Vol 15, Special Edition, February 2004

Informedprotest

Special on the BillsJOURNAL OF THE FIIQ

While fall 2003 was marked by an avalanche of laws, each more contentious than the other, it looks like winter and spring 2004 will be turbulent times. Indeed, the Charest government intends to move quickly with regard to the changes stipulated in Bills 25,

30 and 31, not to mention the others. In spite of the legal action taken by some union organizationsbefore the International Labour Office or elsewhere, and in spite of the fact that certain of thesebills, rammed through, may be declared unconstitutional, the transformations they contain are

already being implemented. In this perspective, it is essential that FIIQ nurses, like all unionized employees for that matter, be informed of the content of these bills in order to have

a better grasp of the issues they raise. The operationalization of these bills concerns you as health-care professionals, nurses, users of thenetwork and women. This is why we urge you to read this special issue on the new laws attentively.

It supplements the information in the FIIQ en Action which you received in early January.

A neoliberal reengineering of health care Under the pretext of integrat-ing services, the Liberal government rammed througha health-care reform whoseobjectives have nothing to dowith improving public services. As a matter of fact,in several regions, integratedhealth-care networks arealready in operation and itwas not necessary to passthese laws, merge institu-tions and unions, and modifythe process of negotiations inorder to offer these types ofservices to the population.According to the FIIQ, theobjective of this reform is toopen up the health-care network to the trade agree-ments on government

contracting and privatization.Thus, this reform is a politi-cal project, in line with theeconomic liberalism whichgave rise to the trade agreements. The health-care reform istherefore one of the majorcomponents of the Charestgovernment’s reengineeringproject while the integratednetwork model legitimizesthe six strategies set forth bythe World Bank: deregulation,privatization, communitiza-tion, user fees, create a delib-erate shortage of resourcesand decentralization.

From October 21 to December 17, 2003, 24 bills were presentedor passed by the National Assembly. That is a lot in such a shortlapse of time, especially since several bills were, and are still,controversial. Even before the parliamentary session began, union organiza-tions, community and women’s groups expected that the legislative agenda would be indigestible. A new concept had thenappeared: reengineering. What some believed to be a mere question of vocabulary, reengineering, modernization or rational-ization, turned out to be more dangerous. Indeed, the process ofreengineering involves starting from scratch, making a blankslate of ideas and, consequently, of past gains. Nothing wasshielded from this transformation and, on October 21, the tablewas set for public protest. On November 11, Bill 25 respecting the local health and socialservices development agencies, Bill 30 respecting the bargainingunits in the social affairs sector and amending the process ofnegotiation of the collective agreements, and Bill 31 whichamends the Labour Code were presented to the NationalAssembly. As a face-saver for democracy, there were two or three days oflimited consultations. Organizations that were able to makethemselves heard -- as this was upon invitation only -- had hardlya few weeks to analyze the bills and prepare their positionpapers. Things went so fast that some parliamentary commis-sions had not completed their work when the governmentimposed the guillotine, to silence debate and pass the bills. This is how the Charest government succeeded, in just a few

weeks, in setting itself up against the majority ofprogressive organizations in Quebec, by

measures designed to downsize thegovernment and open the door

to the private sector byfacilitating sub-

contracting andredesigning a net-

work based onpublic-private

partnerships.

The government:obstinate and in a hurry

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In addition to appearing in parliamentary commission, the FIIQ, demonstrated on October 21, with the Réseau de Vigilance,

on December 10 with the APIIAQ, APIQ, APTMQ, CPS, FIIAQ and the SPDNQ,and on December 15 with the labour organizations and independent unions,

to express high and loud its disapproval of the bills and of the manner in which the government flouted democracy last fall.

A reform open to public procurement

Integrated networks involve agreementsthat will bind various partners, including

private resources. What exactly are theseagreements? They are business contractsbetween a public and a private partner. By

giving an official status to the private sector within the health and social servicesnetwork, the Quebec government subjects

the network to the trade agreements onpublic procurement. As for the merger of

institutions, they will make it possible to reachthe set levels (amounts of money) for businesscontracts to fall under the jurisdiction of public

procurement. This fundamental modification willpush for a re-interpretation of the principle of "publicadministration" in the Canada Health Act, as business

circles have been demanding for so long. On the otherhand, since the Canada Health Act provides for the

reimbursement of diagnostic, laboratory and surgical services in particular, only when they are offered in hospital

centres, the de-insurance of certain services could result in theintroduction of fees for these services.

