This report provides an overview of the issues tackled and actions taken since the 2014 Convention. This new format also includes an outlook analysis in order to begin debate and reflection on our actions. It goes without saying that the actions described herein took place in a context of austerity which has wreaked havoc over the last few years: cuts to the health and social services budget and partisan decisions that opened the door to more privatization. To make matters worse, the “Barrette reform” increased care inequality for the population and immersed the Federation in an unprecedented whirlwind of structural changes. We will only truly be able to take stock of the consequences of the reform years from now.
Against all odds, the FIQ has stayed the course with its main mission and kept its interventions securely in line with its statement of principles. This document is not just a list of actions, but rather an organizational review outlining our achievements from November 1, 2013, to May 1, 2017. Guided by strong values and an unwavering commitment to healthcare professionals, our employees proudly serve and represent the FIQ’s members.
To work at the Federation is to promote proactive and strategic proposal-oriented unionism. It’s about embodying the voice of healthcare professionals in their daily struggles, goals and challenges. Without further ado, we are pleased to present this report.
Statement of principles:
A democratic and open organization
An organization dedicated to improving working conditions
An organization focused on health care
An organization that promotes women’s rights
An organization under the banner of solidarity
An organization that is open and democratic
Developing understanding and fuelling reflection among the organization’s union representatives, members and employees on the Federation’s union, sociopolitical and professional initiatives
Democratic and deliberative meetings
At meetings, delegates must develop their reflection on important issues related to sociopolitical and professional contexts that affect them. A strong effort was made in the last few years to widely circulate the Federation’s analyses, which served as a basis for the recommendations presented at the meetings.
Annual commissions (e.g.: OHS – Drawing up overviews, identifying issues, TOT – Knowledge, will, power: three vital keys to quality professional practice, organization of work and working conditions) They ensure each group of job titles has a platform and can propose recommendations at the Federal Council. Consequently, the licensed practical nurse commissions enabled the union reps to mobilize in preparation for the OIIAQ’s annual general assembly. Through its interventions, the Federation was able to question the OIIAQ on its responsibilities with regard to enabling licensed practical nurses to use their full potential in a more standardized way across the network.
On another note, let’s address data sharing on occupational health and safety, specifically employment injuries, and the current high incidence among licensed practical nurses.
Working toward a collective agreement
In order to generate collective support, the renewal process for the 2016-2020 provincial collective agreement was designed to encourage union reps to get more deeply involved in democracy and for the negotiation process to transcend the Federation’s provincial structures. The Federation wanted to ensure the affiliated unions and members would be properly represented and act as stakeholders in the decisions that determine their working conditions. The union reps adopted a negotiation structure that ensures all job titles at the FIQ are represented. They elected the negotiating committee, adopted the guidelines for the negotiation process and actively participated in union initiatives in the field (communications, information and support). Members were asked to give their opinion on the issues around renewing their group work contract by adopting the negotiation priorities. They were also consulted on the demands central to the collective agreement at the Federal Council and local general assembly.
The FIQ in political debates
In addition to tabling memorandums at parliamentary commissions, we gave presentations on specific topics to affiliated unions, e.g., the analysis of federal and provincial budgets. We also gave other presentations on: austerity, tax havens, the FIQ’s new offer of service, international solidarity, etc. On occasion, the Federation shared its analysis of particular issues with partner organizations, such as the RIIRS, e.g., on physician-assisted dying, activity-based financing and free trade agreements.
Several meetings were held with elected members of political parties on various subjects. Executive Committee members made representations to ministers and party leaders. During the negotiations, members of the Regional Action and Consensus Building Tables (TRACs) from all regions met with members of the National Assembly to present their demands and those of the FIQ.
Training and raising awareness
Over the last few years, we have led initiatives (at all levels of the FIQ) to raise awareness among and train union reps on several issues. For example, we developed and gave sociopolitical training to ensure the union reps have a good understanding of the political movements that affect their reality as workers and to shed light on the political nature of their roles. In the last few years, we also delivered a series of accredited advocacy training sessions to members. These training sessions provide an opportunity to interact with members in a context other than one of dispute resolution. It is also an opportunity to establish the relevance of the FIQ’s values and orientations by encouraging and supporting healthcare professionals to take action. They are a reminder that a patient’s right to health care and a healthcare professional’s right to provide care in a healthy environment go hand in hand. The Safe Staffing Form is a perfect example.
We have produced various publications for both union reps and healthcare professionals. For example: the pamphlet on austerity and related issues (made in collaboration with the FAE); the FIQ Special Report – 2015 federal elections, which was presented at a meeting, and provided a breakdown of the main parties’ electoral platforms and their impacts on members; the FIQ Special Report – Safe Care, which aimed to reposition how healthcare professionals talk about care safety and raise awareness about safe healthcare professional-to-patient ratios.
Improving the FIQ’s union reps’, members’ and employees’ ability to intervene in union, sociopolitical and professional action
A growing presence online and in social media
Improving members’ and employees’ ability to intervene means using various methods to inform them. Communications are a key part of the FIQ’s activities, namely the production and translation of publications, as well as maintaining a strong presence on social media and its new website. During the 2017 voting period, approximately 500 people visited the site per day to learn more about our labour organization.
We need everyone to get involved in order to provide quick, personalized answers to members’ questions, chiefly about their working and practice conditions. In this way, employees have helped to enrich press release content and prepare the Executive Committee for interviews by breaking down union, sociopolitical and professional issues that affect our members into easily understandable language. We also offer a media training session to union teams so they can use it as a tool of intervention.
The voice of healthcare professionals
The Federation expressed its concerns following the review of the Lean projects in 2014. The adopted recommendations confirmed that it should be a priority to invest in problems related to the organization of work through channels in the collective agreement, like the Committee on Care. This, in turn, led to the development of the union reps’ field work.
Furthermore, following the commissions in December 2016 on occupational health and safety, we drafted a document on the incidence and gravity of injuries among healthcare professionals between 2007 and 2017. The document was designed to prepare OHS officers for discussions with employers.
These tools, along with the interventions carried out with union teams, support their actions and equip them to mobilize members around demands for their rights as women, workers and healthcare professionals. For example, the follow-up on Lean projects, additional employer projects on the organization of work, workshops on the Committee on Care for local teams and work on commissions. By promoting and helping to develop new care models (SABSA Clinic, Archimède project, Coop de santé du Nord de la Petite-Nation, etc.), the FIQ challenged the government’s inaction, demonstrating that the public health and social services network is capable of renewing itself from the inside out.
Bringing safe care to the public
One of the FIQ’s unifying projects, in line with union reps’ intervention skills, is to promote a culture of quality, accessible, safe, ongoing and coordinated care. The project set in motion an initiative for the FIQ’s safe healthcare professional-to-patient ratios through:
- Political structures (federal councils, assemblies, conferences, department delegate meetings),
- The International Symposium on Safe Health Care held in October 2016 (in collaboration with the SIDIIEF),
- The FIQ Special Report: Safe Care,
- Committee work on Letter of Understanding No. 17 regarding ratio pilot projects,
- Networking with organizations who could be potential allies in our fight for safe care.
Promoting democratic vitality and supporting affiliated unions in their initiatives to gather mass participation in union life
Follow-up work after the 2014 convention
Further to one of the recommendations adopted by the Convention, a special work group was appointed to research, develop and implement new labour practices in order to bring members closer together. Then, in fall 2014, a quantitative and qualitative assessment was done to provide an overview of the prevailing state of union democracy at the FIQ.
Among the actions proposed, several were implemented, such as electronic voting for the referendum on the tentative agreement on the provincial collective agreement. Another example was the creation of innovative local units, which were organized by common interests and practices rather than by former geographic territories covered by the CSSS.
Restructuring to adapt to the new health and social services network
As soon as Bill 10 was announced, the FIQ set up focus groups (which included union reps) to assess the impacts and issues of the reform. These reflections led us to the conclusion that the Federation should respond to Minister Barrette’s centralization strategy by providing regionalized services to affiliated unions and making our consultation services interdisciplinary. This new vision of the service offer will help us tackle the many challenges that arise in the new health network in the years to come.
Throughout the Bill 10 reform, the FIQ supported affiliated unions in planning the voting period, developing recruitment plans and a communication plan (help and support for media and public appearances, the TRACs meetings, etc.), liquidating unions, revising the constitution and bylaws, setting up new unions and organizing a training symposium in Mauricie and Laval in January 2017.
A variety of tools for members and union reps
We developed practical tools and new approaches to achieve more optimal work organization and professional practice for members. One example is the Safe Staffing Form, online since June 2016, which healthcare professionals can use to report situations in which safe care is compromised. It is also a way to keep union teams informed so they can intervene locally. Since we integrated new information and communication technology, this new online tool allows for more spontaneous, dynamic communication between the local union team and members.
