Universal pharmacare in Canada

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Brachina
Universal pharmacare in Canada
Francesca Allan

This is a good idea but I'd like to see more attention being paid to entire health care, including dental (as opposed to just drugs).

 

Sean in Ottawa

The thing is a drug plan would save so much money we could afford dental. Without a drug plan we can barely afford what we have now. A national pharmacare plan is a no-brainer and is only being stalled due to ideology, the interests of insurance companies and pharma.

Fidel

Quote:
While Canadian politicians claim they cannot afford to introduce Pharmacare, New Zealand adopted such a system precisely because the country was in dire economic circumstances.

Our two old line party politicos in Ottawa and provinces are full of shit as per usual. Nothing new. Fascists do not believe in free markets and, instead, work diligently to create monopolies for their big bizness friends.

And Ralph Nader warned Canadians back in the 1980's against handing 20 and 30-year drug patents to big pharma. They've pocketed billions of dollars worth of our donations to their shareholders cause to become filthy rich while plowing a pittance back into r&d of new drug discoveries.

 

Brachina

Fidel wrote:

Quote:
While Canadian politicians claim they cannot afford to introduce Pharmacare, New Zealand adopted such a system precisely because the country was in dire economic circumstances.

Our two old line party politicos in Ottawa and provinces are full of shit as per usual. Nothing new. Fascists do not believe in free markets and, instead, work diligently to create monopolies for their big bizness friends.

And Ralph Nader warned Canadians back in the 1980's against handing 20 and 30-year drug patents to big pharma. They've pocketed billions of dollars worth of our donations to their shareholders cause to become filthy rich while plowing a pittance back into r&d of new drug discoveries.

 

Yep and a good chunk of the R&D investment is crap like balding medicine and viagra verison 3 billion.

Fidel

My god I forgot about their billion-dollar snake oil potions for male pattern baldness. The sex mechanic drug is one thing, but baldness? I think we were designed to be hairless/topless since evolution kicked-in. Or something.

Next thing we know they'll be claiming to have cured body odour like it's a disease or something. I don't know of anyone who's ever died of smelly arm pit syndrome. But we can be sure that big pharma will produce pseudo-cure v.28.625-02 with the many billions of dollars we've donated to their shareholders over the years. Pills to calm kids down is another one. The kids don't wanting sedating - they want freeing from this fascist matrix setup.

lagatta

Fidel, you didn't get the message about the new cure for grey hair! I kid you not. As in viagra, they found this was a side-effect of other medication. Obviously not releasing it yet, so as not to sabotage the lucrative hair-colouring industry.

But I agree about dental. Only serious malady I have (knock wood), but can of course lead to all manner of disease. My teef are powdery because I as allergic to dairy as a postwar kid, and they didn't have all the alternatives that now exist.

Fidel

Aye up, lagatta, I could use some permanent hair colouring. lol!

I think the corporatocracy is not interested in investing serious money in long-term r&d. Some day there will be breakthroughs and real discoveries. Some day they will cure diabetes and save health care systems billions of dollars. There should be real incentives to discover real cures, but I'm wondering whether that's true or not. How many billions of dollars in profits would be missing from corporate balance sheets if real cures were to make all of their snake oil potions and pills obsolete?

janfromthebruce

A good friend of mine who is a hair dresser also said she would not want that product to hit the market - said most of her business was colouring hair.

lagatta

Yes, colouring hair pays a lot more than cutting it. Also creates a "dependency", as roots showing are seen as a sign of being a slob. It is hard to quit colouring for that reason, even if one wants to. And no, shaving one's head is not an option for most women with conventional jobs. People either think you have cancer or some other disease, or that you are very strange.

I'm really glad I stopped the colour, though it meant playing with a lot of scarves and headbands for a while. My hair was black when I was younger (I started to go grey very young, genetic on the maternal side of my family).

Michelle

But do most people who colour their hair colour it because it's grey, or do they colour it because they want it to be a different colour?  Certainly when I was dyeing my hair, even when I did it to cover grey, I wasn't aiming for my natural, mousy-brown/dirty-blonde colour!  I would colour it bright red, burgundy, and other shades...

Sineed

Francesca Allan wrote:

This is a good idea but I'd like to see more attention being paid to entire health care, including dental (as opposed to just drugs).

 

I agree. In Canada, physicians are reimbursed by fee-for-service, meaning that the more they prescribe, the more they get paid. If Pharmacare is added to the mix without bringing in changes that compel physicians to use evidence-based medicine and be more accountable for their prescribing habits, all we will do is over-medicate Canadians.

For instance, type 2 diabetes can be mitigated by losing weight, but there is little support or reimbursement for strategies that help people with weight loss, while physicians are fully reimbursed by prescribing the drugs. Ditto drugs for chronic pain.

I like this way of doing it:

Quote:
In France, drugs that are weak in therapeutic value are reimbursed at 15 per cent of cost, moderately effective drugs at 35 per cent, and highly effective drugs at 65 per cent.

lagatta

Strategies such as keeping fit and weight loss also require funding for a more holistic system, such as non-profit, non-humiliating sport and recreation facilities (i.e., places people can afford, free or with a modest fee, and no discrimination against people who aren't gym bunnies). Not to mention access to affordable, nutritious food.

But the lack of access to dental care is a huge gap (bad pun) in the healthcare system.

6079_Smith_W

I think both drugs and dental work should be covered. I think covering children's dental work is the highest priority, though, simply because of the cost as it affects most families.

And I see universal coverage as a pandora's box, considering certain medications which can run at thousands of dollars a month. We have already had a few cases here in Saskatchewan of the province agreeing to cover a drug in specific cases. If drug companies knew they could charge whatever they wanted and it would be paid we'd have new conditions and new drugs to treat them every week.

It is a shame, but as Sineed rightly points out, it is a system which can be abused.

 

kropotkin1951 kropotkin1951's picture

Sineed wrote:

I like this way of doing it:

Quote:

In France, drugs that are weak in therapeutic value are reimbursed at 15 per cent of cost, moderately effective drugs at 35 per cent, and highly effective drugs at 65 per cent.

I think that is a bad idea. Paying a 35% fee for drugs is too high.  Do you know if those user fees are imposed regardless of income?

kropotkin1951 kropotkin1951's picture

6079_Smith_W wrote:

The rates may not be the best, but the scale is a good idea, especially if it means being more inclusive.

How is this more inclusive? I am lucky enough to be on a good benefit plan and there are no co-payer fees. A 35% co-payer fee would be a major step backwards. What I have for myself I wish for everyone else. There are other good ideas to help with lowering drug costs although I think that a universal drug and dental plan without co-pay should be a priority.