On the other hand, by wanting to reduce income taxes substantially,the Charest government creates a deliberate shortage of resources

that justifies his conception of the role of the State. The next Séguinbudget will give us clear indications in this respect.

As for decentralization, Ministre Couillard raised the possibility thatthere be a second phase next fall. Everything seems to point

towards a decentralization of front-line services to the municipallevel, as shown by the fact that the integrated networks are defined

according to the MRC territories. In short, this neoliberal reform proposed by the Charest

government is a real threat to the public health-care sector inQuebec and in Canada.

When the President of the Conseil du Trésor speaks of public-privatepartnerships (PPP, PAPP or 3P), she is in fact speaking of "public procurement" as defined in the trade agreements.

The various trade agreements signed by Canada and Quebec all have one point in common: they contain provisions concerning government contracting. Quebec, for its part,has signed to date six agreements by which it agrees to open government activities to the

process of public contracting, by the signature of business contracts in the public sector. In thehealth-care sector, there are only two agreements in effect currently, i.e. the Agreement on the Opening

of Public Procurement for Quebec and Ontario, and the Agreement on Internal Trade.

By virtue of these agreements, public administrators are obliged, in the case of goods, construction workand certain services, to bid for tenders when the cost or the purchase of construction is above a certain

amount, which varies according to the level or sector of public administration (Federal government, provin-cial government, municipalities, ministries, health and education). The call for tenders must be done in

Canada through the MERX electronic system. The Ministère de la Santé et des Services sociaux evaluatesthat the transactions carried out by way of this tendering system total around 2 billion dollars. Over

37,000 products and 480 independent institutions are currently targeted.

In the health and social services network, several services and goods have already been purchased byvirtue of these agreements on public procurement: "hazardous waste", "fast-food lunches", "peeled

potatoes", "cafeteria coffee". The Canadian government has gone one step further with tendersfor health services: for example, "nursing services", "medical services for inmates", "medical,

hospital and professional drug addiction services." These services are now markets thatpublic sector employees cannot occupy without running the risk of having the government sued for potential loss of profit, a procedure which is very similar

to the one so strongly decried in Chapter 11 of NAFTA.

Spéc

ial

Spec

ial

BILL

PUBLIC PROCUREMENT

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4

Bill 25 creates agencies that replace the health and social services regional boards. The board of directors of these agenciesis composed of 16 members appointed by the Minister of whichthree come from the regional medical commission, the regionalnursing commission and the regional multidisciplinary commis-sion respectively.Since February 1st, these agencies have the mission of establish-ing one or several local health and social services networks. Eachnetwork will be composed of a local authority, resulting from theamalgamation of a CLSC, a CHSLD and a hospital centre.Amalgamation with a hospital centre could be suspended onaccount of the absence of the latter, the size of the territory, thenumber or capacity of the institutions, or the socio-cultural,ethno-cultural or characteristics of the population. Each network will have to coordinate, by way of agreements, theservices of the pharmacists, community organizations, socialeconomy enterprises and private resources, as well as the special-ized and super-specialized services of university hospitals. Medicalservices will also be coordinated by this authority. However, theywill be subject to prior consultation of the regional department ofgeneral medicine and the regional medical commission.After consultations with the institutions concerned, the regionaldepartment of general medicine and the people’s forum, themodel for local networks, drawn up regionally, will be presentedto the Minister of Health and Social Services within the time theMinister specifies. The amalgamation of institutions will be madeofficial with a letter patent that specifies the name of the 15 members of the board of directors of the local agency.Finally, the integrated services networks set up by the agencieswill be evaluated by the government on January 30, 2006, andthis evaluation will justify the expediency of maintaining the law or modifying it.

The reengineering of health-care has begun. It is being conductedhastily by the Ministère de la Santé et des services sociaux. Theimplementation of the Act follows a two-year schedule. A document,entitled L’intégration des services de santé et des services sociaux 1,which is circulating in the health-care network specifies the terms ofthe application of the law. Having examined this law, the FIIQ identi-fied the crucial periods of the reform and the major questions it raises.