The FIQ also developed a:
- Pocket guide and poster called Our Reserved Activities;
- A practical training session regarding Letter of Understanding No. 6 (Regarding the stability of positions, local negotiations and the deployment of the reserved activities set out in Bill 90);
- A resolution process for the problems in organization of work and a model of professional practice determinants proposed during the commissions held on the topic of Knowledge, will, power: three vital keys to the quality of professional practice, organization of work and working conditions and the subsequent action plan;
- Steps to follow when intervening in the organization of work (proposed as part of the Lean projects review), etc.
Developing, updating, communicating and evaluating the content of internal training programs for union reps and members and fostering support for the Federation’s values, principles and orientations among members
A wide range of training programs
Training programs regularly offered to union reps, depending on their roles and functions on the local teams:
- Introduction to union life
- New delegate at meetings
- New grievance agent
- Medical arbitration
- OHS – Compensation
Available since 2013:
- Sociopolitical training: Intellectual self-defence class
- New treasurer
- Interacting with the media, a strategic approach
Union reps had access to one-time training sessions on:
- Federation committees
- Local negotiating committee
- Department delegate
- Information and Support
- 2016-2020 Collective Agreement
- Local negotiations
- Letter of Understanding No. 6
- Insurance, disability and RREGOP
Local teams are asked to attend these training sessions so they are more prepared to respond to members’ needs.
We offer information sessions about the FIQ and union life in educational institutions that train future healthcare professionals. In particular, cégeps and training institutions for licensed practical nurses. Employees are asked to give conferences, training sessions and workshops at activities organized by the FIQ, including for the Youth and Women’s Network, commissions, and other events (e.g., FAE Women’s Network, The Caregiver Network, Rendez-vous CNESST, SIDIIEF international symposium).
Training sessions for members
In addition to the two Advocacy training sessions, the FIQ developed an accredited training program for members and made it a pilot project in 2015. The training course L’éthique pour les soignantes was offered free online and taken by over 1,000 healthcare professionals of all job titles represented at the FIQ.
Overall, we received very positive feedback from members, which bodes well for developing additional continuing education or online training courses, whether accredited or not.
The FIQ’s first summer school
In 2016, we held our first summer school, selecting 16 union reps to develop the knowledge, skills and attitude to help them get further involved at every level of the organization.
Trends and findings
Despite the fact that the union reps are capable of presenting their arguments and explaining the issues around the recent changes to the health and social services network to the healthcare professionals in their institutions, many members say they don’t feel engaged by their union or see how the unions’ role as a social agent of change ties into their day-to-day. In today’s context (difficult conditions of practice and repeated attacks on the public health network), we need to take these realities into account and raise awareness about the organization’s responsibility, at every level, so that everybody can fully exercise their influential union role.
Furthermore, the Federation’s committee Networks, and sometimes their luncheons, bring up important issues, i.e., the place of women and youth at the FIQ, the impact of economic and social reforms on women, violence in the workplace and society, occupational health and safety and family-work-study balance. These events are opportunities to raise awareness among union reps, deepen their understanding, stir up debates, have them develop a union- and feminist-oriented vision of what’s going on today and awaken a sense of belonging to their union.
On another note, our systematic research and analysis ensure that the Federation’s decisions are based on the most accurate and complete picture of the situation when initiating political action on sensitive issues or informing the organization when issues require action. It also means that decisions are made based on solid arguments in the interest of healthcare professionals and protecting the FIQ’s credibility.
What’s more, we can almost guarantee that social media will continue to change the way we communicate with our members. More and more, the Federation is speaking directly to its members, offering an alternative way to access information. In future, we foresee increased collaborations resulting in more integrated publications, made more accessible via web applications.
The FIQ should deepen its reflection and take action to ensure that its union reps can intervene, all the while encouraging greater participation among women and young people. We must therefore equip them with the tools and conditions to do so.
In the same vein, we know that each union rep, member and employee is currently very busy and that soon many resources will be dedicated to priorities like local negotiations. As such, member mobilization remains a challenge. Now more than ever we must ensure that information on strategic issues is accessible and clear to everyone. This reconfirms how essential our efforts over the last years have been to make information on union, sociopolitical, feminist and professional issues available to everyone.
The current context surrounding healthcare professionals leads us to believe that the FIQ will need to forge ahead with its proposal-oriented unionism. Promoting a unionist, labour approach and culture of advocacy will be crucial for healthcare professionals and patients alike.
An organization dedicated to improving working conditions
Ensuring a full member defence in line with our orientations
The Federation has represented members in various proceedings, including before the Administrative Labour Tribunal (TAT), professional associations, and in arbitration. It has provided information and support to members and local representatives at all stages of their cases, i.e., with disputes in cases of rehabilitation and returns to work, accommodation, representation with inspectors from the Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST), etc.
Over the last three years, there’s been a steady rise in the number of cases opened. This may be due to increased employer contestations and our members’ increased awareness of their rights.
The Federation has also collaborated with various experts when representing its members. What’s more, we developed an action plan in 2014 to:
- Diversify our network of experts;
- Resolve cases in advance;
- Develop closer ties with the management of the health services offices;
- Implement three pilot projects in three institutions in Greater Montreal.
This action plan enabled us to significantly reduce costs associated with expert opinions in 2014 and 2015. However, in 2016, these costs rose again mostly due to an increase in the number of expert psychological evaluations caused by a marked hike in psychological cases at the CNESST.
Since January 1, 2016, the TAT replaced the Commission des lésions professionnelles (CLP) and the Commission des relations du travail (CRT). At the same time, the Commission de la santé et de la sécurité du travail (CSST), the Commission de l’équité salariale (CES) and the Commission des normes du travail (CNT) merged to form the CNESST. Consequently, new rules of evidence and procedure were implemented to ensure the standardization of practices across the four TAT divisions.
The Crown Counsel strike that began late October 2016 and lasted 19 weeks generated a great deal of requests to postpone hearings before the TAT, thus delaying them even longer.
We have had a number of exchanges with the CNESST since March 2016. The discussions were about the Commission’s position on the insurance coverage the unions were supposed to have to protect the executive committee members and union reps during union activities.
To ensure that the recommendations issued would protect our executive officers and union reps, the Federation drew up a list of case law on rulings on employment injuries that occurred during union activities since 1990; rulings related to the definition of ‘executive officer’ passed by a law in 2007; and rulings on the notion of “volunteer.”
Demanding, negotiating and ensuring union members’ rights are respected
The FIQ offers consulting services, through its teams assigned to institutions, in close proximity to all unions. The consulting service provides teams with support in all areas of their representational duties, including grievance resolution, negotiating local or specific agreements, setting up committees on care, having a presence on labour relations committees (CRT), in addition to supporting the consolidation, collaboration and provision of training.
The reform introduced by Bill 10 allowed employers to restructure many public services. As such, the merging of several of the centres of activities directly affected our members. It was in this context that the Federation worked to ensure each collective agreement’s local provisions were respected “separately” to maintain the unions’ bargaining power for the next round of local negotiations and to actively support the negotiation of agreements aimed at minimizing the impact of the restructuring. This also led to the formation of several committees on care or organization of work, many of which are still active.
Organization of work
The Task and Organization of Work Sector got involved in the provincial negotiations in order to collectivize the issues of excessive workloads, and the working and practice conditions which make it possible to provide safe care. At the most recent provincial negotiations we made a historic gain: for the first time in Canada, a collective agreement features a commitment to set up pilot projects on safe healthcare professional-to-patient ratios (Letter of Understanding No. 17), and to document the problems of attracting and retaining specialty nurse practitioners (SNP) and issues related to their continuing education and working conditions (Letter of Understanding No. 18).
The Federation negotiated the renewals of the group insurance contract at the lowest possible price, in part by using surplus amounts and government allocations at the last negotiations. The Federation also revised the Administration Guide, Insurance brochure and Logbook.
To discourage private healthcare employment agencies in the public network, the Federation implemented its action plan and, in August 2016, presented its arguments to the TAT. A judge then recognized that due to the nature of the healthcare field’s institutional framework, only the institution can be considered the employer of workers from employment agencies. He also stated that employment agency staff should be included in the union’s bargaining unit.
A subsequent Superior Court ruling (contested by the FIQ in the Court of Appeal, at the time of writing this) put the Federation right back where it started. However, the courts will be able to rule anew on the argument based on the institutional framework in another case underway.
During the last provincial negotiations, the FIQ supported its affiliated unions in developing lists stipulating the amount of staff to keep on in the event of a strike and an employer contestation.
In order to keep the limits imposed during a legal strike to what is necessary to ensure essential services to the public, the Federation contested a TAT ruling that invalidated a pressure tactic which consisted of wearing one’s ID card so it’s not visible.