In BC we had a very good program that looked at which drugs were effective for various conditions and the cheapest alternatives were then the recommended ones with Doctors requiring a good reason for prescribing a more expensive alternative.  A good reason included that the patient had tried the less expensive treatment and it had not been successful for them.

6079_Smith_W

The rates may not be the best, but the scale is a good idea, especially if it means being more inclusive. There are plenty of treatments (dentistry is just one example) and medications for which people already pay 100%.

If you get your arm set at a clinic in this province you pay for the cast. It's not expensive, but it is a good example of our coverage being far from universal.

(edit)

@ lagatta

It is already the case that some items (physiotherapy tools and equipment) can be covered or not covered, depending on whether there is a prescription or not. And there are other things that probably should be covered, like compression garments, which are not; at most they are non-taxable with a prescription. I know that is for treatment, not preventative, as I think you mean.  And I should out myself because that is part of our business.

 

 

6079_Smith_W

kropotkin.

I'm not taking issue with you over the 35%. It is very high. I agree with you. But I do think a sliding scale is better than leaving a lot of things uncovered; I'm not saying that the pricing in France's system is a good thing.

And I cross-posted with you a few examples of things which are completely uncovered, which one would think should obviously be paid for.

 

 

Catchfire Catchfire's picture

The fight for pharmacare in Canada

Canada is the only developed country that has a universal health-care system but doesn't cover prescription drugs. Not only is this bad fiscal policy, but it has left eight million Canadians without coverage.

In the absence of a national pharmacare program, every province, territory and federal health-care system (RCMP, military, veterans, inmates, First Nation and Inuit) has its own pharmaceutical program. This has led to a patchwork of pharmaceutical insurance plans across the country where different medicines are available in different provinces, eligibility for public coverage differs dramatically, co-pays and provincial/territorial deductibles go from a few dollars to thousands and Canadians in some parts of the country find greater financial barriers to filling their prescriptions than others.

Often Canadians do not know which drugs their province/territory covers and which drugs other provinces/territories cover. While decision-making about which drugs to cover should be based on evidence, the power lies in the hands of politicians who may be swayed in favour of one drug over another by special interest groups such as big pharma. The financial ability of provinces or territories to cover drugs -- especially those not yet off patent -- can be a major influencing factor in deciding which drugs the province is willing to add to their purchasing list.

 

Bacchus

I would soo support this. My drugs and dental is costing me thousands right now, which of course I dont have

Slumberjack

Mine runs about $60.00 per month.  This gets me to thinking that a prescription for it might go toward covering most of the expense under my veteran's benefits.

Bacchus

My new diabetes drug Im on is $83/month alone. The others are far cheap, maybe $40/month total for the other two (I got off my cholestreol drug for now but if I go back on after my next test its another $40/month)

6079_Smith_W

Thing is, health is a provincial jurisdiction, so it makes sense that those systems would be provincial. Even medicare may fall under federal legislation, but it is administered provincially. The only lever the feds have is transfer payments, and that is unlikely to change.

After all, there are treatments which are covered in one province, but not another, so that same argument could be made about medicare.

A major part of the current problem is that our federal government is trying to undermine those systems, and not holding up its end of funding.

 

 

Sineed

kropotkin1951 wrote:

I think that is a bad idea. Paying a 35% fee for drugs is too high.  Do you know if those user fees are imposed regardless of income?

It's a way of enforcing evidence-based medicine. Currently, our doctors are not accountable for their prescribing habits, allowing themselves to be influenced by drug company reps and their patients' opinions; ie the people who have educated themselves at Google University and are convinced they need the newest drug, when newer drugs are more expensive and have less of a proven track record for safety and effectiveness.

Regulatory bodies approve drugs on the basis of randomized controlled trials that show statistically significant benefits. But what they don't do is consider the drugs already on the market. To clarify, drug companies don't have to prove that their new drug is better than the old drugs, and in fact, they avoid such head-to-head trials because they collide with a robust bottom line. For instance, there are six proton-pump inhibitors on the market, for treating ulcers and GERD (heartburn): Losec, Pantoloc, Nexium, Pariet, Dexilant, Prevacid. None has been found to be any better than the other, but there are people who insist that Nexium, the most expensive one, works better for them. I wrote a report for my Ministry that I presented at a conference, which found that our ministry spent $55,000 on Nexium in 2010, and if the doctors had instead written for Pantoloc, it would have cost $3,000.

Of course, if people have a condition that necessitates something newer and pricier, they should get it without penalty. Proper drug formulary systems have protocols written into them to ensure genuinely needy patients are not denied access. But if people want the newest, less proven, most expensive drug for their heartburn just 'cause, they should pay, because as it stands, we have a free market system for approving drugs. Allowing physician prescribing without regulatory oversight means that physicians and pharmaceutical companies get richer, but patients don't get healthier.

To answer another question someone had, this would for sure happen at the provincial level because health is a provincial responsibility, though the legislative impetus would come from the federal government, with amendments to the Canada Health Act.

jerrym

When medicare was set up hospitals were the biggest cost item in medicine. Today it is pharmaceuticals which continue to grow as a percentage of total costs. It is no coincidence that the pharmaceutical industry is also the most profitable industry in the world on a percentage basis. In order to set up an effective universal pharmacare program, cost controls need to be created and/or improved in Canada so that we can avoid pharmacare consuming an unsustainable portion of the government budget.

Although Canada's government purchasing system for drugs is better than the US where the legislation was designed by pharmaceutical lobbyists and its legislation drafted by a Congressman who then left to work as a vice president in the industry in the typical revolving door manner, there are practical steps that could be taken here to greatly improve our system. The American system has become a major cost driver of the US national deficit.

Ninety per cent of all pharmaceutical patents are for drugs that have no net benefit over already existing drugs. Often things like pill size and drug coatings are changed in order to get a new patent as an old patent for a previously high-priced version runs out and encounters price-lowering competition from generics. Then the new drug is marketed in physician literature, on the media and through drug salesmen while the old version is quietly allowed to die out. The pharmaceutical firms are also in an inherent conflict of interest when they provide the literature on the benefits and side effects of the drug to the patent office, medical practitioners, the government and the public.  

Unfortunately, one such existing component of an improved pharmaceutical system created by the 1990s NDP governmen in BC, the Therapeutics Initiative, has recently had its government funding eliminated and survives at this moment only because 

Quote:

UBC did not want to see the integrity of that unit compromised, and was willing to say, ‘OK, let’s keep the lights on, keep the staff paid, keep things in operation until we have an indication that things are going to get resolved one way or another”. ...