January ■ Period of consultations with the directors of the boards of direc-

tors of the institutions targeted by the amalgamations and identifi-cation of the territory of each local network

■ meetings with physicians to draw out a consensus on the basiccriteria of the reorganization

■ creation of agencies and disappearance of the regional boards

February-March ■ Meetings with the stakeholders involved in the integrated services

networks in the sub-regions determined during the months ofJanuary and presentation of the various hypotheses being consid-ered by the agency

■ Public consultations on the local health and social services networks

April 30 ■ Presentation by the agency to the Minister of an organization

model based on one or several networks with the amalgamationsof institutions and the delimitation of the territory served by eachnetwork. This delimitation should be based on that of CLSCs

June to September ■ Approval or modification by the government of the model pro-

posed by the agency■ Issuance by the Inspector General of Financial Institutions of let-

ters patent authorizing the amalgamation of public institutionsinto a local authority and identifying the members of the board ofdirector appointed for a two-year period

September to December ■ Setting up of the local networks and thus implementation of the

amalgamations of institutions

Year 2005During the year 2005, the negotiation of agreements regarding spe-cialized services will be conducted with regional institutions, thelocal networks of other territories, the local and supra-local agencies,the integrated university health networks (IUHN), the medical clinicsand the Family Medicine Units on the territory and neighbouring ter-ritories, CHSLDs and other partners from the private sector, munici-palities, and schools. Afterwards, the government will review the legislative framework of the Act respecting Health Services andSocial Services. According to the previsions of the Minister, agenciesshould have accomplished their mandate by January 2006. 1.MSSS, L’intégration des services de santé et des services sociaux, Quebec

government, version of January 15, 2004, 19 p.

What can we expect for2004 and 2005?

Mergers andintegration ofservices

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mental health problems,young people in crisis, etc.)may be quite differentdepending on the type ofmanagement approachadopted by the local network.

Difficulties

The unrealistic schedule setby law leads us to believethat decisions will be madequickly, and that public con-sultations, also held hastily,will follow the same logic asthe one behind the guillotineimposed on the NationalAssembly last December.They show the government’sdetermination to impose itsproject for the reengineeringof the health sector neglect-ing the expertise of the stakeholders of the networkand disregarding the mostelementary democratic principles. Besides the delimitation ofthe territory, in particular inurban areas, which is anobstacle to the partitioning ofthe network since municipali-ties, school boards and hospital centres do not coverthe same zones5, other obsta-cles are to be feared regard-ing the new dynamics thatshould be establishedbetween stakeholders.Moreover, these upheavalswill disrupt services offeredto the public who will probably have difficulty finding its way in the newservice structure.

In the same way, the periodfor the amalgamations ofinstitutions and union certifi-cations may complicate therelations between employersand employees.Finally, the question of thefunding of local networks isone of the major issues ofthis reform since, until now,no investment has beenannounced regarding thetwo-year transition periodand, afterwards, the fundingof health care will bereviewed with a eye to performance.

A major re-organization of health care and services The reorganization of care and services provided for in this billrevolves around two words: integration and coordination. Toreach the objectives of this reform, the structural integration ofcare and services (amalgamation) must be accompanied by thefunctional integration of the said care and services (hierarchiza-tion of services – 1st, 2nd and 3rd lines – complementary nature ofservices). Thus, each network will have to ensure that the popu-lation on its territory has access to a vast range of front-linehealth and social services, in particular prevention, evaluationand diagnostic services, treatments, rehabilitation and support.It will have to ensure that a complete and diversified range ofservices are offered, set up mechanisms for the referral and follow-up of beneficiaries as well as the setting up of clinicalprotocols regarding the services offered, proceed to the groupingof institutions (CLSC, CHSLD, CH). Finally, by way of agree-ments or otherwise, it will have to plan the coordination of theactivities and services which they offer. To orient and support such changes, indispensable conditionswill have to be respected, like the involvement and mobilisationof the current managers, the mobilization of clinical personnelfor the organization and management of services, measures thatensure the preservation of the mission of each institution. Thenetwork will also have to dispose of the means (resources, ser-vices, skills) needed to reach the goals and objectives: adequatefunding; favourable organizational context; sufficient technologi-cal support; adequate information system; realistic schedule;adhesion and involvement of all health-care professionals in thisprocess, permanent training of the personnel.

A reform focused on decentralization and performance

1.MSSS. L’intégration des services de santé et des services sociaux, Quebecgovernment, version of January 15, 2004, p. 2.

2.Ibid., p.15.3.The weighted per capita is calculated on the basis of the average consump-

tion of services by the entire population weighted mainly according to age,gender and the socio-economic status of this population. MSSS, La budgéti-sation et la performance financière des centres hospitaliers, 2002, p. 21.