We also contested the interpretation of the rules on establishing essential services lists, which are not adapted to CISSSs and CIUSSSs. They assert that required staff percentages should be applicable to each centre of activities rather than each facility.
The Federation also intervened in a case underway opposing the percentages of essential services to maintain, as provided by the law, stating that managers should also be considered when determining essential services.
Raiding and voting
Regional and sectional unions received support from the organization during raiding and voting periods in 2014 and 2017. In 2014, the Federation was also successful in getting the CRT to deem that intimidation carried out by a rival association was unacceptable. In 2017, multi-party agreements were concluded to structure raiding in some institutions. Guidelines provided equal access to facilities, among other things. The TAT acknowledged that raiding activities could proceed even during the voting period following the passing of Bill 10.
Before the vote in spring 2017, the FIQ represented 67,000 members in 158 institutions and 61 unions, 5 of which were regional. The vote brought 7,500 new members to the FIQ. Most are from the regions of Mauricie, Centre-du-Québec and the Nord de l’Île de Montréal. Others are in Saguenay, Estrie, the West Island of Montreal and the Laurentians. We now represent nearly 75,000 members in 61 institutions across 32 unions, four of which are regional. All this was made possible thanks to the mobilization of the Union Organizing Service and Labour Relations Sector, the union reps and the contributions of other sectors and services.
It is through negotiation that the critical care premium is extended to new centres of activity. The Federation was successful in getting the Superior Court to recognize in 2016 that link nurses have the right to the critical care premium for hours worked in the emergency department of another institution. This case is currently under appeal.
The Federation had an arbitrator recognize that:
- By systematically using compulsory overtime to compensate for absences the employer is exercising his management rights in an abusive manner (2014);
- Meal breaks spent in the centre of activities at the employer’s request must be paid at the overtime rate (2016).
Contesting the Pay Equity Act
On February 22, 2010, the Federation filed a lawsuit against the Government of Quebec in the Superior Court so that particular provisions in the Pay Equity Act would be declared unconstitutional. The FIQ opposes provisions that require the employer to perform a pay equity audit every five years and the scope of provisions that violate healthcare professionals’ rights, especially with regard to selecting December 31, 2010, as the date to calculate retroactivity and that it is impossible to file a complaint contesting the results of the audit. Other labour organizations (Canadian Union of Public Employees – CUPE, Syndicat québécois des employés de service – SQEES, Alliance du personnel professionnel et technique de la santé et des services sociaux – APTS) have filed similar suits.
The Quebec Court of Appeal confirmed the ruling to maintain the frequency added to the Act in 2009 concerning some provisions covering the pay equity audit. It was ruled unconstitutional to only make salary adjustments every five years, as it perpetuates systemic discrimination. As such, adjustments can be retroactive within this period. It goes without saying that this ruling has a major impact on women in Quebec. In November 2016, the Attorney General of Quebec asked the Supreme Court for permission to appeal the Quebec Court of Appeal’s decision.
Outaouais’ special status
Because of the particular situation in the Outaouais region, where the working conditions in Ontario are more attractive, the Federation negotiated an agreement with the MSSS to attract and retain more healthcare professionals from that region. The increase in evening and night premiums, the conversion of the premiums to paid days off and the incentive premium for 12-hour shifts are incentives that encourage these professionals to stay in Quebec. The measure is monitored annually with an indicator assessment.
Members from other labour organizations also benefit from the Federation’s gains.
Conclusion of the provincial negotiations
The negotiations will have enabled us to make several gains for each priority adopted by the members.
- Reduced workload
- Increased job security
- Improved working conditions
- Training recognition and development
- Elimination of the adverse effects of Bill 10
As a result, members can benefit from:
- Increased full-time positions for healthcare professionals
- Healthcare professional-to-patient ratios pilot projects
- Shift overlaps for several licensed practical nurses working in long-term care
- New premiums for critical care, deployment of reserved activities set out in Bill 90
- Ranking changes in 2018 resulting in better pay for several class-1 jobs
- New salary structure in 2019
Many of these gains are transferable to members of other labour organizations which, at the outset, had very few sectoral demands. During this period, we supported affiliated unions by providing material for action plans and handling communications and media relations.
During negotiations, mobilization and activities to gain visibility went particularly well. The Info-Support team was responsible for coordinating these activities. They organized a few groups to carry out a series of bold actions aimed at elected officials and decision makers. The team orchestrated the immobilization of the National Assembly’s ministers’ limousines as well as the chaining of the union reps to the Premier of Quebec’s official residence.
The Info-Support team also ran the pilot project using electronic voting to vote on the tentative agreement.
Various gains won in grievance arbitration include the cancelation of administrative and disciplinary measures and suppression of fictitious jobs. The employment of an employee who was the victim of a criminal act while on disability leave has been extended. It was recognized that:
- Replacement challenges do not constitute valid grounds for refusing to grant a leave with deferred pay;
- Rotation cycles are personal to each employee with a rotation position and can differ for each employee;
- Union leaves must be managed separately by the former union after a merger of institutions until the new provincial provisions have come into effect.
The Federation also had the following acknowledged in grievance arbitration: equivalent credits earned through a college diploma or bachelor’s degree can be taken into consideration when determining advances in pay scale; and personal benefits for accommodation fees in a remote region constitutes an acquired privilege that should be maintained.
The FIQ also took part in consultations on bills that could potentially affect the rights of its members and unions, such as Bill C-377 on union finance disclosure and Bill 42 which established the CNESST and the TAT.
During our time on the Liaison Committee of the Montréal Bar with the TAT, we reported challenges in case management to raise awareness among the stakeholders and find solutions.
Trends and findings
The Federation dedicates a lot of time to individual grievance cases, especially on dismissal and harassment. Arbitration takes longer now than ever before and there has been an increase in the number of harassment cases. What’s more, arbitrators require a statement of facts be presented at the hearing, which means unions must document their cases very quickly. In cases of psychological harassment, we have found that arbitration decisions or TAT rulings are rarely satisfactory for either party. We also handle a great deal of dismissal cases for incompetence or a high absenteeism rate.
Lastly, many complaints are filed under article 47.2 of the Labour Code, which can influence the unions’ decision regarding grievances.
Disseminating, conveying and defending the Federation’s orientations and positions on issues that will improve our members’ working and practice conditions
The Federation presented its orientations on organization of work, professional practice, care quality and accessibility, and promoting patient advocacy namely by tabling memorandums in parliamentary commissions and responding to bills, such as Bill 15 on workforce management and control in the network and Bill 87 on facilitating the disclosure of wrongdoings. Our analysis of this last element was circulated widely in major media publications, strongly suggesting that it played a part in having the bill amended. The version of Bill 87 that was assented to makes legal advice, among other things, accessible. Private subsidized institutions were also added to the organizations covered. Now we need to determine how all of this can help to defend the interests of members and patients.
On another note, the Federation submitted documents to the government on best CHSLD practices and initial nurse training. It also gave conferences at the SIDIIEF in 2015, the World Social Forum in 2016, and the UQAR’s colloque des étudiantes en sciences infirmières in Lévis in 2015 and 2016. Next, it participated in the Peoples’ Social Forum, the À Bâbord symposium on health care in 2016 and the Broadbent Institute’s 2016 Summit on Progress.
We have held places of influence, sharing our analysis and promoting working and practice conditions for healthcare professionals while networking with decision-makers, e.g.: Assembly members, professional associations, Ministry of Health and Social Services, ASSTSAS, Provincial Inter-Union Committee on Health and Safety Prevention, Provincial Joint Committee on Task and Organization of Work, Provincial Labour Relations Committee, Ministère de l’Éducation et de l’Enseignement supérieur and universities. These political efforts, which sometimes go unnoticed, made a significant impact in the last rounds of negotiations.
What’s more, the Federation has supported and participated in several research projects, including:
- Vers l’amélioration des services et des soins palliatifs de fin de vie : implanter et évaluer des programmes de formation et de soutien en milieu de travail et leurs effets sur la satisfaction, le sens au travail et le bien-être des infirmières (projet SATIN II);
- Prévention de l’incapacité prolongée liée aux troubles de santé musculo-squelettique ou psychologique par l’amélioration de l’environnement psychosocial de travail basée sur une démarche de qualité de vie au travail en milieu hospitalier (projet SATIN III);
- Application of preventive practices by nurses: the innovative perspective of absorption capacity (IRSST project);
- Exploration of Nurses’ Ethical Dilemmas in Connection with Occupational Health and Safety (IRSST project);
We informed our members of the positions we adopted and the actions we took using different information and mobilization tools: The International Symposium on Safe Health Care, OHS Week/OHS Network, Special Reports (Safe Care and 2015 Federal Elections), A Safe Maternity Experience, RREGOP and Activities Reserved for Healthcare Professionals. Our website and the President’s Blog are additional information platforms that are increasingly important.