The [BC] Liberals cut the 15-year-old agency’s funding and access to key health data after the government launched an investigation last year into the alleged inappropriate sharing of patient health records. The probe has resulted in seven ministry employees losing their jobs.

But the future of the Therapeutics Initiative was put in jeopardy several years ago, Dix said, when the Liberals appointed a pharmaceutical company-dominated committee to review the effectiveness of its work. The result was funding cuts and a reduced mandate.

http://www.vancouversun.com/news/bc-election/fears+pharma+influence+woul...

The Therapuetics Initiative still allowed a physician to prescribe a higher-cost medicine if he felt it was warranted but generally helped to drive down costs. 

Therapeutics Initiiative was created during the last NDP government with the

Quote:

mission to provide physicians and pharmacists with up-to-date, evidence-based, practical information on prescription drug therapy. To reduce bias as much as possible the TI is an independent organization, separate from government, pharmaceutical industry and other vested interest groups.

 http://www.ti.ubc.ca/

The Liberal government used a pharmaceutical industry-dominated panel to cut Therapeutics Initiative funding and last year suspended it completely, using the excuse that seven employees improperly shared the health data of some BCers with researchers. Adrian Dix had promised to keep Therapeutics Initiative going, but now that the BC Liberals have been reelected, it is on the verge of dying as UBC is unlikely to continue funding it. Journalist Craig McInnes outlined the "shroud of secrecy" surrounding this issue, noting

Quote:

"For almost two decades, the TI has been looking at whether prescription drugs really perform as claimed. Its findings have saved lives and health care dollars that otherwise have been squandered on ineffective, or worse, dangerous treatments.

Not surprisingly, the companies that supplied those drugs have not been amused, and have been trying with some success to isolate the TI and get it shut down. An industry-dominated panel appointed by the Liberal government five years ago was the precursor to a series of cuts to TI funding, which was recently eliminated completely after being frozen as a result of the investigations into the alleged privacy breaches." 

http://www.vancouversun.com/business/bc2035/health+researchers+could+dee...

As noted above, we need such an intiative, preferably operating at a national or provincially-integrated level, both to save lives and reduce pharmaceutical costs. 

 

Unionist

Québec now has a pharmacare program of sorts. Everyone must belong to their workplace or institutional drug insurance plan if they have one - if not, they are automatically covered by the public plan. It's better than what's available in the other provinces (I believe), but it's not good enough.

There's a lot of material available in French about Québec Solidaire's proposal for a fully universal plan, as well as a government-owned pharmaceutical production and research facility. Their bill to this effect was (of course) defeated a few months ago in the National Assembly, after the neoliberals of all the other parties called it "extremist". Here's a pre-election article in English:

[url=http://www.montrealgazette.com/health/Qu%C3%A9bec+solidaire+wants+univer...ébec solidaire wants universal drug insurance[/url]

 

6079_Smith_W

We already have the provinces, and the western provinces doing communal drug purchases to save money.

I don't see any problem with cooperation. For that matter, I think supportive federal reform in support of that is a good idea. But right now that is all theory. Our federal government, and many of our provinces have no interest in doing that.

Also, the sad fact is that taking up much of that slack, and inroads into supporting that preventative care lagatta is talking about, is being made by private insurers.

Sean in Ottawa

The feds have the economy of scale to save the most money and they control the trading side that is critical to making it work. It is difficult for the provinces to go it alone compared to a national approach.

Dental care is very central to preventative health -- there are direct connections to oral infection and heart disease for example. I point to pharmacare as the most important not because dental is not important but because pharmacare offers enough saving to entirely cover the cost of universal dental care. Dental care must be provided to adults as well as children.

And while we are at it vision care is another area...

Let's not forget we have a long-term care sector that is mostly private, shockingly insufficient and inaccessible with safety and care issues. Low unionization in long-term care is also a problem making it weaker given how central unionization is to patient safety and advocacy. People often do not realize how central nurses unions have been to progress in health safety for example.

 

6079_Smith_W

@ Sean

As I said, a supportive federal government can play a strong role in driving an agenda like this forward. But health care delivery is primarily a provincial jurisdiction, and I think trying to override that is to needlessly side track the real issue here. The provinces have shown that they can cooperate and combine resources to share costs.

And really, the best first step the feds could make is to restore adequate funding and hold the provinces to committments that are already being bent and broken.

Of course all those things should be covered, but I feel children's dental care is a priority because we are already getting permanent teeth by the time we are 8 or 9, and the hits are often massive, and outside the range of many families.

As an aside, I believe a recent study cast doubt on the causal relationship between dental health and heart disease, although there is a correlation.

And yes, you are absolutely right about long-term care, expecially since in many places it has backed up into hospital spaces.

 

Unionist

I agree with Sean about the prime importance of pharmacare - for the reasons he gave - and the importance of public care and unionized service delivery.

And Smith is right about the non-link between dental care and heart disease:

[url=http://www.mayoclinic.com/health/heart-disease-prevention/AN02102]Will taking care of my teeth help prevent heart disease?[/url]

 

Sineed

I like your thorough posts, jerrym!

jerrym wrote:
Ninety per cent of all pharmaceutical patents are for drugs that have no net benefit over already existing drugs. Often things like pill size and drug coatings are changed in order to get a new patent as an old patent for a previously high-priced version runs out and encounters price-lowering competition from generics. Then the new drug is marketed in physician literature, on the media and through drug salesmen while the old version is quietly allowed to die out.

Formulary systems were developed to help organizations take control over drug costs. You discussed formulary systems already. What would also help is some sort of eHealth system, to enforce responsible prescribing by physicians.

And yeah; dental care, too.

jerrym

We can also learn how to control pharmacare costs by looking at how this is done in other countries.

For example, New Zealand has a drug formulary and Australia has the Australian Medicines Handbook (AMH).  

New Zealand's drug formulary has helped reduced costs.

Quote:

A national formulary has been proposed as a priority element of Canada’s National Pharmaceuticals Strategy. We review a variety of formulary-based policies that might be used in conjunction with a national formulary, drawing on the policies and practices of the Pharmaceutical Management Agency of New Zealand. We consider the potential price impact of an actively managed national formulary by conducting a Canada–New Zealand price comparison for equivalent products in the four largest drug classes: statins, angiotensin-coverting enzyme (ACE) inhibitors, selective serotonin reuptake inhibitors (SSRIs) and proton pump inhibitors (PPIs). The results suggest that potential price savings for Canada in these drug classes are on the order of 21% to 79%. Such price differences would translate into billions of dollars in annual savings if applied across Canada, potentially offsetting the costs of the expansion of pharmacare coverage necessary to achieve both equity and efficiency goals in this sector. ...

