the quality of care and produce negative and sometime fatal results.
There is a desperation in almost all UNA worksites for more skilled workers—more nurses to provide proper and adequate care to patients/residents/clients.
The employers know there is a nursing shortage and even though the government repeatedly denies any connection between government cuts and the current nursing shortage, it seems strangely coincidental that we cut about 3,000 nursing jobs since 1993, and in 1999 are short about 3,000 nurses.
More than one Region has held a Recruitment and Retention workshop and many Regions are scouring the United States and Europe for nurses. One rather original retention idea came from a nursing home employer who installed a time clock and all nurses must now punch in and out. It probably works well for the Union in that it is mechanical proof of all those minutes and half hours and hours that nurses put in but sometimes do not claim as overtime.
Occupational Health & Safety
All of the above conditions have a direct effect on the nurses themselves as well as on their patients/residents/clients. Rising stress levels primarily due to short staffing and increasing acuity levels are having negative effects on UNA members. More nurses are getting sick; more nurses are on WCB; and more nurses are on disability. The cumulative effects of working in health care in Canada has produced some startling statistics. A Laval University study revealed that 40% of registered nurses were considering leaving nursing due to high levels of stress. Both the B.C. Nuses’ Union and the Manitoba Nurses’ Union have done recent surveys which show similar trends. 60% of B.C. nurses report burnout and over-exhaustion symptoms. More than half of these nurses said they would not recommend nursing as a good career choice. 47% of B.C. nurses
would leave nursing if given the opportunity to pursue another career. 55% of Manitoba nurses said they would leave nursing if they had the opportunity to pursue another career. 69% of Manitoba nurses would not recommend nursing as a good career choice.
In response to this kind of stress and pressure, UNA Occupational Health and Safety Committees have presented management with these problems. It seems, however, to always come back to money and budget cuts, especially staffing cuts. So UNA launched its own Creative Healthy Workplaces initiative. UNA sent letters to all employers informing them that UNA Locals would be monitoring the sick leave statistics and if a unit or office was identified as having a rate of absenteeism which appeared to excessive, the Union would reserve the right to call a meeting to notify management about the concern and about the possible occupational health and safety hazards including short-staffing which needed to be addressed in order to reduce the use of sick time and other form of illness-related absences. If the employers did not act in a timely
manner to address the problems, UNA would have the ability to contact the Department of Labour or the Workers’ Compensation Board as well as the Regional Health Authorities. This program was not overly welcomed by the employers but sustained UNA pressure at the Local level may indeed reduce some of the stress levels causing increases in sick leave usage.
In response to a recognized need, the government-union-registration body group called the Staff Abuse Task Force is updating the 1993 Abuse in the Workplace guide for health care facilities.
Pensions
The Board of the Local Authorities Pension Plan (LAPP) continued to pursue the independence of the pension plan from the Government. In 1993, the Government agreed to relinquish control of the pension in trade for a commitment to assist in the coverage of the accumulated unfunded liability. In addition, from that time forward, the Goverment guarantee of the benefits was removed. The last major hurdle will be the passing of legislation which will facilitate the removal of the LAPP from Statute. The LAPP Board continues to focus on January 1, 2000 as the date for independence from the Government.
Political Action
January 5, 1998, saw the implementation of the Protection for Persons in Care Act. This is a very difficult piece of legislation for UNA members because UNA strongly supports the intent of the Act—protecting persons in care from abuse and mistreatment. However, the Act is so badly constructed that it verges on being a violation of the rights of workers.
First of all there was not a good enough job done by most health care employers in explaining the ramifications of the Act and so many health care providers remain ignorant of these new legislative pitfalls.
One of the deficiencies of the legislation is that the definition of abuse is too general and too open-ended but the law places a statutory obligation on every Albertan to report any abuse s/he believes may be occurring. “Causing bodily harm” is part of the definition of abuse and yet almost every nursing function can cause pain and discomfort which a visitor or passerby could construe as causing bodily harm. If the person does not report suspected abuse, they are subject to a fine up to $2,000 or in default up to six months in jail.