4.Loc.cit.5. Régie régionale de la santé et des services sociaux de Montréal-Centre, La

santé en action. Plan montréalais d’amélioration des services de la santé etdu bien-être 2003-2006, Document de consultation, p. 75.

The bill aims at shifting theresponsibilities from theregional level to the locallevel within two years andprovides for the accountabili-ty of local stakeholders. Inline with the policy of govern-ment disinvolvement, localauthorities will then beinvested with a responsibilitytowards the population.

Each local network will haveto make accessible a "varietyof services as complete aspossible"1 organized in "services programme" 2 andfunded according to themethod of weighted percapita3, a method of fundingadjusted to indicators suchas access, quality, costs andthe results on health. Butwhat does the ministerunderstand by these perfor-mance indicators? Will localauthorities that do not meetits criteria or that prefer apreventive approach basedon health determinants havetheir funds cut back becauseof their poor results, or unre-alistic schedules? Moreover,will this type of budgetingforce institutions to "reducecosts for comparable ser-vices" when expenses arehigher than the forecast, orenable others to "offer a higher level of services"4

when expenses are lowerthan forecasted?

Now under local jurisdiction,programmes designed forspecific clienteles (elderlypeople in the process of losing autonomy, people with

An unprecedented impact on professional and organizational practices

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A major reorganization of work

Moreover, the introduction of local networks will not only disrupt theorganization of health care and services: it will also affect, in animportant way, the organization of work. The key words of thestructural reform proposed in this bill are interdependence,cooperation, collaboration and decentralization. Indeed, eachlocal health and social services network will have to be thoughtup so as to involve the different professional groups on the ter-ritory and make it possible to develop links between them; pro-mote the cooperation and involvement of all stakeholders in theother sectors of activities on the territory that have an impacton health-care and social services; ensure the participation ofthe needed and available human resources. Health-care professionals will therefore be called upon toestablish or develop, depending on the case, inter-professionalcooperation. The fact that practitioners from different profes-sions, different categories of personnel, different environmentsdo not always share the same work methods, the same prac-tices, the same values may make it difficult and complex toachieve professional consensuses. It will also be difficult to reachconsensuses on the practices which are essential to the coordinationof services. To succeed in having these caregivers work and cooperate together, itwill be necessary to change our way of doing things and working on adaily basis with users, to develop mutual trust, share the same visionwith regard to the values, approaches and orientations to uphold during interventions, create a culture specific to each local network,create new alliances, develop new theoretical and practical learnings,develop common tools and inter-institution protocols for care andservices, agree on a common care philosophy, develop an interdisci-plinary and multidisciplinary approach, share respective skills, agreeon the fields of competence of the caregivers in compliance with therespective fields of practice. Lastly, It will be important to agree onthe coordination of the roles, duties and functions with all the stake-holders in the network. All the conditions required for the implementation and success of theintegration of services indicate that while the administrative amalgama-tions of institutions may be a condition, among others, for the integration ofcare and services, they alone are no guarantee of this integration. Thus,there are in fact several factors that influence the success of an integrationprocess.

A few pertinent and impertinent questions …

■ Will this hospitalocentric approach conceal the chronic lack ofresources in the network, the shortage of personnel, the shortcom-ings of the information systems, the need to develop front-line ser-vices, the under-funding of home-care services?

■ Will the creation of integrated services networks promote bettercooperation between the various stakeholders in the network? Willthis encourage interdisciplinary work? Will this promote optimal useof skills?

■ Will the integration of care and services facilitate the process of work-force planning, the appropriation of the organization of work by care-givers? Will it guarantee that public services are better adapted to theneeds of the various communities?

…and cumulative risks

■ Risk of an even greater cleavage between themedical and social spheres – the risk ofdiluting the social mission of local networks,and the social and preventive dimensions ofCLSCs – the risk of ousting the socialapproach from the field of health;

■ The risk of aggravating the imbalance inworkforce supply between one institutionand the other – the risk of losing front-lineexpertise;

■ The risk of negative impact on the morale ofthe nursing personnel, motivation, faithful-ness and attachment to an institution, thefeeling of belonging and retention – risk oftaking up a lot of energy and creating greattensions.