In economic terms, formularies concentrate buying power by “steering” the purchases of drug plan beneficiaries towards particular products (Garber 2001). This is because drugs that are “on formulary” are available at lower cost to the patient than drugs that are “off,” and because certain drugs on the formulary may be available at lower cost to patients than others. It is common among American formularies, for example, to list only one or two products within otherwise large drug classes or to provide select manufacturers with a “preferred” listing under which patient co-payments are significantly lower than co-payments for competing products (Malkin, Goldman et al. 2004; Quinn and Barisano 1999). Where there are multiple products in a given therapeutic submarket, being listed on a formulary gives a manufacturer a significant advantage in terms of potential sales volume. ...

National formularies exist in many countries, including Australia, France, Italy, Sweden, New Zealand and the United States (Veterans Affairs but not the main government program).

he cost-effectiveness of a product is profoundly influenced by its price. Once a drug has been developed, and particularly after it has been marketed for many years, there is relatively little that a manufacturer can do to change the clinical evidence concerning whether and to what extent the product meets the health needs of a population. What a manufacturer can change is price.

If a clinically effective product is offered at a price that reflects comparative value-for-money in the NZ context, it will be listed on the Pharmaceutical Schedule. For PHARMAC, determining the price at which comparative value is reached is a matter of negotiation. What distinguishes the related policies of PHARMAC from extant negotiations of Canada’s drug plans is the breadth and consistency with which PHARMAC’s policies are used to negotiate prices that reflect value and the consolidated negotiating power that the single management agency has – there are no opportunities for “whipsawing” in the context of New Zealand’s public drug coverage.

A Canadian system set up where the physician could still recommend a higher-priced drug if medically warranted, as was the case in BC under the 1990s NDP government, would avoid the problem that has occurred in some more rigid systems where the drug paid for is the cheapest, even though with some individuals using it may have rare side effects. 

 

The Australian Medicines Handbook (AMH is another method that has been used to reduce costs. The AMH has made medical practitioners less dependent of pharmaceutical industry literature and salesmen for drug information, thereby reducing costs and side effects.

Quote:

an independent medicines reference tool for medical practitioners, pharmacists, nurses, students and any health practitioner with an interest in the quality use of medicines in Australia.

AMH’s mission is to provide concise, practical, reliable, comparative drug information to promote the quality use of medicines in Australia. AMH content is Extensively researched and peer-reviewed, the AMH content is published in book (hard copy), PC/Mac and mobile formats.

AMH (Australian Medicines Handbook Pty Ltd) is jointly owned by the Royal Australian College of General Practitioners (RACGP), the Pharmaceutical Society of Australia (PSA) and the Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists (ASCEPT).

AMH is independent of both Government and the pharmaceutical industry. AMH editorial staff are all qualified pharmacists or medical practitioners, and its Editorial Advisory Board and reviewers include many of Australia’s most recognised authorities in medicines-related fields.(www.amh.net.au)

http://en.wikipedia.org/wiki/Australian_Medicines_Handbook

This not only makes it easier for medical practitioners to identify the best drug, but by providing an alternative to the pharmaceutical corpoaration's marketing literature and salesmen for drug information, reduces the risks of expensive high-priced drugs that are highly promoted being chosen and of being totally dependent on the corporations own research for drug effectiveness and side effectiveness. The drug industry fully understands with the plethora of pharmaceuticals on the market and a physician's busy schedule that he/she will often select the one that is freshest in his mind (and most costly) thanks to their marketing system if there is no easy alternative source of information. 

 

Sean in Ottawa

People need to fully understand the role of unions in healthcare.

Unions provide an organized voice for those who are at the front lines. They are the greatest safety feature available in the healthcare system. Unions in Canada are incredibly supportive of the public system and are engaged in improving it as well as maintaining it -- they have access due to their size to undertake research that nobody else will do and due to their role the proximity to make that research relevant. They are truly the guardians of healthcare in Canada. One of the reasons acute care has a better record than long term care is the lower unionization rate in long-term care. As long-term care organizes it will improve.

Nurses unions specifically see themselves as being advocates for their working nurses, for their patients, for their profession, and for the public system. They well understand the common interests of the three and produce very strong proposals that link the three interests together. They are also dynamic because of the direct connection they have to the front line. Nurses, for example, have done a lot of work on the issue of Pharmacare even though the connection to nurses work lives is indirect. That is due to their role in health care.

The same can be said about teachers and other public sector unions. These organizations protect the integrity of their systems, their professions, their workers, the public and their clients, students, patients and the public. There is a lot more than worker advocacy going on. When the public reacts badly to the role of unions they miss all of this.

kropotkin1951 kropotkin1951's picture

That is true about nurses with the exception of the BCNU which has been thrown out of the labour movement, including the CFNU, for raiding and is a strong ally of the BC Liberal government.

jerrym

kropotkin1951 wrote:

That is true about nurses with the exception of the BCNU which has been thrown out of the labour movement, including the CFNU, for raiding and is a strong ally of the BC Liberal government.

Here is what the BCNU and the BC Liberals have been up to in their attack on the HEU (Hospital Employees Union) - a union with a strong history of standing up for its members.

Quote:

In one of its final acts in the legislature before facing voters in May, the BC Liberals used their majority to pass legislation that restructures health care bargaining.

Bill 18, the Health Authorities Amendment Act, redefines the membership of the Nurses Bargaining Association to include Licensed Practical Nurses.

Although it was passed into law this past Thursday, Bill 18 won’t take effect right away. Health minister Margaret MacDiarmid has said there will be a period of consultation and then the new legislation will be implemented by an order of cabinet.

As a result of Bill 18, LPNs currently in the Facilities Bargaining Association and Community Bargaining Association are expected to be transferred into the Nurses Bargaining Association. This move would impact about 1400 HEU members and hundreds more LPNs who are members of BCGEU and other unions.

HEU LPN members in stand-alone independent collective agreements are not impacted by the legislation.

The health ministry has contacted HEU and other unions to begin a consultation process, but not until after the legislation had passed second reading in the B.C. legislature.

HEU has said that the lack of prior consultation runs afoul of a 2007 Supreme Court of Canada decision that struck down provisions of 2002’s Bill 29. The court established that government’s had an obligation to engage in meaningful consultation on such matters.