Conciliation to resolve complaints filed over the pay equity audit in December 2010
The conciliation work ended in October 2015 when the Conseil du trésor (Treasury Board) submitted a comprehensive proposal in response to all of the complaints filed by the CSN, FTQ, CSQ and FIQ. Of the 7,000 complaints affecting over 300 jobs in the pay equity program, only twenty were settled. The employer’s proposal was rejected by all of the labour organizations.
The Federation then decided to focus on one of its negotiation priorities aimed at a broad-scope, standardized application of Bill 90, ensuring that healthcare professionals can practice the full scope of their profession and, consequently, get a new value recognized in the job classes with reserved activities. Certain jobs in the nurses’, licensed practical nurses’ and respiratory therapists’ groups, starting in 2018, will benefit from a change in ranking that reflects their true value as compared to male-dominated jobs in the health and education network. In exchange, complaints that the Federation was going to defend were withdrawn.
All healthcare professionals in class 1, regardless of their union allegiance, will benefit from the gains made by the Federation.
Comité national des emplois (provincial jobs committee)
In the last few years, the MSSS called for labour organizations to review their list of job titles. The review was meant to standardize and update the names of diplomas and revise job title descriptions. The diploma names were reviewed and an agreement was concluded on most jobs in class 1.
The partial results of this review gives unions greater control over re-evaluating a job if major changes are introduced, for example, if a professional association modifies its requirements.
Reducing workplace violence, discrimination and harassment
Statistics show that workplace violence is still a problem. The health and social services sector is no exception: data released by the CNESST concerning violence-related injuries in the workplace between 2011-2014 shows that health care staff are affected the most. In 2014, 70.3% of accepted injuries affected women.
As a predominantly female organization, the Federation is very concerned about this. In 2013, an inter-sectoral committee was formed to review the policy on violence and discuss content for a new training program to address it. Next, a new pamphlet was published, Towards Well-Being at Work: A policy for fighting against violence (2014). Unfortunately, the committee’s work was put on hold and the training program hasn’t been developed yet due to a lack of time and resources.
An in-depth inquiry into violence and harassment is needed, which would require a lot of time and work. In 2013 and 2014, a pilot project was set up at the Quebec City office to bring back grievance cases about workplace violence and harassment. At the end of the project, an evaluation and a review were supposed to be done. However, due to the context, the review wasn’t done and the Federation didn’t follow up on the project.
Currently, the most common approach to workplace violence is more reactive than preventive and more individual than collective. This is directly related to workplace disorganization, the lack of training offered to local union teams and the challenge of adopting strategies that take into account the systemic nature of workplace violence.
An organization focused on health care
Maintaining the Federation’s credibility and visibility on Quebec’s sociopolitical and union spectrum and raising public awareness of our demands, positions and orientations
Austerity and privatization: a dangerous mix for our public health network
The government’s austerity measures have impoverished the health network by keeping it chronically underfunded and thus creating excessive workloads and overtime. The situation has gotten so bad that it puts care quality and safety at risk. Government cuts to public services have also had repercussions on the personal finances of healthcare professionals. They don’t have access to health services in the public network because of the drastic cuts and are forced to turn to private services, in particular for psychotherapy, physiotherapy, occupational therapy and speech therapy, for themselves and their families. This puts upward pressure on group insurance premiums and on their direct financial contribution to these services. We’ve noticed that some coverage even encourages the government to disengage from making care accessible in the public network. As a result, we questioned our own insurance coverage and if our members will be able to afford it in the future.
The last three years have been marked by decisions and projects which call fundamental principles into question. For instance, day-surgery pilot projects in private clinics that open the door to increased privatization and the many reports and disturbing findings regarding the living conditions of seniors in residences.
Fortunately some of the battles we waged were successful and gave hope to members, such as the elimination of accessory fees.
In response to the attacks on our health system, we focused all of our energy on bringing the Federation’s voice to the forefront in debates and defending health care issues in the name of the thousands of healthcare professionals we represent. Our main focus throughout was the scope of practice of healthcare professionals.
The FIQ’s ad and awareness campaigns and efficient use of social media have made it a leader in the health network and increased its visibility. It also successfully coordinated several press conferences and media interviews on a variety of political issues. What’s more, the FIQ has the most followers on Facebook of any labour organization.
Taking a stand on politics, public finance, social rights and defending and promoting public services
The Federation’s response to the dismantling of the public health network
We conduct daily monitoring of legislation, media and science, staying abreast of bills and regulations, ministerial notices, media output, specialized publications and university research. It keeps us alert and ready to take fast action on specific issues.
Through strategic monitoring conducted every two weeks, we have kept the Executive Committee informed on major upcoming cases, issues and threats to the Federation and alerted them to key opportunities.
In fact, several of the Federation’s sectors conduct ongoing research on core issues. Since the 2014 Convention, we have kept a close watch on issues concerning the privatization of health care and services, doctors’ compensation, socioeconomic health determinants, free-trade agreements, seniors’ living conditions, health-system funding here and abroad and health-network management. We have paid special attention to regulations and professional practice, front-line care, safe healthcare professional-to-patient ratios, advocacy culture, initial healthcare professional training, interdisciplinarity, governance based on clinical analysis and measure, various projects on work organization started in institutions, etc.
We focused our research activities on very specific subjects related to bills, regulations and other types of consultation. We often led research, conducted analyses and drafted statements, opinions and comments leveraging our diverse expertise.
The Federation responded to a number of proposed bills, several of which concerned key components of the Barrette reform.
An overview of the Federation’s position on proposed bills:
Bill 10: An Act to modify the organization and governance of the health and social services network, in particular by abolishing the regional agencies (2014)
The Act decreases rather than increases patient access to care. It also centralizes decision-making power in the hands of the Minister of Health and Social Services and disrupts labour relations management in addition to opening the door to increased privatization of health care services and subcontracting.
Bill 20: An Act to enact the Act to promote access to family medicine and specialized medicine services and to amend various legislative provisions relating to assisted procreation (2015)
The Federation proposed concrete methods to improve interprofessional collaboration, to limit practice barriers and to foster professional independence: optimization of the contribution of front-line healthcare professionals, broader nurse prescribing, more adapted collective prescriptions, broader SNP practice, etc. We also evaluated the impacts of the amendments made to measures on assisted procreation from a feminist perspective.
Bill 28: An Act mainly to implement certain provisions of the Budget Speech of 4 June 2014 and return to a balanced budget in 2015-2016
The Federation called the legislation an “everything-but-the-kitchen-sink” attempt to achieve a balanced budget, and in its comments objected to the fact that subjects as varied as natural resources, tax evasion, municipal governance, economic growth, private employment agencies, childcare services, stuffing materials and health services be dealt with in the same bill. The Federation also strongly objected to removing medications from the insured list and the government’s intention to raise the cost of childcare services and create a private childcare services network.
Bill 42: An Act to group the Commission de l’équité salariale, the Commission des normes du travail and the Commission de la santé et de la sécurité du travail and to establish the Administrative Labour Tribunal (2015)
In the Federation’s comments sent to the Commission, it substantiated its fears regarding the proposed changes and the negative consequences on workers’ rights, particularly on women’s rights. The Federation said that it was concerned by the merging of the Commission de l’équité salariale (CES), the Commission des normes du travail (CNT) and the Commission de la santé et de la sécurité du travail (CSST) and objected to the merger which could weaken the specific mission of each of the organizations and dilute their areas of expertise.
Bill 92: An Act to extend the powers of the Régie de l’assurance maladie du Québec, regulate commercial practices relating to prescription drugs and protect access to voluntary termination of pregnancy services (modified title) (2016)
In the memorandum the Federation tabled at the Commission de la Santé et des Services sociaux, it accused the government of concealing the health network’s real issues, including doctors’ compensation and accessory fees.
Bill 115: An Act to combat maltreatment of seniors and other persons of full age in vulnerable situations (2017)
In its memorandum, the Federation demanded a systematic approach to fight the maltreatment of seniors and other vulnerable persons, while underlining the contribution of healthcare professionals in order to raise awareness among decision-makers about recent scientific findings. This evaluation was conducted from a feminist perspective.
Bill 130: An Act to amend certain provisions regarding the clinical organization and management of health and social services institutions (2017)
The Federation strongly objected to the Minister of Health and Social Services’ intentions to legalize and extend the Ministry’s powers over management of the health network. It also flagged the danger of transferring responsibilities for complaints, once reserved for commissioners and assistant commissioners, to health institution managers.
Some of the Federation’s statements were presented at the Federal Council.