In the brief presented before the parliamentarycommission, the FIIQ upheld that the mergers of union

certifications imposed by Bill 30 was a direct attack on freedom of association and freedom of representation. By partitioning

unions on the basis of management concerns, the government disregards the will ofemployees of the health-care network to organize on the basis of community of interests. In a context were industrial peace is threatened by an Act that forces health-care sectoremployees to choose only one union organization to represent them in an institution, nurses, nursing assistants, respiratory therapists, perfusionists and baby nurses shoulddevelop new union alliances in order to cope with the new management organization. Our union action will therefore be oriented towards developing stronger inter-professionaland inter-union solidarity.Bill 30 modifies the system of union representation inhealth-care institutions by stipulating that only one unionwill henceforth represent all the personnel of a categoryand by establishing mechanisms to determine which unionwill obtain the certification. The later will then have theresponsibility of enforcing defending the collective agree-ments that were concluded by the former union or unions.Thus, since December 18, 2003, the only bargaining unitsthat can be set up in health-care institutions must coverone of the four categories of personnel. The category thatapplies to nurses is that of nursing and cardiopulmonarypersonnel. Besides nurses, it includes nursing assistants,respiratory therapists or technicians in respiratory function, perfusionists ou extracorporeal technicians andbaby nurses. In the end, all the employees in these job categories who work in an institution will be in the sameunion. The bill also determines the job titles to be found ineach category. As a general rule, they are the job titlesfound in the collective agreements. Any job titles not listed in the law will have to be recognized by way of anagreement between the parties at theQuebec level, and then submittedto the Quebec Labour RelationsBoard before it can beincluded in a personnel category.

Spec

ialAmalgamations

of certifications

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Together in the same

union Nurses,

Nursing assistants, Respiratory therapists,

pulmonary function technicians,

perfusionists, extracorporeal

circulation technicians and

baby nurses

What can we expect?A complex process to keep an eye onYou work in a university hospital centre,an affiliated hospital centre, a youth centre or a health network? The Minister of Health and Social Services will set the date at which theinstitutions excluded from the new local networks, in particular the uni-versity hospital centres, the affiliated hospital centres, the youth centresand the already existing health networks, that he will have identified,should begin regrouping bargaining units according to categories of personnel. The list of employees belonging to the category nursing andcardiopulmonary personnel will then be posted during 20 days. This listwill include all the employees of the institution including those who areon leave without pay and those on the availability list who have workedin the course of the last 12 months. Only an employee whose nameappears on this list can take part in the vote. Nurses, nursing assistantsand the other employees in the nursing and cardiopulmonary categorywill join together to set up a single union for all of the employer’s facili-ties and missions.

You work in an institution that will beintegrated in a local network?The government will set the date or dates of coming into effect of theprovisions regarding the determination of a new bargaining unit in insti-tutions that will be integrated into local networks. Within 30 days follow-ing the integration or merger, the local network will post, for a period of20 days, the list of employees that will be part of the nursing and car-diopulmonary personnel category. This list will include all the employeesof the institution including those who are on leave without pay and thosewho are on the availability list and who have worked in the last 12months. Only an employee whose name appears on this list can take partin the vote. Nurses, nursing assistants and other employees in the cate-gory nursing and cardiopulmonary personnel will join together to set upa single union for all of the employer’s facilities and missions.

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The second aspect of Bill 30consists in the decentralization

of the negotiation of collectiveagreements. Abolishing the process of

negotiations by which the parties at theQuebec level, that is the FIIQ and the Comité patronal de négociation du secteur de la santé et des services sociaux(CPNSSS), negotiate together the content of the collectiveagreements for each of the categories of institutions (CHP,CHSLD, CLSC, EPC, CR, CPEJ and regional boards), this billdivides the content of the collective agreement into two sections. The first section, the Quebec section, will be negotiated between the FIIQ and the CPNSSS for all the institutions regardless of the category of institution. The secondsection, the local section, will be negotiated locally betweenthe union affiliated to the FIIQ and the employer. However,many questions will have to be discussed at both levels. This new process of negotiations, imposed by the government,will entail many changes in negotiation practices. More thanever before, union solidarity will have to be expressed at thelocal level, in the context of local negotiations with the new employers, as well as at the Quebec level, during the upcoming bargaining round.

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To choose a union:three possible options Three methods can be used to determine whichunion, among those already present, will henceforth represent all the nursing and cardiopulmonary personnel.

Creation of a grouping

If all the unions who have a certification to represent either nurses, ornursing assistants, or respiratory therapists, or perfusionists, or babynurses, agree, they can form a union grouping. This grouping will thenbe certified to represent all the employees of the new category. If onlysome of the unions agree to form a grouping, employees in the categorynursing and cardio-pulmonary personnel will decide by way of a secretballot whether the "grouping" or the other union applicants will hence-forth represent them. The one that obtains the greatest number of voteswill then be certified.