The new law has the potential to impact decision-making around care delivery and especially the skills mix on the nursing team.  It will also impact the collective agreement provisions covering LPNs. ...

http://www.heu.org/publications/bc-liberal-government-passes-bill-18

 

Sean in Ottawa

I am not going take a side in this but instead try to explain that things are not as simple as they are being made out.

The BCNU is hardly a friend of the government and has fought them very hard over the years.

Agree with them or not or with how they have managed this or not-- things are more complicated than they are being made out to be. Both unions have done almost the only things they could have done-- or could have been expected to do.

Let's look at more of the history here:

Nurses unions have achieved higher salaries for nurses and pressed for more nurses to be hired. The evidence is there to support what nurses unions have done. Many health employers abetted by provinces that are being less straight with the public have sought to reduce costs by redefining nurses work-- reducing the safety and quality of healthcare in the process. In BC the RNs were represented by one union, BCNU, and the LPNs by other unions. The province and its health employers were systematically redefining existing work from RN work to LPN work. (And over much of Canada we have LPN and RN work being redefined as not even regulated nursing work, something even more scary.)

Yes, raiding is bad. But at the same time, a union does follow the work. You can't take work from one union in the same workplace and effectively give it to another union without having trouble. So if BCNU had done nothing it was going to shrink and RN jobs would be given to LPNs. The exact same work in the exact same location would pass from one union to another. BCNU followed the work and also considered that by representing both LPNs and RNs they could get around the conflict between the two and bargain for the best interests of both.What they did to the other unions was aggressive but recognize that the BCNU was against a wall on this one and not merely just trying to expand.

This of course meant a raid and you cannot take just some members-- it was all or nothing. This is a situation the Liberals set up that has effectively damaged union representation of healthcare workers in BC for quite a while. But what could the BCNU have done about it? Let the work go? Let their union be sidelined? Maintain a fight between LPNs and RNs based not just on appropriate staffing but union jurisdiction? Agree or not-- you have to understand where they were coming from and the truly awful position they were in.

For the other unions, LPNs represent big numbers and unlike most public and private sector unions it is the LPNs that represented growth -- even if much of this came at the expense of another union. Not an easy thing to give up. You can't expect either side to back down. They each had a duty to their membership not to.

The CFNU, for its part, is a part of the CLC. It cannot abide raiding. As much as the CFNU could be aware of what was going on it did the only thing it could do. So did the CLC. You can be certain none of the nurses unions in the country like what is happening. Still before we attack, let's at least understand just how bad the circumstances are for all concerned.

As for the CFNU, they represent nurses in most of Canada. The ideal situation would be if both LPN unions and RN unions were within the CFNU. In that case perhaps better communication could have been explored between the unions. Also a stronger CFNU is a stronger advocate for nurses, for healthcare, for nursing professions and for patients. To that end I think less support for a continued war between those unions and more understanding of the difficulty they all face would be better.

To suggest that the BCNU is selling out to the Liberal government is simply ridiculous. That is not what is happening here.

But go ahead and blame the government becuase it has not had its share of the blame in spite of being the architect of the whole mess. At stake is a lot more than union turf. You have the systematic de-professionalization of healthcare. We replace RN jobs with LPN jobs then LPN jobs with unregulated workers. The government saves money and the public pays.

Unionist

Thank you very much for those observations, Sean. I know nothing about the situation in BC, but: 1) I think everyone (yes, everyone) should be in the same union; 2) I have never had any problem with "raiding" (can't hold on to your members? make way for someone else); and 3) when I first started on this board, I had to face ignoramuses that judged a union by which party it supposedly supported electorally, rather than by where it stood and how it fought. I'd like to hear more about the BCNU. Sounds as if they've been doing better for their members than others in the health care field - or is that impression all wrong?

Anyway, it's thread drift, but it does happen to intersect with one of my small interests (unions lol).

ETA: Why in God's name would LPNs not be in the same bargaining unit as RNs???

kropotkin1951 kropotkin1951's picture

The HEU was attacked viciously by the BC Liberals in 2003 and had their membership decimated by privatization. Then they had the BCNU knife them in the back.  The HEU is one of the most progressive and activist unions in the province and that is why they are targeted. 

Sean your history is revisionist and the idea that the BCNU is not selling out to the BC Liberals is ridiculous. I am married to an HEU activist and know many of their Business Agents.  The knife is always most painful when it is welded by someone you thought was an ally.

Unionist you don't get the culture in the hospitals in BC. The nurses are in fact the main supervisors of LPN's and they are seen by many REAL nurses as a second class nurses. Sean has it right that the BCNU went after them not because they could better represent the LPN's interests but because they wanted their union dues.

Unionist

kropotkin1951 wrote:

The nurses are in fact the main supervisors of LPN's and they are seen by many REAL nurses as a second class nurses.

I know several unions (or more precisely bargaining units) where workers and supervisors are in the same unit, covered by the same collective agreement. Those "supervisors" are more like lead hands in most cases, and they don't mete out discipline, but they do look after scheduling, overtime, etc.

You're right, I know nothing about hospitals (or the health care sector in general). I'm imagining that the cultural difference between RNs and LPNs might resemble that between MDs (at least, the ones on staff at a health care facility as opposed to private practice) and RNs? If that's the case, there may well be a problem about putting them in the same bargaining unit, although I'm not clear that's what the BCNU is proposing. And those cultural differences (i.e. prejudices, privilege) are something progressive folks should be seeking to overcome rather than simply "recognize" and perpetuate, no?

Anyway, thanks for the info.

 

kropotkin1951 kropotkin1951's picture

Unionist wrote:

Thank you very much for those observations, Sean. I know nothing about the situation in BC, but: 1) I think everyone (yes, everyone) should be in the same union; 2) I have never had any problem with "raiding" (can't hold on to your members? make way for someone else); and 3) when I first started on this board, I had to face ignoramuses that judged a union by which party it supposedly supported electorally, rather than by where it stood and how it fought. I'd like to hear more about the BCNU. Sounds as if they've been doing better for their members than others in the health care field - or is that impression all wrong?

Here is some history and yes Unionist you are wrong. The HEU is under attack because they are the original "one big union" in health care.  They not the BCNU have led the major fights to get respect for health care workers especially women.