Moreover, the Federation came forward with a statement on the day-surgery pilot project in private clinics. It also presented a memorandum to the Commissaire à la santé et au bien-être (CSBE) as part of the consultations on Quebec’s range of health services. A memorandum was also drafted on the topic of union and health issues related to the Trans-Pacific Partnership Agreement and presented to the Standing Committee on International Trade.
In addition, the FIQ participated in consultations held by the Commission de révision permanente des programmes chaired by Lucienne Robillard (2014). It took the opportunity to stress that the public health system needs proper funding to meet the public’s needs and enable healthcare professionals to provide patients with safe care.
The Federation accepted the CNESST’s invitation and pinpointed particular challenges with respect to enforcing the Pay Equity Act. The CNESST must submit a report to the Minister of Labour, as stipulated in the Pay Equity Act, on the implementation of the Act and the advisability of keeping it in force or amending it in 2019. To this end, the CNESST undertook extensive consultations, especially with labour organizations, to discuss the enforcement of the Act and hear their points of view. The Federation reiterated the relevance of this proactive legislation and proposed important amendments regarding the maintenance of pay equity, requiring employers to conduct a joint-exercise and requesting to extend it to employers with 50 or fewer employees.
Every year the Federation takes part in pre-budget consultations held by the Ministry of Finances. At these meetings, we present our vision, investment priorities and expectations for the next budget and bring up issues that are important to us. Next, we analyze the budget to measure the gap between our initial position and the government’s final position. This way we can evaluate the impacts on the working conditions of healthcare professionals and identify the government’s economic trends.
The Federation took a stand on these issues, intervening in parliamentary commissions, consultations and major conferences, thereby exerting its influence in different areas. Its stance on issues is widely covered by the media, thus broadening its power of influence. The Federation also attended meetings with the Ministry of Health and Social Services on the licensed practical nurses’ training on intravenous therapy, as well as an inter-union meeting on the MSSS’s support guide for developing a nursing staff plan. Furthermore, it issued comments at the Forum on best CHSLD practices (2016). These presentations highlight current issues and the FIQ’s stance on important topics.
As such, the Federation created innovative and promising ways to support healthcare professionals. One of the FIQ’s proposals was to implement healthcare professional-to-patient ratios, which led to organizing the International Symposium on Safe Health Care in partnership with the SIDIIEF in 2016. The purpose of the event was to show the importance of improving the safety of health care in Quebec and introduce the safe healthcare professional-to-patient ratios. It was meant for a wide audience, including healthcare professionals, RSSS decision-makers, students, academics, citizens concerned about safe care and ratios, etc. It was a day to raise awareness about international practices and to cement the new proposed ratios in Quebec. The event was also a great opportunity to network with key figures in the health field.
Taking action to ensure the principles of accessibility, universality, integrality, transferability and public management of the health system are followed and maintained
Growing bargaining power and stronger media presence
Preserving the SABSA clinic in Quebec City’s lower town and setting up two other clinics in Petite-Nation, Outaouais, and North Montreal demonstrated the strong need for these types of services in our public health network. Starting these clinics was also a way to showcase the contribution of healthcare professionals on the front line in all service locations. It’s our way of politicizing care.
Taking full advantage of local and regional places of influence in health care
The Safe Staffing Form was a great success from the start. Our members have filled out the form over 1,700 times to report situations that endanger care quality and safety. Over the last few years, our union reps have also increasingly integrated ratio and safe care vocabulary. The Federation is a leader in the debate on safe healthcare professional-to-patient ratios in Quebec. Furthermore, the FIQ’s stance on current sociopolitical issues has attracted extensive media coverage in Quebec since 2014.
Trends and findings
To preserve our position as a leading labour organization in the health field, it is key that we create closer ties with our members. To this end, it would be good to strengthen new communication channels so that employees and elected officers of the concerned sectors and services can gather feedback on a regular basis (discussion groups on negotiations, the voting period and work organization, Status of Women Sector tour, etc.). We also need to look at ways of transferring our gains to the members in order to highlight how global sociopolitical and economic issues affect what happens in our health institutions.
In doing so, it will be easier to understand their impacts and to collectively and locally reflect on the methods and strategies necessary to deal with them.
In this regard, the new service offer looks promising. This renewed synergy will fuel our analysis and encourage everyone to support the major sociopolitical, economic, professional and feminist issues that the Federation fights for.
An organization that promotes women’s rights
We have identified three main issues since 2013.
- We are fighting for women’s rights in a context of economic austerity.
- Even though the Federation is 90% female, people oppose using a feminist approach due to the belief that we have achieved equality. Yet a feminist approach is essential because of the systemic nature of inequality.
- Women’s withdrawal from the union structure has become a paradox for fighting for gender equality.
Promoting the merits and integration of the feminist approach in the FIQ’s causes and actions and deepening understanding of it among the organization’s union reps, members and employees
The Intersyndicale des femmes* took note of the strong and indisputable finding on the place of women in labour organizations. The myth that equality has been achieved has prompted us to re-examine feminist issues. The committees discussed ways of defending women’s rights and find it disturbing that proportional representation of women in union structures is no longer seen as self-evident.
*The Intersyndicale des femmes is composed of the following labour organizations: APTS, CSD, CSQ, FAE, FIQ, SFPQ, and SPGQ. The FIQ has been involved since its founding in 1987.
Representation of women in the union structure
Once it came to light that the proportion of women and men at our union meetings had changed in the last few years, the Federation decided to investigate and document the reason why women were participating less.
The FIQ’s Status of Women Sector and committee were asked to reflect on the current place of women in union democracy, to evaluate how the unique reality of members (predominantly female) can be better reflected throughout the organization and to formulate recommendations.
First, the results of their work were presented as part of a special Women’s Network bulletin called “Union democracy and the influence of women at the FIQ.” The resulting obstacles and solutions can be divided into two kinds of approaches: one that looks at the number of women present and elected in the union structure and the second at understanding and deconstructing the mechanisms that perpetuate stereotypes and gender inequality.
Second, following the presentation of the Bill 10 Strategic Coordination Committee’s recommendations at the Federal Council, the delegation added “involvement of women at the Federation” and “the place of union reps at the Federation” to the Statement of Principles. The principle of “representativity” was rejected. However, the union reps adopted a proposal to develop a policy to ensure equal representation of women in all areas of power at the Federation in June 2016. The policy is being developed.
In the same vein, the Women’s Network newsletter “Being empowered: strategy, solidarity, action!” explored strategies to politicize and empower union reps. Unfortunately, we were unable to carry out the work to apply these principles, i.e., through local status of women committees, in the last few years.
Tour of affiliated unions
In spring 2016, the Status of Women Sector toured affiliated unions to raise awareness about the place of women at the FIQ. The tour was part of a greater effort to obtain the mandate to prepare a policy that would ensure fair representation for women at all levels of the organization.
The purpose of the tour, inspired by myths about the status of women, was to raise awareness among delegates about how important it is to continue to fight for the feminist cause, as much within the Federation as in Quebec society. The network also took stock of past struggles and gains and highlighted ongoing inequalities. It was an effort to foster greater awareness that, despite major gains for women’s rights (pay equity, policy against sexual assault, etc.), there’s still a lot of work to be done before we see true equality, especially with respect to fair representation.
Gender-based analysis is a feminist strategy that can help create more equality. Our activists received training on this topic courtesy of the group Femmes, politique, démocratie. The training offered insights into how public policy affects people differently depending on their gender. On a more general note, while the FIQ summer school (2016) did a component on the status of women, it must be noted that the feminist approach is sorely lacking. The training programs still need to be developed in order for the status of women component to become part of the labour relations consultants’ responsibilities in the new service offer.
Working to prevent the deterioration of women’s living conditions
Austerity and economic and living conditions
To raise awareness among union reps about the consequences of neoliberalism, the Federation decided to deconstruct the government’s rhetoric asserting that policies affect the whole population in the same way. As part of the Women’s Network event For equality, against austerity! participants mobilized around this issue and took part in a major protest on October 31, 2014.
The Federation also worked with the Intersyndicale des femmes, Relais-femmes and the IRIS on a study called Les mesures d’austérité et les femmes : analyse des documents budgétaires depuis novembre 2008 (austerity measures and women: a study of budgetary documents since 2008) (March 2015). The study shows that from an economic standpoint, men profit from stimulus measures while women suffer most from austerity measures.
Retirement, insurance and disability
The Federation has always striven to defend measures which guarantee improved retirement living conditions while preventing the impoverishment of women. It sits on the RREGOP retirement committee, which works to ensure the plan is well-managed and prospers. More and more young people take the RREGOP training session offered by the FIQ. It helps members plan their retirement future. To ensure members have the latest information on their rights, we updated the RREGOP brochure (reference tool) in 2016. The Federation also works with the FTQ’s Fonds de solidarité to ensure members have access to it, first by attending the provincial meetings with the Fonds’ local executives and by funding their training.