Agreement on a designation

Unions who have a certification to represent either nurses, or nursingassistants, or respiratory therapists or perfusionists, or baby nurses canagree on the designation of one of the unions to represent the nursingor cardiopulmonary personnel. If there is agreement between all theunions concerned, the union thus appointed will then be certified to represent all the employees of the new category. If only some of theunions agree on the designation of one of their unions, a vote by secretballot will be held among all employees of the category nursing and car-diopulmonary personnel and the union that obtains the greatest numberof votes will then be certified.

Filing a petition for certification

Each union who has a certification to represent either nurses, ornursing assistants, or respiratory therapists, or perfusionists orbaby nurses can petition for a certification to represent all employeesin the new category nursing an cardiopulmonary personnel. The latterwill then be able by secret ballot to choose, among all the unions, theone that will henceforth represent them. The union that obtains thegreatest number of votes will then be certified.

Decentralization of negotiations

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Concerning when negotia-tions at the local level willbegin, the Negotiation Sectorwill use the period necessaryfor holding the votes regard-ing the certification of thenew unions (see previousarticle) and to prepare thenecessary material to sup-port local teams and consul-tants in the local bargainingprocess. The government hasplanned that the transitionbetween the centralized system of negotiations andthe decentralized negotiationplan will be implementedinstitution by institution,once the new local union iscertified. Thus, the employerand the newly certified unionwill have a maximum of twoyears to negotiate and agreeon the content of the localsection of the collectiveagreement. Failing a negotiat-ed agreement, the legislatorstipulates that a mediator-arbitrator will be called uponto rule on the content of thelocal section of the collectiveagreement. However, thedecision of the latter cannotengender additional costs forthe employer, which leads usto believe that there will belong debates at the time ofthe presentation of the finaloffers by each of the parties.

The legislator also stipulatesthat the merger of senioritylists will only take place oncelocal negotiations are completed. It is therefore not before this time that the

Two-level negotiations At the Quebec level The parties at the Quebeclevel will negotiate all money-related questions. Indeed,salaries, quantum of annualleave, premiums and planssuch as the insurance plans,parental rights, union leavesand job security will continueto be negotiated at the centralbargaining table.

At the local level The local parties will negoti-ate all issues which, in theopinion of the government,concern the organization ofwork. Among the 26 mattersto be negotiated locally, let usmention the notion of posi-tion and transfer, and theirconditions, the rules for voluntary transfers, statutoryholidays, floating holidaysand annual leaves, with theexception of the quantumand pay, the development ofhuman resources with theexception of the amountsallocated, travel expenseswith the exception of thequantum.

This new plan for decentral-ized negotiations, demandedfor years by employer associ-ations, will modify in animportant way establishedpractices in the field of labourrelations. For example, theFIIQ will discuss, at theQuebec level, demands con-cerning the number of daysof vacation leave. Then, it willbe up to the parties at thelocal level to establish theconditions for taking thesevacation leaves (the period,per centre of activities, perwork shift, etc.)

And what about our draft collective agreement?This modification in the process of negotiations, which comes about afterthe FIIQ has presented its draft collective agreement, forces us to re-examine our draft agreement in the light of the how the government hasdivided up matters. Moreover, it is probable that this project will have tobe modified for greater protection against sub-contracting and to dealwith the multiplication of local networks (union life, multiplication offacilities and missions with the same employer, etc). In the comingmonths, the Negotiation Sector will present to delegates at a FederalCouncil meeting the amendments needed to resist the wind of privatiza-tion of services and the government’s anti-union policies.

Ambiguities to clear up Moreover, before beginning negotiations proper on the content of thedraft collective agreement, the FIIQ and the CPNSSS will have to agree onthe scope of the matters that are decentralized. Indeed, since the govern-ment passed this bill at full speed, without any in-depth discussion, thelist of the 26 matters that are decentralized are subject to interpretation.The FIIQ, which stands against the imposed decentralization of negotia-tions, will argue that this list should be interpreted in a restrictive way,and chances are the CPNSSS will oppose this viewpoint.