Quote:

HEU is B.C.’s oldest and largest health care union. But when workers created HEU nearly seven decades ago, the union had only 300 members working in just one facility – Vancouver General Hospital (VGH). And those members, like all hospital employees throughout the province at the time, worked for very low wages in terrible conditions. Hours were long, breaks were few, and there was no formal sick leave or protections against being fired unfairly. It was these sweatshop conditions that motivated health care workers to create a union that could stand up for equality, fairness, respect and social justice.

When an all-women’s union and an all-men’s union at VGH joined forces to create HEU in 1944, members wanted a structure that would give them the power they needed to improve their working conditions. And so they chose to organize as an “industrial union” – a model that crossed traditional craft and occupational lines. HEU’s very first members included job titles like orderlies, cleaners, kitchen workers, maintenance workers, laundry workers, storemen, painters, ward assistants, household workers, tuberculosis unit and powerhouse workers. Nursing team members also formed an important part of the union from its earliest days.

Through HEU, they were able to win a shorter work-week with improved wages and benefits. It didn’t take long for HEU members to see that the industrial model worked. Or that their working conditions were closely linked to the care they were able to provide.When public pressure forced government to fund an extended public health care system after World War II, the union’s membership quickly grasped that they had a critical role to play as health care advocates. Membership grew rapidly as hospitals expanded and the union won improvements to wages and working conditions. In 1968, members used their strength to bargain the first province-wide master agreement, which standardized wages and conditions in every unionized hospital.

ORGANIZING THE UNORGANIZED

By 1971, HEU represented workers at 69 facilities – mostly acute care hospitals – but the long-term care sector was largely unorganized. And it showed. The conditions in the sector, especially in privately operated facilities, were deplorable for both residents and workers. But after a decade-long campaign, HEU represented 77 long-term care work sites in a sector that, by 1983, was 70 per cent organized. These workers had many reasons for joining HEU, but according to one organizer, at the time, they were chiefly motivated by “a sense of unfairness.” It was that same sense of unfairness – especially the lack of parity with other health care workers doing similar work – that led to successful organizing efforts in the 1980s and 1990s in the community health and community social services sectors. And it’s the struggle for fairness and respect that continues to attract newly organized health care workers to HEU today.

ENDING WAGE DISCRIMINATION

By 1970, the union had embraced the fight to end gender-based wage discrimination. By filing a successful human rights complaint on behalf of 10 radiology attendants at Vancouver General Hospital, the union won big wage hikes for the workers. A 1973 complaint, filed on behalf of practical nurses in Kimberley, yielded similar results, which led to a major equal pay campaign. More than 600 human rights cases were filed. Finally, the B.C. NDP government of the day negotiated an agreement with HEU that saw 8,400 of its members receive “anti-discrimination” pay adjustments. Though progress continued to be made through the job review process in the 1980s, women were still concentrated in the lowest paid occupations. And, in a female-dominated sector, both men and women were underpaid in comparison to other industries. That’s why the union put “pay equity” at the top of its bargaining agenda. And through job action in 1992, HEU won pay equity language in the province-wide master from the NDP government. This resulted in the establishment of pay equity targets, and annual adjustments worth hundreds of millions of dollars to HEU members. Although these gains were undermined by B.C.’s Liberal government in 2004, the principle of pay equity remains one of HEU’s most important achievements, and a benchmark in our work to eliminate wage discrimination.

Unionist

Actually, krop, my question was more about how BCNU and HEU and others had been doing in collective bargaining gains in recent years of austerity and attacks. Not a big deal, just wondering. Rates of wage increases? Other benefits? Concessions? Etc. I know we're still on a thread drift.

ETA: Maybe I should be discussing this stuff [url=http://rabble.ca/babble/labour-and-consumption/heu-video-welcomes-new-me... here.[/url]

 

kropotkin1951 kropotkin1951's picture

The government wrote a new collective agreement for the HEU and after 6 years in court had that overturned for breaching the Charter.  While the government was hammering the union the BCNU decided that it would be a good time to raid the HEU.  There is real bad blood because of the lies and tactics used by the BCNU.  Part of their campaign included telling LPN's that the HEU gave away 15% of their wages in bargaining when it was a measure imposed by the government.

Quote:

In 2002, B.C.’s Liberal government – under the leadership of Gordon Campbell – arbitrarily eliminated key job security provisions in HEU’s collective agreement with the passage of Bill 29, the Health and Social Services Delivery Improvement Act. This legislation allowed health authorities to lay off thousands of health care support workers, without cause, and privatize their work. It was the biggest mass firing of women workers in the history of the Canadian labour movement. And the newly privatized jobs reduced wages and eliminated previously hardwon benefits.

Then, during a strike by health facilities members in 2004, the BC Liberals arbitrarily imposed a 15 per cent wage rollback through Bill 37 – the Health Sector (Facilities Subsector) Collective Agreement Act. The fallout from those events generated controversy and debate among HEU members, and revitalized the bargaining process. Attempts to return health care to the days when poor wages and working conditions were “the norm” continue to meet with opposition. And many newly privatized workers have overcome significant organizing obstacles to join HEU.

HISTORIC VICTORY

On June 8, 2007, the Supreme Court of Canada ruled key sections of Bill 29 to be unconstitutional under the Canadian Charter of Rights and Freedoms. After a five-year court challenge and months of negotiations, a $75-million compensation package was established for HEU members impacted by the legislation. And for the first time in history, free collective bargaining has become a charter-protected right for all Canadian workers.

WHERE DO WE GO FROM HERE?

With B.C.’s current health care climate, many HEU members are working in areas impacted by restructuring and privatization. Gone are the days when most HEU members were covered by one master provincial agreement. HEU now negotiates about 100 collective agreements for facilities, community health, community social services, First Nations, “Big 3” (Sodexo, Aramark and Compass) and other independents.vBut like the generations of health care workers who went before them, today’s HEU membership is a force to be reckoned with when it comes to standing up for decent jobs and quality patient care. That’s why thousands of workers continue to join HEU to help them deliver better care to those they look after, and secure a better deal for themselves and their families.

http://www.heu.org/sites/default/files/uploads/HEU_history.pdf

jerrym

In an article on April 17th Vaughn Palmer, hardly a friend of labour and a centre-right journalist, describes how the BCNU leadership worked with the BC Liberals to trample due process in removing the LPNs from the HEU in April and saw it as a way of gaining nurses' votes in the May election. 

Quote:

As the clock ticked down on the election call this week, the B.C. Liberals signed off on one last decision, ignoring warnings from within their own government that it was expensive, rushed and potentially disruptive. Cabinet order 222 was approved Monday, less than 24 hours before the issuing of the election writs and the day when by long-standing practice government assumes a caretaker role for the duration of the four-week campaign. Signed on behalf of the whole cabinet by ministers Margaret MacDiarmid and Pat Bell, the order enacted a reclassification of some members of the nursing profession, to the benefit of the nurses’ union and to the detriment of other public sector unions. ....