Negotiating the insurance contract renewal is also clearly done with a view to meeting women’s needs. Furthermore, members are given information on purchasing medication, which was especially important for the last renewal due to the introduction of the generic drug concept.
Defending disability cases is a very important part of our efforts since members on disability are more vulnerable both in terms of health and finances. As such, it is essential that we work to prevent the deterioration of members’ living conditions.
Developing a critical approach in order to support women’s right to be healthy and have access to health services adapted to their needs
The systemic nature of gender inequality and austerity policies affect women three times more than men in their roles as women, healthcare professionals and caregivers. According to one unpublished study by Tremblay, D.-G. And Dakhlaoui, A. (2014), 14% of healthcare professionals are caregivers. One aspect that always seems to fall under the radar due to successive reforms and fiscal restraint, is work that no one sees and the development of a significant population of caregivers. For years, governments have been relying on the unacknowledged work of women, especially in the healthcare field. This points to several issues, including the exploitation of women’s labour, professionalization of unqualified persons, competition between paid and unpaid work, and a population at risk of burnout partly due to the new tasks women take on. We have begun to document this phenomenon and establish connections between support groups and caregivers, particularly with the Regroupement des aidantes et aidants naturel(le)s de Montréal and the Institut de planification des soins. We must continue with this work and take it more in-depth.
Fight against all violence against women
Violence against women has been one of the FIQ’s central concerns from day one. However, it will remain a concern for many years to come. In recent years, sexual violence has been at the centre of public debate due to new eye-opening information. The Federation commemorates the École Polytechnique massacre at the Federal Council on December 6 every year and supports campaigns against sexual violence and the trivialization of rape, to prevent further crimes of this nature. To increase awareness among the delegation, we featured a
presentation on the history of rape from a legal standpoint at the Women’s Network lunch in December. We also helped draft a statement by the Intersyndicale des femmes presented at the consultations on the 2008-2013 Government Action Plan Concerning Sexual Assault (2015).
Systemic violence in the workplace
Despite the degradation of working conditions for healthcare professionals, which in turn deteriorates the work atmosphere and increases violence in healthcare institutions, the organization was unable to complete all the updates needed to meet members’ new needs. While we were able to revise Towards Well-Being at Work, A Policy for Fighting Against Violence, we were unable to complete a joint project on issues of violence or develop a training session on this topic. The new training should take into account the new workplace structures and their particularities, the complexity of types of violence and specific skills required by grievance agents.
Trends and findings
Even if the three issues initially mentioned may be interpreted as obstacles to defending women’s rights at the Federation, concrete measures directly related to members’ living and work conditions (e.g., parental rights, pension plan or family-work-study balance measures) promote gender equality. These rights and demands affect members in a more obvious way.
The concerns around women’s rights, the feminist approach and women’s waning involvement in union initiatives were important issues from the outset in the women’s groups’ work and collaborations and the FIQ’s work. However, the Federation focused its efforts on the third issue, namely the organization’s ability to fight for gender equality in a context where female members do not always represent or defend their rights.
An organization under the banner of solidarity
The international context impacts workers in a number of ways, especially through austere government policies which weaken public services. This leads to uncertain working and living conditions for many people, specifically women and those who are more vulnerable. It is clear that issues concerning socioeconomic determinants of health, including poverty, education, access to health services and the preservation of public services, are international concerns. These issues are also of great concern to us. It is vital that we strengthen, maintain and develop ties of solidarity with organizations that stand up for collective and world goals. These connections allow us to pool expertise, share experiences and develop bargaining power.
In addition to developing connections, our actions over the last three years have been part of an effort to wander off the beaten path and develop new solidarity practices that reflect our organization’s intrinsic values.
Broadening the Federation’s ties of solidarity with labour organizations, community groups, citizens and any other social change activists who could become allies
The many activities and meetings organized at different phases of solidarity building are meant to raise awareness among activists about social, labour and professional issues in the countries we visit. We also contribute funding to various projects in support of solidarity throughout the world.
Solidarity internship in Nicaragua
In collaboration with Groupe Spirale, we organized a two-day training session for the Centre Romero interns before they left for Nicaragua.
Since the first internship in 2012, over 30 union reps have gone on this extraordinary trip. The internships help them to gain deeper insight into the various facets of inequality between southern and northern countries and, above all, to evaluate the various impacts on the Nicaraguan population.
Inter-union mission in Palestine
The Federation became involved in the inter-union mission organized by the Centre international de solidarité ouvrière (CISO) in Palestine (2015) and we sent one union rep to participate on site.
Training Skilled Birth Attendants in Haïti program
The FIQ gives financial support to the Training Skilled Birth Attendants in Haiti program in partnership with the Institut culturel Karl Lévesque. The program aims to provide women in remote areas with access to trained birth attendants who can help them give birth safely, thus reducing the overall maternity and infant mortality rate.
Mutual aid in Madagascar
The Federation contributed funds to Entraide sans frontières, a non-profit organization which provides essential material to a training centre for nurses and midwives in a small town in Madagascar.
Solidarity and sharing expertise with our sisters
The Federation participated as an observer in executive committee meetings of the Canadian Federation of Nurses Unions (CFNU). These meetings were a way to get up to speed on sociopolitical, professional and union issues that concern our female counterparts across Canada and to build solidarity over significant concerns. The Federation now has a standing invitation to all Canadian negotiator meetings with CFNU-affiliated organizations. At the meetings, we hold discussions on the state of negotiations in each Canadian province and collectively define the demands to negotiate in each province for the medium- and long-term.
The FIQ built strong ties with international healthcare unions to advance healthcare professional-to-patient ratios. The unions include the California Nurses’ Association, National Nurses United (NNU) and the Australian Nursing and Midwifery Federation Victorian Branch (ANMF). These ties helped us to better understand the struggles they went through to achieve ratios, as well as the challenges that arise at implementation and obstacles to their longevity. Consultants conducted research and the organizations’ representatives were panelists on these issues at the symposium in October 2016.
Active participation in Public Services International (PSI)
Over the last thirty years, we have built ties of solidarity between labour groups here and abroad. The purpose of our involvement is to campaign for essential causes and values and develop our expertise on these topics. One of the issues at stake is the defence of public services. That is why the Federation is a member of the PSI, which unites 20 million public service workers around the world. We have taken part in several PSI meetings, on topics such as free-trade agreements, taxation and the union reaction to Donald J. Trump’s election as the American president.
It has already been over five years since the Federation, the ANMF and the NNU requested that a health component be added to the PSI. Recently, the organization came out with a new publication, The Right to Health, giving member unions a way to share initiatives and concerns related to union health rights. The Federation has contributed to this international publication several times, on topics such as healthcare professional-to-patient ratios and access to data in Quebec’s health network.
A full member of Global Nurses United (GNU)
Thanks to the ties fostered with PSI, the Federation helped found Global Nurses United. The organization represents nearly one million nurses across 21 unions in 19 countries. Its main mission is to provide a means to pool individual experiences in fighting against austerity and the privatization of public health services. The idea to start an international labour organization specifically for healthcare professionals originated at the 2012 PSI Convention and the Federation was involved in developing the idea. Since then, political officers from the Federation have attended Global Nurses United meetings, including in Las Vegas in 2014 and Brazil in fall 2015, to strengthen ties of solidarity between founding members, strengthen the labour group’s mission, and establish priority actions. At these meetings, we discussed subjects such as the impacts of trade agreements on healthcare professionals, climate change and healthcare professional-to-patient ratios. The Federation also presented new models, its bargaining strategy and results at the Dublin meeting (2016). It will host the GNU’s annual assembly in Lévis in December 2017. All of this work was very important as it enabled us to advance priority issues that have a positive impact on our members, i.e., healthcare professional-to-patient ratios. In fact, it was in 2013, at the American union National Nurses United (NNU) Convention (which led to the establishment of the Global Nurses United) that the Federation learned about healthcare professional-to-patient ratios. This soon became a key element in its bargaining strategy.
Solidarity in the Women’s Movement
When fighting for gender equality, solidarity, social ties and mutual support are all crucial. Especially in a context where women’s rights groups have been undermined by provincial and federal government austerity measures. In the women’s movement, solidarity is the most efficient method of defending women’s rights and fighting systemic discrimination over the long-term.
World March of Women
The Federation integrated feminist solidarity very early on. The Women’s Network invested in the World March of Women and joined the procession of resistance and feminist solidarity that converged toward Trois-Rivières (2015). Women conveyed the message “Liberate our bodies, our world and our territories.” In particular, they wanted to speak out against the government’s austerity measures and economic development based on environmental destruction and warlike and military policies.