Maintaining the current collective agreementsAs you remember, in the context of the process of negotiations, in effectsince 1985, the FIIQ was responsible for the negotiation of all mattersincluded in the collective agreement. Once the collective agreement wassigned, the local parties (union and employer) could modify the Quebec-wide agreement by way of local agreements. A list of subjects that couldbe the object of local agreements was included in the Act respecting theprocess of negotiation in the public and parapublic sectors (Bill 37). Thissystem of local arrangements is not abolished. However, the current provisions of the collective agreements and their respective amendmentswill remain in effect for each of the groups concerned as long as newQuebec-wide or local collective agreements have not been concluded.

When are local negotiations to begin?

effects of the merger of certification units will be felton a daily basis. Until then,the working conditions ofnurses, nursing assistants,respiratory therapists, pulmonary function techni-cians, perfusionists or extracorporeal circulationtechnicians and baby nurseswill continue to be governedby their current collectiveagreements.

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mental rights, democratic lifeand solidarity. Despite shortnotice, people from theregion of Montreal, Laval,Montérégie, Saguenay-Lac-Saint-Jean and theLaurentians came to QuebecCity to take part in theprotest. Other similar rallieswere held in Sherbrooke,Trois-Rivières, Gatineau and Rouyn. After having participated inthe various demonstrationsheld in December against thepresentation of Bills 25, 30,31 and many others, theRéseau de vigilance decidedto mobilize in January-February around the consultations held byMinister Séguin prior to thepresentation of the budget.The FIIQ has already sent an

Concerned by the first mea-sures adopted by the Charestgovernment, the major unionorganizations, including theFIIQ, community groups andwomen’s groups decided towork together, as a network,to counter the expectedsocial and union setbacks. At a rally on October 21, thefirst day of the new sessionof the National Assembly,these organizationsannounced the creation ofthe Réseau de vigilance.Close to 1500 people weregathered in Place D'Youville,in Quebec City, to sound thealarm with bells, whistles andpots and pans. They wantedto alert the public to the dan-ger of the projects presentedby the Charest governmentfor public interest, funda-

position paper to theMinister. In line with this, the Réseau de vigilanceevaluated that it would bestrategic to organize protestsat the time of the public hearings held before the presentation of the budget.Thus, it invited all groups tospeak out high and loud forquality public services,accessible to all, and forsocial programmes adequately and collectivelyfunded, the redistribution ofwealth, sustainable develop-ment in a viable future, a tax

system that serves the publicinterest and rests on the principle of the fair taxationof citizens, corporations andcompanies. Other actions will be organized by the Réseau devigilance and the FIIQ urgesits members to take part inthese actions, both at thelocal and regional level,because it is important to letthe Charest governmentknow that we reject hisreengineering plan.

Making our voice heard withthe Réseau de vigilance

Phot

ogra

phe C

lémen

t Alla

rd

On the picture, Lorraine Guay and Serge Roy, both spokeper-sons for the Réseau de vigilance.

school expenses, theincrease in the cost of child-care by the Minister of theFamily or the reform ofadministrative justice drawnup by Minister Bellemarewhich will make justice lessaccessible to people in a situation of poverty.

And what about sub-con-tracting which is facilitatedby the recent amendments toArticle 45 of the LabourCode. This simple modifica-tion is heavy with conse-quences. It imperils theworking conditions of thousands of men andwomen workers in Quebec.By transferring jobs towardsthe private sector or the com-munity sector, the govern-ment decided to maintain a predominantly-female workforce in under-paid jobs.

And what about the Charestgovernment’s delay in pre-senting its plan of action tocounter poverty, despite thefact it is compelled to do soby Bill 112. As a matter offact, persistent rumours leadus to believe that this plan ofaction may be attacking thepoor instead of attackingpoverty. Indeed, there is talkof abolishing the $111monthly allowance for people

Besides Bills 25 and 30which seriously affectswomen workers, unionizedemployees and users of thehealth and social servicesnetwork, the vast undertakingof deconstruction of theQuebec State is hittingwomen head on. Other bills,adopted in December, orabout to be, other regulationsor policies announced affectwomen directly, and often themost deprived women.

This is the case with therefusal of the Minister ofLabour’s decision not toapply the minimum wage toseasonal agricultural workerswho harvest berries, the$209 million cut in the welfare budget decreed bythe Minister of Finances lastJune, the 25% cut in themaintenance budget of low-income housing decreedby the Minister of MunicipalAffairs, Sport and Leisure.This is also the case withHydro-Québec’s increase inelectricity rates, or the revi-sion of the Régie du loge-ment’s rules for the calcula-tion of rent.