If, for any reason, a person believes that abuse is an issue, their reporting of that abuse must be sent directly to the Minister of Community Development who passes it on to the relevant Minister—e.g. health, social services, advanced education, municipal affairs etc.
There is no possibility for the administrator of the facility to look into the complaint and determine that the complainant suffers from dementia and therefore the complaint should be dropped. All complaints are subject to the investigation of the government.
Another problem with the Act are the noticeable absences of certain care services such as home care, public health mental health facilities and small home care services with fewer than 4 residents.
Other problems are that there is no obligation to notify the worker that a complaint has been filed and an investigation is proceeding. A nurse might find out that she has lost her license to practice and her employment simply from a letter from the Minister of Health. And there is no appeal process. Luckily for regis-tered nurses the AARN will notify the nurse of the hearing and allow her to be present and present a defense. But that is not a statutory requirement. In fact there is no statutory obligation for a hearing to take place at any stage—a simple closed-door investigation is sufficient. Thus things like the rules of evidence where the accused gets to examine the evidence and cross-examine the complainant do not exist.
To show how difficult an Act it is, within the first 16 days of implementation 40 complaints were filed, 30 in health care. By December 31, 1998, there were 2154 calls with 939 complaints being filed. Of these, 640 were in health care, 268 of which were closed and 372 remaining open. Most of the alleged abusers were patients and residents—most often suffering from dementia conditions. Most of the abuse reported in all fields was for emotional abuse (613) and physical abuse (534). Most alleged victims were 84-89 years of age and the second greatest number of alleged victims were 78-83 years of age.
UNA has alerted all members and Local Executives that if any of them or any members of their Local are charged under this Act to call their Labour Relations Officer immediately in order for UNA to provide advice, direction and representation.
The Freedom of Information and Protection of Privacy Act (FOIPP) became operational October 1, 1995 but only applied officially and legally to health care bodies effective October 1, 1998. Many lawyers have said that this Act is the most complex piece of legislation in Alberta and it was, therefore, a huge challenge for health care employers and employees to figure out what the specific applications to health care would be.
The Act is divided into two sections—the freedom of information part which allows any person the right to access their own personal records in the control of the government and to regulate the government’s use of disclosure of such information. Such access to personal information is either without charge or very reasonable in cost. Access to other people’s records will also be possible but under very controlled access regulations. In addition, the Act would give Albertans access to government documents and papers which up until 1998 have not been accessible. This access is again very controlled and very expensive.
One very important piece of the legislation is that the public body has to provide personal medical information to a patient/resident/client within thirty days of the request being made. That means if a nurse is approached for information, the clock starts ticking then. She must either provide that information directly by taking the person into a private room and sitting with them with the open chart, or must direct them to the records department or whatever department has access to the requested information.
The other part of the Act has to do with privacy of information. So important is this aspect of the legislation that violations of patient confidentiality can attract up to $10,000 in fines.
UNA supports the intent of the legislation but spent much of 1998 trying to figure out the applications this would have in the workplace. Many employers became extremely rigid and decided that whiteboards in emergencies and on the units would be a violation of privacy; that having a patient’s name on charts or medication orders would be a violation; that all patients would have to be referred to by number etc. The office of the FOIPP Commissioner was very helpful in this moment of panic and determined that common sense must prevail. Yes, patient/resident/client records are to be protected but only up to the point where such protection becomes detrimental to their care.
For individual employees great care must be given not to divulge private information unless duly authorized and to show diligence when speaking on the phone, working on the computer, speaking to patients/residents/clients within earshot of others and when conferring with colleagues about different patients/residents/clients.
Great care must also be made in the storage and retrieval systems of confidential information as well as in the shredding or disposal of such information. For transitory information the rule of thumb is Collect/Use/Dispose—but dispose in a careful and protective manner. For permanent records the rule is Collect/Use/Store Securely/Retrieve Carefully on a Need-To-Know Basis.
