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Members of the Fédération interprofessionnelle de la santé du Québec (FIQ), Quebec's largest nurses' union, voted 66% in favour of a new collective agreement with the provincial government last week. Seventy-five percent of some 80,000 nurses, clinical perfusionists and respiratory therapists cast their virtual ballots in a referendum held late last week.
To better understand the contents of the agreement and its implications, The North Star spoke with Sébastien Roy, a health care worker and FIQ member who works in the Montreal area. "This is a major defeat on the main issues the FIQ wanted to fight for," Roy insisted.
A conciliator was hired when negotiations with the provincial government reached an impasse. The conciliator's recommendations now form the FIQ's collective agreement. While the new contract includes some minimal concessions for workers, many workers are disappointed with the results of the referendum.
Roy pointed to wage increases in the agreement that do not keep up with inflation and the failure to address workers' longstanding concerns about mandatory overtime, patient ratios and, crucially, forced transfers. "In my opinion, nobody has switched sides enthusiastically over what we've been offered," he said of the referendum result. A previous agreement in principle was rejected by 61% FIQ of members in April.
The new contract places some constraint on where and how health care workers can be transferred between departments. But Roy pointed out that the phrasing of these clauses does little to prevent the destabilizing effects of moving nurses from one department to another:
"It's a bit of a game of words. There are departments that are going to merge under one activity centre so they can share nurses."
Many professionals have observed an overall worsening of workplace conditions in Quebec's public health care system. Roy says this is no accident. "They don't necessarily have an interest in saving the public network. Privatization is already well underway, even accelerating. It's a very narrow vision of how we can really solve the problems."
Santé Quebec, the province's new health care administration, is overseen by a board comprised mainly of businesspeople.
As conditions have worsened, many nurses and other health care workers in Quebec have left the public system. Roy observed that the government now seems to be pushing part-time workers into full-time work by paying them less.
"What this will ultimately lead to is more departures, more burnout, something that's already really problematic with our profession. We can expect that, in five years' time, none of the health network's funding problems will have been resolved by this agreement. We'll continue to have shortages, we'll continue to have huge waiting lists for surgery, which will justify more and more privatization."
Roy feels things could have gone differently had the FIQ taken a more combative stance against the government. "After the rejection of the agreement, with 61%, which was really major, they took absolutely no advantage of this to increase the pressure on the government. On the contrary, they stopped holding demonstrations."
In the autumn and early winter of 2023, the FIQ engaged in several days of strikes and pickets. The union still had strike days left in its mandate when it returned to the negotiating table this summer. "Unfortunately, we didn't come back with strike days. We didn't come back with more combative methods, where people really feel directly involved in the struggle," remarked Roy.
The FIQ's strikes occurred at the same time as those of the Common Front, which saw over 420,000 public sector workers from four union centrals engaging in coordinated strikes and demonstrations. The FIQ chose not to participate in the Common Front and thus negotiated separately from the other public sector unions.
For Roy, this lack of solidarity was a mistake: "If we had been together, we could have jointly fought for better. If we weren't satisfied with what the other unions were prepared to accept, we could have ultimately denounced the agreement that was presented to the Common Front to say that we think we need better than this."
Over the course of the negotiations, FIQ leadership decried the government's hardline stance, accusing them of negotiating in bad faith. Roy says this should have been expected and is all the more reason to take a combative approach rather than a conciliatory one:
"We must have a class struggle perspective and not seek to collaborate with a government that ultimately has interests completely opposed to us."