This is also the case with theabolishing by the Minister ofEducation of the $15 milliongrant to reduce the back-to-

who receive welfare and havea dependent child who is fiveyears or less, and recipientswho are between the ages of55 to 64.

And this is not all. Far from it.We must keep an eye on theproject to reform of theQuebec Pension Plan whichplans to replace the sur-vivor’s pension, a lifetimepension, with a higher pen-sion that will last only threeyears. The reengineeringannounced by the govern-ment will inevitably meanhuge setbacks for women,since its prime objective isState disinvolvement.

Unfortunately, we are short ofspace to continue the list ofcalamities which are the workof the Charest government,but it is clear that we mustabsolutely organize to resist."International Women’s Dayis a perfect opportunity tofight back against the government's campaign tosteal our hard won gains.Everywhere in Quebec, in ourworkplaces, in our families,in our day-to-day lives, let'swork together to developstrategies that we all canuse." This is the essence ofthe message for InternationalWomen’s Day.

With women in women’sgroups, community groups,other union organizationsand with men supportive oftheir struggles, nurses areinvited to stand shoulder toshoulder in order to takeaction. We must force thegovernment to maintain theaccessibility and universalityof public services by ensur-ing that they have adequateand collective funding. Wemust bring the governmentto respect the democraticprocess when it wants tointroduce changes.

The Intersyndicale desfemmes reminds us that wemust react together to theconsequences of sub-contracting and the incursionof private enterprise, resistthe lure of lower taxes, whichwill mean a reduction in public services and a hike infees. Together, we must forcethe government to take intoconsideration the status ofwomen.

Fight back

11

The content of this article is drawn in part from the pamphlet entitled Women Fight Back - Together everything is possible, produced by the Intersyndicale desfemmes, of which the FIIQ is a member, and which will be distributed on March 8, 2004.

FÉDÉRATION DES INFIRMIÈRESET INFIRMIERS DU QUÉBEC

POSTE-PUBLICATION_________________Convention 40007983

Vol 15, Special Edition,February 2004

This special edition wasproduced with the help ofthe following sectors andservices:

● Health-Care: Lucie Mercier andFlorence Thomas

● Union Organizing:Hélène Barry

● Task and Organizationof Work: Thérèse Laforest

● Negotiation: Richard Beaulé

● Communication-Information: Marie-Andrée Comtois Micheline Poulin

● Translation: Martine Eloy

● Secretary: Céline Bourassa

● Graphics: Josée Roy, graphiste

● Photography: Clément AllardRainville photographe

● Printing: Caractéra

ISSN : 1203-9837

We are about to experiencemajor changes as nurses,unionized employees and citizens. We did not wantthese changes, however, wemust now choose how wewill react and take the meansto have a union life thatcounts on the contribution ofall the Federation’s members,union activists and services.We must unite our ownforces and feel stronger withthe new members who willjoin our ranks, that is nursingassistants, respiratory therapists, perfusionists,extra-corporeal circulationtechnicians and baby nurses.

Challenges are great since,on the one hand, the FIIQ isabout to experience thelargest union allegiance campaign ever undertaken

in almost all health-care institutions and, on the other,we will have to wage a struggle to force the Charestgovernment to take its socialresponsibilities and ensurethat the public has access toquality health services.

Throughout the year, we willshare information and analyses of the changes thatmodify our work organizationand our union life. We willwork together to create a newunion force in the image ofits members, a rallyng forceto which we can identify.

The Charest government haspassed laws that do not correspond for the timebeing to our expectations andour choices. Despite ourobjections and those of several organizations regard-ing these bills, they wererammed through at the endof the past year, after theCharest government imposedthe guillotine to stop thedebate on all the bills beingexamined. The governmentmuzzled parliamentarians,but it will not be able tosilence all movements ofresistance. If the governmentpassed these laws in a hopeto weaken union organiza-tions, it will not be able toquell the movements of solidarity.

More than ever before, it isessential to develop andmaintain alliances with otherunion organizations, socialgroups and women’s groups,here and elsewhere, in orderto be able to face up to thegovernment’s anti-social andanti-labour attacks, We muststand shoulder to shoulder.

Unitingfor action

Head Office2050 de Bleury, 4e étage, Montréal (Québec) H3A 2J5 tel: (514) 987-1141 fax: (514) 987-7273

Quebec City Office1260, bd Lebourgneuf, # 300, Québec (Québec) G2K 2G2tel: (418) 626-2226 fax: (418) 626-2111

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