The measure had its roots in the successful drive by the B.C. Nurses’ Union to recruit more than 7,000 licensed practical nurses who were members of the rival Hospital Employees’ Union (HEU). ...

But they did so without respecting the court-mandated obligation to consult with the other unions that would be affected by the arbitrary reclassification of a significant portion of their membership.

“They have to be consulted (and) ideally the consultation would have happened ahead of time,” MacDiarmid conceded to me during an interview on Voice of B.C. on Shaw TV a few days after the legislation was introduced. “However, legislation like this can be tabled, and the consultation can happen afterwards.”

Only it did not happen afterwards, leastways not to the extent necessary. The government passed the bill through the house on the final day of the truncated pre-election session, including a provision that it would be proclaimed into law by cabinet order at a later date. But as March gave way to April, the affected unions were still complaining, in much the same vein as the aforementioned letter from the health authorities, about the lack of due process.

When the Liberals did proclaim the measure onto law on Monday, they tried to provide cover on the consultation front by including a one-year transition period to the new nursing regime. ...

The rationale had even Liberal insiders wondering why their government rushed to get this done at the last possible opportunity. The answer was provided by the nurses’ union, in the person of its formidable leader, Debra McPherson.

“The nurses are watching,” she declared last week. “Certainly you would have thousands of nurses who would be very upset with a party who promises, through legislation, to deliver them into a new bargaining association — something they’ve worked for, for over a decade — and then doesn’t deliver on the final last step.”

Disdained by the New Democrats because of the raid on the rival, NDP-allied Hospital Employees’ Union, the nurses’ union saw the Liberals as its last hope to get this done. And the Liberals concluded there might be some votes in it for them if they complied, never mind ignoring the concerns of the health regions, trampling due process, and saddling the system with costs that extend well beyond the current election year.

http://www.vancouversun.com/news/bc-election/Vaughn+Palmer+Last+minute+L...

 

jerrym

Because the HEU has stood up against the right-wing free enterprise parties for its members, it has been a target of the BC Liberals. The consequences of the privatization of HEU work has led to increases in hospital-based illnesses as less experienced, poorly trained workers pushed to work faster have led to a reduction in hospital cleanliness. Nor are there any guarantee that the LPNs will get higher wages under the BCNU, something even the BCNU president admits as the following articles reveal. Finally, as favoured unions of right-wing governments have discovered in the past, the love only extends until they have weakened the other unions. The construction unions favoured by Wacky Bennett in the 1980s were decimated by Bill Bennett in the 1980s. Reagan's allies in the Teamsters unions now find that the once high wages of truck drivers are gone. And we have all heard how public sector unions don't deserve the job security, pensions and other benefits provided by their unions, now that private sector unions have been decimated. How long before the BC nurses hear the same story?

Quote:

Since the privatization of cleaning services in B.C.'s hospitals, healthcare workers say they've seen a sharp increase in "healthcare-associated infections" -- diseases contracted by patients and staff within the hospitals themselves.

The infections are serious: Methicillin-resistant Staph aureus (MRSA). Norovirus. Vancomycin-resistant Enterococcus (VRE). Clostridium difficile. Once established in a hospital, they're tough to get rid of. Established in a patient, they can be fatal.

According to a CUPE background paper, these infections have been growing. The incidence of MRSA in Canadian hospitals increased by a factor of 17 between 1995 and 2006. Between 1991 and 2003, the number of patients coming down with "C diff" quintupled. One hospital patient in nine gets a healthcare-associated infection, for a total of 220,000 infections every year. Between 8,500 and 12,000 Canadians die yearly of such infections. ...

Mo Norton, currently running as the NDP candidate in North Vancouver-Seymour, is chief steward for the North Shore chapter of the Health Sciences Association. She handles the paperwork for outpatients in the community, and says she and her colleagues are seeing a "huge" increase in post-operative infections.

"Most charts come through me," Norton says. "We're seeing increases in staph infections and MRSA positives." The deterioration, she adds, has come over the last five or six years. Without enough staff to keep hospitals clean, "Patients sometimes walk out sicker than when they walked in." ...

It's not just a problem in Vancouver Island hospitals. Last year, after a three-year freedom of information suit, HEU learned that privatized cleaning had also meant less cleaning: Vancouver Coastal Health signed a deal with ARAMARK in 2003 that included a reduction of over 153,000 cleaning hours annually.

In its most recent yearly report (2007-2008), Vancouver Coastal Health reported 778 new MRSA cases, three-quarters of them acquired "in-house" or in another healthcare facility. Out of 472 VRE cases, 95 percent were "in-house" or acquired in another facility. ...

As long ago as 2004, the BC Nurses' Union and HEU co-authored a detailed report, "Falling Standards, Rising Risks," warning about the health hazards implicit in privatized housekeeping. Among its findings: "Employees of a private contractor are no longer integrated into a facility's infection control system and are no longer identified with the health care team itself. Responsibility for orienting and training cleaners is no longer under the hospital's control, which opens up questions about skill development and training standards...Evidence also points to the fact that privatizing hospital cleaning contributes to falling standards of cleanliness."

Cleaning is key: HEU's Darcy

Judy Darcy, secretary-business manager of the HEU, concurs: "It's essential to have cleaning staff who are part of the healthcare team. The health authorities have put their stock in hand-washing. It's important but it's only part of the solution. It's negligent and wrong to ignore the connection between cleaning and the spread of these superbug infections."

Darcy sees three steps to begin solving the problem: "First, we've been pressing for functional health and safety committee to ensure good training and identification of issues. Second, we want to stabilize the workforce, and ensure ongoing training. Third is workload reduction -- we know that our members have impossible workloads plus inadequate training.

"All three involve investment in people, and recognition that cleaning staff are a vital link in preventing the spread of superbugs."

The privatization of HEU work and the cutbacks in pay was done in the usual manner: these workers are overpaid compared to others without high levels of education, other sectors of the BC economy and workers doing similar work in other provinces. Of course, the public was reassured that privatizaiton would achieve similar levels of health care and safety. However, many of the longest term, most experienced workers left for other fields because they couldn't maintain their households in what is now the second most expensive city for housing in the world. One of my friends left ands was able to get another job without which he would have lost his townhouse as he could not have paid his mortgage. The private firms cuts in work and less skilled workforce have contributed in a major way to the spread of hospital-based illness. 

