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Quebec nurses reject deal – la lutte continue

FIQ members at protest
Chantal Sundaram

April 15, 2024

The last year has been tumultuous in the Quebec public sector labour movement. After years of crisis that began even before the pandemic, all public services – but especially health and education – remain critically underfunded and understaffed.

The labour shortage is due to falling real wages, severe overwork, and the inability of front-line workers to meet public need, causing many more to quit. Nowhere has this been more clear than in Quebec’s healthcare system, which is now being further ravaged by privatization.

And Quebec healthcare workers are only the latest to put their foot on the brake, following a massive uprising of public sector workers last November and December, when close to 18% of the entire population of Quebec was on strike, mostly women.

And now, almost 66,000 healthcare workers have told both their government employer and their own union that they’ve had enough, by massively rejecting a deal recommended to them.

Quebec Common Front and health professionals

Last fall 420,000 members of the public sector-wide Common Front staged a series of short “warning” strikes, getting a deal as they approached a deadline for an unlimited general strike in the new year. They were joined by two other unions that were also negotiating with the Legault government.

One was Quebec’s biggest nurses’ union, the FIQ (Fédération interprofessionelle de la santé du Quebec), with 80,000 members, including the majority of Quebec’s nurses as well as nursing assistants, respiratory therapists, and clinical perfusionists (technicians who operate blood pumps during cardiac surgery). They staged eight days of strike last fall.

After the Common Front got its deal, the FIQ leadership kept negotiating. In April, the union recommended a deal to its membership, but after several membership meetings and three days of voting, by midnight of April 12, the membership massively rejected the deal: 66,000, or 77% of the membership, cast their vote, and 61% voted to reject. In the east end of Montreal, the deal was rejected by 80% of FIQ members.

FIQ president Julie Bouchard expressed disappointment at the result but said the message was clear. And member posts on social media show anger over relocation of nurses and mandatory overtime.

Flexibility and overtime

The deal’s 17.4% salary increase over five years falls far short of keeping pace with inflation. But this isn’t about money.

Throughout negotiations the government has been insisting on “mobility” and “flexibility” of nurses, and the fight over forced overtime due to short-staffing is far from new.

In 2018, when a nurse at the Gatineau Hospital in Hull was told she needed to stay after a 12-hour shift to work mandatory overtime—and responded she was too exhausted—eight of her coworkers held a two-hour on-the-job “sit-in” in solidarity.  After a meeting with the union all nine nurses were sent home and no one did mandatory overtime.

In 2021, nurses across Quebec engaged in a mass refusal of overtime, through the FIQ as a refusal of unsafe work. In a dozen regions including Montreal, 30,000 members refused extra hours for a weekend in October and issued a November deadline to ban the practice of forced overtime entirely or face further action.

The rejected deal states that mandatory overtime should only be used in emergencies. But what constitutes an “emergency” can become constant, as nurses have learned over years of never knowing when they will be allowed to go home – only worsened by the ravages of the pandemic.

And one of the issues that almost led to a breakdown in negotiations this past January was the nurse-patient ratio. A pre-pandemic viral Facebook post by a Quebec nurse coming off a shift in tears over the inability to help too many patients raised a public alarm. The situation has worsened since, and yet the FIQ deal only includes a promise to implement a realistic patient ratio gradually. In the meantime, the labour shortage will still mean more overtime or more “short-blanket” care.    

Pressure and the big picture

Though the FIQ leadership appeared shocked by the rejection of the deal, Bouchard said that the high voter turnout shows that the membership remains mobilized. Talks began again on the night of Sunday April 14.

The FIQ is not excluding the possibility of more days of strike like the ones last fall. Following the rejection, Bouchard told a press conference, “We already had a strike mandate in our pocket to go as far as an unlimited general strike. If the 80,000 healthcare professionals tell us: we are ready to go that far, then we will use it.”

But the FIQ leadership say plans for a general strike are not immediately on the table, because they want to engage in a consultation process with the members on where the deal falls short. But it may be difficult to narrow down the members’ anger to only what can be easily settled in bargaining.

In December 2023, the Legault government adopted Bill 15, “An Act to make the health and social services system more effective.” The Bill creates a provincial agency, Santé Québec, to oversee all activities related to public healthcare, including providing services and facilitating access. CAQ Health Minister Christian Dubé claims that this will allow people to access a medical specialist more quickly, but healthcare workers will experience “significant changes” which the government will have to explain.

The truth is, Bill 15 will allow even more privatization of Quebec’s public healthcare system – but also, it pits healthcare workers against each other. Santé Québec becomes a single employer, merging unions and seniority lists, allowing staff to move from one region to another. The FIQ has maintained that the government wants to impose mandatory transfer/relocation on its members, while the government has maintained that transfer is voluntary.

Transfer of nurses literally amounts to rearranging deckchairs on the healthcare titanic. It intentionally detracts attention from underfunding, and places the burden on staff who should be happy to move around. Worse, it is a divide and conquer strategy that invites an internal fight over seniority which has nothing to do with why healthcare is in crisis in the first place.

The Quebec government has already made clear they don’t intend to back down in the face of the FIQ members’ rejection. Treasury Board President Sonia LeBel said on X: “the context and our goals will remain the same, in particular on the question of flexibility.” Minister Dubé also reiterated that the government must forge ahead with the necessary changes to reform the healthcare network.

So, the FIQ leadership, and membership, should not delay. Consult away on what was wrong with this specific deal, but the big picture is more than clear. This mobilization of healthcare workers should not be squandered in challenging the dismantling of public healthcare.

Nurses lead the way

The fight by Quebec nurses is yet more evidence of a growing willingness to fight back by workers in general. And nurses above all have been exposing the empty “frontline hero” lies of governments who only passed the burden of the pandemic onto the backs of those very frontline workers.

In Alberta and Ontario, rallies by nurses and health workers have led opposition to disastrous health care decisions by those provincial governments. Nurses in both Alberta and Manitoba have been in the forefront of fighting back against government public sector wage freezes, whether through legislation or informal interference in bargaining – including with the threat of job action. Even in Ontario, where nurses don’t have the right to strike, they were a key part of opposition to the wage freeze imposed by Premier Ford’s Bill 124.

The goal of privatization by stealth remains front and centre for the Quebec's CAQ government. The possibility of further strike action by nurses could not only win a better deal for members of the FIQ, but also strike a blow against the government’s disastrous healthcare agenda.

The fight for public healthcare belongs both to those who need it, and those who provide it.

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