#AgressionNonDénoncée (unreported assault)
With a concern for the systemic discrimination inherent in sexual assault and violence against women, the Federation joined the #AgressionNonDénoncée movement. It even created the hashtag, #NiviolenceNiSilence (neither violence nor silence), in reference to violence suffered by healthcare professionals in their workplace. The Federation also showed support for the Indigenous women’s struggle against the unique type of violence they suffer by holding a Women’s Network lunch on missing and murdered Indigenous women. Moreover, it asked its delegates to sign a petition demanding a commission of inquiry on police practices with respect to First Nations and sexual violence against women in Val-d’Or and other regions.
Manifeste des hommes pour l’élimination des violences envers les femmes et les enfants (men’s manifesto to end violence against women and children)
In November 2016, the Fédération des maisons d’hébergement pour femmes held its second breakfast bringing together influential men to discuss the collective work that needs to be done. Participants committed to getting actively involved in the struggle to end violence against women and children. Following this initiative, 51 union reps, employees and elected officers from the FIQ signed the men’s manifesto, made public on December 12, 2016.
Promoting family-work-study balance
The Federation collaborates on a regular basis with several coalitions, including the Coalition pour la conciliation famille-travail-études (CCFTE) and the Collectif 8 mars. However, the Intersyndicale des femmes remains the most decisive, as it has been mobilizing forces behind women’s labour struggles in Quebec for 40 years. The Intersyndicale develops stances and collective demands around issues such as violence against women, the fight against poverty, austerity’s effect on women, prostitution, work-family-study balance and abortion. In addition, the Intersyndicale brings bargaining power to the table when it comes to building relationships with bodies like the Conseil du statut de la femme, the Secrétariat à la condition féminine, or even the government. Shaken by successive waves of budget cuts, the Federation also united with the Fédération des femmes du Québec (FFQ) and the Collectif 8 mars.
To broaden its horizons with respect to retirement, the Federation developed a partnership with the Observatoire de la retraite, which is already associated with several other labour organizations. Given that defined benefit plans are under increasing attack in the public sector, we feel that this type of relationship will allow us to delve deeper into the social and economic issues around retirement, and subsequently keep our members better informed. It also means we will be better equipped to defend ourselves should the RREGOP ever come under attack.
Since 2016, the Federation has fostered ties with the Quebec Health Professional Students’ Round Table (FRESQue), an initiative that brings together students and future health professionals from various disciplines, including social work, psychology, pharmacy, medicine and, of course, nursing. The organization’s mission is to actively defend the students’ vision of a more efficient, fair and accessible health system. That is why the FIQ wanted to back the initiative by supporting two summits bringing together students, organizations active in the health field and patients. The first summit was on access to primary care in Quebec, while the second was on mental health.
Participating in social and political debates on the reform of democratic institutions
At a provincial level, the Federation renewed its partnership with the Mouvement démocratie nouvelle (MDN) in 2016. The prevailing political context at the federal and provincial level persuaded us to join the movement to demand a reform of the voting system, just as we did in 2005. As a member, the Federation took part in strategy development meetings, with other unions and civil society groups, to sway political parties in favour of adopting the principle of the voting reform and raise awareness about the issues around the initiative.
Fighting economic neoliberalism, free-trade agreements and globalization
Since the last convention, the Federation has remained active within the Réseau québécois sur l’intégration continentale (RCIQ). The Federation’s participation has been vital, allowing it to stay abreast of news on provincial and international free-trade agreements and participate in initiatives to further opposition to free-trade agreements, through demonstrations, petitions, etc.
The Federation is also a member of Collectif Échec aux paradis fiscaux, an organization that is skilled at rallying groups that fight against tax evasion. The FIQ participated in the collective’s meetings and mobilization initiatives.
For years now, the Federation has been a member of the Coalition opposée à la tarification et à la privatisation des services publics (nicknamed the Coalition Main-rouge) and the Collectif pour un Québec sans pauvreté. The FIQ was less involved with these two coalitions but supported some of their actions over the last three years.
World Social Forum
In August 2016, at the World Social Forum in Montreal, the Federation presented, alongside the Coalition pour la conciliation famille-travail-études, a workshop called Concilier pour la vie (Balance for life) on the platform for family-work-study balance. In 2014, at the People’s Social Forum in Ottawa, we took the floor to present our vision of the health network, as well as initiatives for new models and healthcare professional-to-patient ratios to participants from the world over. These forums are the ideal place to share ideas with activists from around the world and to enrich our own reflection on issues that are important to our members.
Developing and supporting a collective union project that rallies the Federation’s entire membership
Renegotiating a provincial collective agreement
As regards the renewal of the collective agreement started in 2015, members preferred that the Federation handle the negotiations on its own. They rejected the proposal to form a common front focused solely on financial demands, and with no demands targeting sectoral matters. They opted for more traditional negotiations, independent of a common union front. We were confident we could better promote our members’ interests with this approach. Problems stemming from sectoral matters, such as healthcare professional-to-patient ratios and increased workload could not be neglected in favour of salary measures. The union reps believed that collectively the members’ determination could persuade the government that the proposed solutions to the class 1 healthcare professionals’ problems were sound.
Our delegates were also aware that this could have an impact on part of the negotiations, i.e., intersectoral demands. That’s why they decided to forge an alliance with the Fédération autonome de l’enseignement (FAE). The alliance, representing close to 100,000 employees, gave us the right to an intersectoral table and to be on the front line for issues related to salary, retirement, parental rights and regional disparities.
Trends and findings
Leading collective efforts in solidarity with other groups has many positive effects, even when group discussions and consensus require a lot of time and energy. The first positive effect is that of rallying organizations around common, shared values and generating mobilization.
The second is long-term resistance to neoliberal policies, both in terms of speech, actions and defending social rights, such as gains won by groups of women who were victims of sexual violence (victims coming forward to tell their stories, commission of inquiry, increased public awareness, etc.).
Lastly, the third effect is related to the circulation of collective ideas and in opposition to mainstream thought which counterbalances populism and individualistic values, as demonstrated by the IRIS study, commissioned by the Intersyndicale des femmes, on how austerity impacts women. It stirred writers and economists to comment on the issue and the media to publicly deal with the subject.
Moreover, the Federation greatly benefits from the positive effects of participants’ experiences in solidarity internships. In addition to seeing particular realities abroad firsthand, they awaken the spirit of solidarity in other participants. The internships inspire them to fight for various causes, including workers’ rights abroad.
Efforts that go into building solidarity are often invisible and even called into question at times. All the same, it is long-term groundwork that lays the foundation for defending fundamental rights, like the right to health, education, equality and peace. This behind-the-scenes work also informs and enriches our struggles and strengthens our stances on many subjects. It allows us to foster a broad social awareness on issues that at times seem far from our union struggles, but which are essential. These solidarity-building activities create ideal spaces for collective creativity and are essential for practising the proposal-oriented unionism promoted by the Federation. Indeed, healthcare professionals have a unique vantage point for observing society as their profession confronts them with social issues and inequalities on a regular basis. And so, it is key that the Federation and its members continue to be part of and even strengthen this broad social mission, despite the government’s agenda, with its successive reforms and cuts which undermine health and social services. In addition to further building solidarity, we believe it is necessary to focus more on these major issues to increase the membership’s understanding and support.
The Federation is a labour organization whose work has been central to the Quebec health network and to the health of millions of Quebecers for thirty years. It is widely respected for its credibility, boldness and expertise on important societal debates in the field of health and social services.
Through their daily work in the health network, the members of the Federation see firsthand the growing socioeconomic inequality and the government’s withdrawal from public services, which jeopardizes care accessibility and quality.
What’s more, healthcare professionals are burdened with a constantly changing workplace. This instability has a major impact on the organization of care and services and their roles as professionals. Social rights, gender equality and, more specifically, union activity are all affected.
In order for the Federation to further strengthen its role as an agent of change and for the proposal-oriented unionism to yield promising results for its members and the public, it needs to develop a political vision of care among its union reps and members.
This is our challenge over the next few years and, as employees, we will be the first in line to lead the way for all members and union reps who wish to join us!
Appendix 1 – Sectors and services and List of employees by sector and service
The FIQ at a glance
Number of offices: 9 (including the new office in Montérégie scheduled to open in October 2017)
Number of employees: 233
Number of coordinators: 9
Employees hired since the last convention: 55
Number of sectors and services: 16
We would like to honour the availability, efficiency and team spirit of two of our colleagues who left this world too soon. They were greatly appreciated and are missed.