Oh, by the way, the alleged increased wages for LPNs are by no means guaranteed as part of the BCNU. 

Health Minister Margaret MacDiarmid confirmed ...

“The licensed practical nurses would be moving into a group that has some after-hour premiums, some on-call premiums and I think there are some clothing and meal allowances as well that they don’t currently have,” she said, explaining the reason for any increased costs.

BC Nurses’ Union president Debra McPherson disagreed with the minister’s statement  “All of that stuff is not automatic. It’s still subject to negotiation, and we made that really clear in our consultation,” she said. “We don’t expect them to get increases in compensation, we expect that will be a part of our next round of collective bargaining.”

http://www.vancouversun.com/health/proposed+nursing+changes+slammed/8213...

 

jerrym

jerrym wrote:

Because the HEU has stood up against the right-wing free enterprise parties for its members, it has been a target of the BC Liberals. The consequences of the privatization of HEU work has led to increases in hospital-based illnesses as less experienced, poorly trained workers pushed to work faster have led to a reduction in hospital cleanliness. Nor are there any guarantee that the LPNs will get higher wages under the BCNU, something even the BCNU president admits as the following articles reveal. Finally, as favoured unions of right-wing governments have discovered in the past, the love only extends until they have weakened the other unions. The construction unions favoured by Wacky Bennett in the 1980s were decimated by Bill Bennett in the 1980s. Reagan's allies in the Teamsters unions now find that the once high wages of truck drivers are gone. And we have all heard how public sector unions don't deserve the job security, pensions and other benefits provided by their unions, now that private sector unions have been decimated. How long before the BC nurses hear the same story?

Quote:

Since the privatization of cleaning services in B.C.'s hospitals, healthcare workers say they've seen a sharp increase in "healthcare-associated infections" -- diseases contracted by patients and staff within the hospitals themselves.

The infections are serious: Methicillin-resistant Staph aureus (MRSA). Norovirus. Vancomycin-resistant Enterococcus (VRE). Clostridium difficile. Once established in a hospital, they're tough to get rid of. Established in a patient, they can be fatal.

According to a CUPE background paper, these infections have been growing. The incidence of MRSA in Canadian hospitals increased by a factor of 17 between 1995 and 2006. Between 1991 and 2003, the number of patients coming down with "C diff" quintupled. One hospital patient in nine gets a healthcare-associated infection, for a total of 220,000 infections every year. Between 8,500 and 12,000 Canadians die yearly of such infections. ...

Mo Norton, currently running as the NDP candidate in North Vancouver-Seymour, is chief steward for the North Shore chapter of the Health Sciences Association. She handles the paperwork for outpatients in the community, and says she and her colleagues are seeing a "huge" increase in post-operative infections.

"Most charts come through me," Norton says. "We're seeing increases in staph infections and MRSA positives." The deterioration, she adds, has come over the last five or six years. Without enough staff to keep hospitals clean, "Patients sometimes walk out sicker than when they walked in." ...

It's not just a problem in Vancouver Island hospitals. Last year, after a three-year freedom of information suit, HEU learned that privatized cleaning had also meant less cleaning: Vancouver Coastal Health signed a deal with ARAMARK in 2003 that included a reduction of over 153,000 cleaning hours annually.

In its most recent yearly report (2007-2008), Vancouver Coastal Health reported 778 new MRSA cases, three-quarters of them acquired "in-house" or in another healthcare facility. Out of 472 VRE cases, 95 percent were "in-house" or acquired in another facility. ...

As long ago as 2004, the BC Nurses' Union and HEU co-authored a detailed report, "Falling Standards, Rising Risks," warning about the health hazards implicit in privatized housekeeping. Among its findings: "Employees of a private contractor are no longer integrated into a facility's infection control system and are no longer identified with the health care team itself. Responsibility for orienting and training cleaners is no longer under the hospital's control, which opens up questions about skill development and training standards...Evidence also points to the fact that privatizing hospital cleaning contributes to falling standards of cleanliness."

Cleaning is key: HEU's Darcy

Judy Darcy, secretary-business manager of the HEU, concurs: "It's essential to have cleaning staff who are part of the healthcare team. The health authorities have put their stock in hand-washing. It's important but it's only part of the solution. It's negligent and wrong to ignore the connection between cleaning and the spread of these superbug infections."

Darcy sees three steps to begin solving the problem: "First, we've been pressing for functional health and safety committee to ensure good training and identification of issues. Second, we want to stabilize the workforce, and ensure ongoing training. Third is workload reduction -- we know that our members have impossible workloads plus inadequate training.

"All three involve investment in people, and recognition that cleaning staff are a vital link in preventing the spread of superbugs."

The privatization of HEU work and the cutbacks in pay was done in the usual manner: these workers are overpaid compared to others without high levels of education, other sectors of the BC economy and workers doing similar work in other provinces. Of course, the public was reassured that privatizaiton would achieve similar levels of health care and safety. However, many of the longest term, most experienced workers left for other fields because they couldn't maintain their households in what is now the second most expensive city for housing in the world. One of my friends left ands was able to get another job without which he would have lost his townhouse as he could not have paid his mortgage. The private firms cuts in work and less skilled workforce have contributed in a major way to the spread of hospital-based illness. 

Oh, by the way, the alleged increased wages for LPNs are by no means guaranteed as part of the BCNU. 

Quote:

Health Minister Margaret MacDiarmid confirmed ...

“The licensed practical nurses would be moving into a group that has some after-hour premiums, some on-call premiums and I think there are some clothing and meal allowances as well that they don’t currently have,” she said, explaining the reason for any increased costs.

BC Nurses’ Union president Debra McPherson disagreed with the minister’s statement  “All of that stuff is not automatic. It’s still subject to negotiation, and we made that really clear in our consultation,” she said. “We don’t expect them to get increases in compensation, we expect that will be a part of our next round of collective bargaining.”

http://www.vancouversun.com/health/proposed+nursing+changes+slammed/8213...

 

jerrym

Unionist wrote:

Quote:
 

 when I first started on this board, I had to face ignoramuses that judged a union by which party it supposedly supported electorally, rather than by where it stood and how it fought. 

 

Can you please make your arguments with engaging in personal attacks? I don't care whether I am included in the group or not. I don't like it and it is totally unnecessary. If your arguments are better, then you might convince them to change their mind. I have never seen anyone change their mind because of name-calling. Of course you know this. You are simply trying to intimidate others from saying something different than what you believe.