The Union itself ran into difficulties with FOIPP interpretations when employers began saying they could give out seniority lists but the names would have to be blacked-out. Or that they could no longer give the Union duespayers’ addresses; or could no longer notify the Union about employee disciplines or terminations. The FOIPP counsel told the Union that nothing in FOIPP is meant to overrule the provisions of a Collective Agreement. We know, however, that in the next rounds of bargaining the employer will be using FOIPP as a reason for not agreeing with certain Union demands.
1999 will see the development of how FOIPP is being applied in UNA workplaces and at the bargaining tables.
The Multilateral Agreement on Investment (MAI) was a focus of UNA political action in 1998. The MAI was a proposed international investment agreement that was negotiated by the world’s richest countries through the Organization for Economic Cooperation and Development. In essence it was an international charter of rights for transnational corporations which would give them the right to trample on nation states and the governments which were duly elected. Maude Barlow called the MAI “NAFTA on steroids”. So sweeping were the powers and rights conferred on corporations, it would have removed the rights of democratically-elected governments to govern by giving corporations superior powers over national, provincial and municipal laws and regulations. The MAI would amend our democratic system by removing the power from our
governments to make laws pertaining to all aspects of Canadian life if those laws interfered in any way with the rights of corporations to make profits. For example, Canada banned MMT (a gasoline additive which has scientifically been proven harmful to people and to the environment) and was sued by Ethyl Corporation for over $9 million in possible lost profits. Canada paid and MMT was forced into our gasoline. And that happened even before the MAI—it happened under NAFTA. In the proposed MAI there was an exemption proposed for health care but that exemption would automatically end in twenty years and Canada would then be bound to amend our public health care system to allow foreign corporations access to our $72 billion public model which would then become a for-profit system.
Many groups in Canada formed coalitions and engaged in political lobbying and actions to convince our federal government that they should stop promoting the MAI and should refuse to sign it.
UNA co-sponsored a conference with the Parkland Institute where the MAI was explained and discussed. An anti-MAI rally was held at the Legislature and much literature was distributed to UNA members as well as workshops on the effects of MAI on health care.
The good news was that the MAI was defeated in Paris in October—too many countries had caught on to what it would do to their ability to govern and sought exemptions for all their legislation. The US wanted all their laws exempted but did not want any other country’s legislation exempted! The OECD meeting which was supposed to be the big signing of the MAI ended in disagreements and accusations. That is not to say, however, that the corporations will not continue to seek such an agreement—next time at the World Trade Organization.
The Alberta Association of Registered Nurses named UNA President, Heather Smith, as Nurse of the Year for 1998. They honoured her for her outstanding professional service to the public and for her strong commitment to community affairs. At the annual AARN Convention in Calgary in May, Heather received the honour saying: “This award belongs to all staff nurses in recognition of the work that we have all done to be strong and vocal advocates for our patients/residents/clients.”
UNA participated in the annual Run for the Rainbow on June 7 and raised $2,500 to help make the wishes of chronically and terminally ill children come true. The event included a celebrity bed race, a walk and a run.
UNA participated in many coalitions in 1998 including the Friends of Medicare, the Parkland Institute, the Medicare Coalition, other health care unions, and the Nursing Workforce Planning Committee.
Annual General Meeting
The 1998 Annual General Meeting was held at the Shaw Centre in Edmonton on October 28 and 29. The delegates directed that a membership vote be taken to determine whether or not UNA would join the National Federation of Nurses’ Unions and thus the Canadian Labour Congress. They also directed that a membership vote be held on whether or not to impose a one-time levy of $30 on each duespayer in order to build up the Emergency Fund as part of bargaining preparations. These votes were held in January, 1999, and both received strong membership endorsement as did UNA’s in-going bargaining demands. The $30 levy will be divided up and a part will come off each pay cheque starting April 1, 1999 and ending December 31, 1999.
Delegates also voted to join the National Action Committee on the Status of Women.
A Silent Auction was held at the AGM with items donated by the Locals and the proceeds donated to the Rainbow Society.
“Stress Reliever Hearts” were given to all those attending the 1998 AGM.
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