Nathalie Frenette, Consultant, Labour Relations Sector (Montreal) Normande Boudreault, Secretary, Labour Relations Sector (Saguenay)
Status of Women Sector
The Status of Women Sector has a mandate to promote and work toward achieving gender equality, both in fact and in law. To this end, the sector informs, equips and raises awareness among FIQ union reps. In recognition of the plurality of feminist thought, the sector develops and uses feminist theories, practices and actions. In solidarity with other unions and women’s rights groups, the sector takes action at a governmental level to influence decision-makers and society at large to fight against discrimination and systemic inequality. The Status of Women Sector works at all organizational levels and in collaboration with the other sectors and services employing strategies that will help it to achieve its mandate, while addressing healthcare professionals’ needs in terms of gender equality.
This sector negotiates and concludes a collective agreement, in the interest of its members, with the government and the Comité patronal de négociation de la Santé des services sociaux (CPNSSS). It provides ongoing reflection in order to develop the Federation’s ability to anticipate and react, enabling it to take swift, effective action to defend and promote the interests of healthcare professionals as women and professionals. Through its actions and interventions, the sector exercises and asserts the Federation’s influence by building solidarity with other labour organizations. The Negotiation Sector regularly intervenes with the MSSS and CPNSSS, by way of provincial committees or other methods, when problems at a provincial level arise, e.g., during changes in the health network. Lastly, this sector acts as a consulting resource for local negotiations.
Labour Relations Sector
This sector provides support to union representatives in their duty to represent and provide information. It defends members during arbitration, occupational health and safety contestations and complaints before professional orders. The sector also provides representation before other bodies, as needed. Lastly, it supports the consultants’ interventions in institutions.
Teams assigned to institutions
Iga Sophie Kolasa
Samuel Pelchat Goulet
Maria Florencia Sauro
Sylvie De La Sablonnière
Chantal A. Roy
Sheila Ribeiro Melnik
The legal team represents affiliated unions and members in grievance arbitration cases, before the disciplinary committees of professional orders and the Administrative Labour Tribunal (TAT). It also provides consulting services on a regular basis to other sectors and services.
The OHS legal team represents members before the TAT. It provides information to and supports members at the various stages of their cases, especially for contestations, rehabilitation and returns to work. The team works with experts to prepare cases and represent members before tribunals. Lastly, it offers consulting services to local union representatives in their duty to represent various CNESST representatives.
Lucie De Blois
Occupational Health and Safety Sector
This sector strives to achieve recognition for all risks inherent in healthcare professionals’ work environments and works to eliminate all dangers at the source. One of its main strategies is prevention—it informs members on protective reassignment of pregnant or breast-feeding workers, professional burnout, back pain and hospital-acquired infections.
Social Security Sector
The Social Security Sector’s interventions are centred on defending members’ rights and interests. The sector also guarantees a better financial situation at retirement and during a disability leave. It offers members a training session on RREGOP and negotiates an affordable and advantageous group insurance plan.
This sector develops a comprehensive intervention strategy in line with the Federation’s dual mission to effect social change and improve the living and working conditions of its members. It assesses political, social and economic topics with a particular focus on the health care and social services field. Furthermore, it works to raise awareness of the sociopolitical issues addressed through the Federation’s union action, and in particular women’s rights.
It strives to fuel the reflection of union reps involved at various organizational levels, anticipates governmental initiatives in order to take action and influence political decisions and facilitates the development of solidarity practices.
Task and Organization of Work Sector
This sector’s actions focus on work organization and supporting professional practice. The sector helps members acquire working and practice conditions that promote full development of their practice and professional independence, while recognizing their clinical judgement. It also aims to equip healthcare professionals to empower themselves and play a stronger role in patient advocacy.
This sector conducts research and strategic analyses to support issues (underway or upcoming) related to work organization and professional practice at all levels of the Federation. It develops tools, helps create training content, promotes union orientations and supports work organization and professional practice interventions.
This service informs, raises awareness, mobilizes and promotes support among the membership and the public for the organization’s demands and interventions. More specifically, it works to develop a strong and broad union practice within the ranks of the Federation. Furthermore, it develops information and mobilization tools and provides activists with communication strategies, especially for media relations.
The service offers bilingual tools, facilitating the participation of anglophone healthcare professionals in union life.
Marie Eve Lepage
This service plays a central role in welcoming FIQ union reps. It strives to foster and promote a feminist, union vision. To achieve this goal, the service relies on the consultants across the FIQ’s sectors and services, while calling on the Education-Animation Committee on an ad-hoc basis.
It also develops and provides tools to assist union reps in fulfilling their union duties in their workplace and at the FIQ meetings as well as to deepen their process of reflection.
The administrative assistants provide support to the Executive Committee, executive director and coordinators.
The Accounting Service is responsible for financial operations and monitoring of the organization’s funds, including billing, payments, payroll, management reports, expense accounts, claims, the year-end audit of financial statements and tax obligations for payroll and income taxes.
Jessica Anh Luong
Hoang Khai Trinh
This service’s responsibilities include hiring, training and recruitment. It also conducts the follow-up for disability leaves and retirement.
Information Technology-Documentation Service
This service is in charge of developing software applications and the FIQ’s infrastructure. It also manages member files, online registration and FIQ Militantes.
Documentation Team Leader
Internal Services provide union reps with logistics, particularly for accommodations and receiving and sending mobilization material at decision-making meetings.
Telephone Systems and Reprography
Union Organizing Service
This service aims to unite all healthcare professionals under the Federation. Through its work to strengthen and expand local union practice, it promotes active union life at every level. It also strives to increase members’ sense of belonging to the Federation by helping them gain a broader understanding of the sociopolitical issues at stake.
Régine Laurent, President, Political Officer: Communication–Information–Web–Translation Service
Line Larocque, 1st Vice-President, Political Officer: Sociopolitical and Status of Women Sectors and Joint-Political Officer: Union Organizing
Daniel Gilbert, 2nd Vice-President (reserved position – nurse), Joint-Political Officer: Labour Relations, Research, Negotiation
Claude Boucher, 3rd Vice-President, Political Officer: Education-Animation and Joint-Political Officer: Union Organizing
Nancy Bédard, 4th Vice-President, Political Officer: Task and Organization of Work and Joint-Political Officer: Negotiation
Linda Bouchard, 5th Vice-President (reserved position – licensed practical nurse), Joint-Political Officer: Labour Relations, Research
Linda Lapointe, 6th Vice-President (reserved position – respiratory therapist), Political Officer: Occupational Health and Safety, Legal Team and Joint-Political Officer: Union Organizing, Social Security – benefits
Roberto Bomba, Treasurer, Political Officer: Treasury, Union Defence Fund (FDS), Solidarity, Information Technology-Documentation, Human Resources and Internal and Administrative Services and Joint Political Officer: Social Security – Negotiation and Union Organizing
Marie-Claude Ouellet, Secretary, Political Officer: Organization and follow-up of meetings, action plan and priority actions, Translation, Youth Committee
Marie-Claude Martel, Executive Director
Julie Blouin, Legal Team, Research Team and OHS Team
Julie Buchard, Social Security, Education-Animation, Meeting Logistics and General Secretariat and Union Organizing
Pierre Desnoyers, Labour Relations
Dominic Garneau, Labour Relations, OHS Sector
Pierre Giroux, Administrative Services, Internal Services, Information Technology-Documentation and Human Resources
Alain Leclerc, Sociopolitical and Communication–Information–Web–Translation
Pierre Leduc, Negotiation and Task and Organization of Work
Marie-Claude Nault, Labour Relations
Michelle Poirier, Status of Women, Convention and New Models
Denis Bédard, Buildings
Antoine Côté-Chabot, Information Technology-Documentation Service
Isabelle Arsenault, Union Consultant, Labour Relations Sector, OHS Team
Aline Aubin, Union Consultant, Occupational Health and Safety Sector
Guylaine Bernard, Union Consultant, Social Security Sector
Vanessa Bévilacqua, Union Consultant, Sociopolitical Sector
Guy Drouin, Union Consultant, Union Organizing Service
Louis Guertin, Union Consultant, Labour Relations Sector, Legal Team
Serge Prévost, Union Consultant, Negotiation Sector
Benoit Riopel, Union Consultant, Communication–Information–Web–Translation Service
Caroline Simard, Union Consultant, Education-Animation Service
Florence Thomas, Union Consultant, Status of Women Sector
Marie-Ève Viau, Union Consultant, Task and Organization of Work Sector
Marc-Antoine Durand-Allard, Union Consultant, TOT Sector
Manuel Dionne, Union Consultant,
Dominic Garneau, Coordinator, RLT and TOT Sectors
Myrna Karamanoukian, Union Consultant,
Julie Rioux, Union Consultant, RLT Sector
Myrna Karamanoukian, Union Consultant,
Luce Dessureault, Secretary
Francine Parent, Secretary,
Jennifer Banks, Union Consultant,
Susan Millroy, Union Consultant,
Brigitte Ayotte (www.ayograph.com)