Despite the government’s repeated assaults on our health network, the Federation has devoted a lot of energy to the survival of the union and daily protection of its members in all regions of Québec over the last three years. This brought many challenges and required efforts from all levels of the organization as well as a few losses. But, today we can say these missions were accomplished and celebrate major victories! In fact, the FIQ now has more than 75,000 healthcare professionals.

It must be said that at the end of this major whirlwind, not only was our world attacked, but THE world changed during the years of austerity, transformed by major neoliberal structural reforms. A rise in socioeconomic inequalities, democratic deficits, intolerance and racism, erosion of social protection, here and elsewhere, produced havoc that we felt we would be on the verge of for several decades. A rise in populist and divisive speeches, migration crises and resurgence of far right movements are only a few examples. Those are the issues requiring all our union values of fairness, equality and solidarity.

The FIQ’s culture of advocacy, which starts at the patient’s bedside, doesn’t stop at the door of the hospital. We have to use our voice to enforce our members’ working conditions, defend causes which seem fair to us and denounce the situations which outrage us. In 2017, we were able to transform the challenge of reorganization into an opportunity and strengthened our status as a power to be reckoned with in health in Québec. Now that we have gotten through the intricacies of the reorganization, that we are a bigger FIQ, supported by 75,000 members, in almost all the regions of Québec, we must continue to take over the public and political arena.

With this in mind, carrying out more joint actions is necessary. This will allow us to have discussions, mobilize, take collective actions and speak out in all the regions to reinforce our identity as healthcare professionals, union representatives and feminists. To talk about health and act together, we have to show great solidarity and remain united around our Federation.

Moreover, don’t forget that 2018 will be an electoral year in Québec. This means the politicians will listen to our demands more attentively than usual. And, there is good reason to believe that the spring budget will be election-minded. The government, which has cut millions of dollars on the backs of the healthcare professionals to the detriment of the quality and safety of care for the population, will polish up its image by reinvesting in health. Even though it may be deplorable that such a strategy guides the elected officials’ orientations, we have to jump on this opportunity and take advantage of this context to push our priorities on behalf of the healthcare professionals that we represent. Compulsory overtime, excessive workloads, psychological distress, injuries… It’s high time that the healthcare professionals stop paying the price of politics and short-sighted budgets. Therefore, this year will be an opportunity to collectively reflect on the principles and values that should back our politics and economy and choose a new government that will have a common vision of the public healthcare system.

At the FIQ, we have been preparing the post reorganization of the network period for a long time. As our 2018 priority actions attest, we are ready to support the new local teams and welcome our new members, while pursuing key projects.

The FIQ priority actions in 2018 are:

Priority 1 – Local negotiations and Letter of Understanding No. 6

Priority 2 – Continue setting up the new offer of services and support mobilization

Priority 3 – Safe healthcare professional-to-patient ratios: Letter of Understanding No. 17 and the ratios “project”

Since fall 2015, the Federation has talked several times about the specific context in which labour relations services must be provided every day as a result of Bill 10. The disorganization of management staff, the turmoil around the imposed voting period and obligation to set up new unions covering vast territories were detrimental to collective labour relations in the institutions. Despite several actions being carried out successfully and proudly over the last two years, the next steps of negotiating the local provisions of the collective agreement and deployment of Letter of Understanding No. 6 in the provincial provisions, represent major challenges for our organization.

This work is the focus of the labour relations sector’s activities for the next year. Obviously, the timetable for these two major mandates differs, Letter of Understanding No. 6 being March 31, 2020 and the negotiation of the local provisions being more or less the end of 2018. Despite this, the Federation believes that, in an ideal world, the analysis and evaluation of the quantitative data by the work teams assigned to completing the work on Letter of Understanding No. 6 should concretely apply within a short period of time after the new local provisions go into effect. Letter of Understanding No. 6 is a major gain from the last provincial negotiations which responds to the priorities of reducing job insecurity and promoting stable teams. In the end, this should reduce the use of compulsory overtime, independent labour and float teams. After all is said and done, a stable work team is a prerequisite condition for implementing healthcare professional-to-patient ratios.

So, as 2018 approaches and after several months of reflection, preparation and development of strategies, we are about to go straight to the heart of an intense phase of activities of major importance for our members. Even if our organization still has to consolidate its gains and several of the affiliated unions have to deal with their new settings, structures and functioning, this important work cannot be postponed until later. We have to, once again, wage a battle that looks to be demanding and difficult faced with bad-faith employers who refuse to grant union leaves needed to prepare the work, and in which the room to manoeuvre in the negotiations seems to have been greatly reduced by a very centralizing government.

One thing is sure; the resources assigned to this work and union representatives responsible for these files will be highly recruited throughout the upcoming year.

Priority 1 actions – Local negotiations and Letter of Understanding No. 6:

• Complete the negotiation of the local provisions of the collective agreement preserving our gains and taking into account the new territorial reality of our unions;
• Complete the analysis and evaluation of the quantitative data for finishing Letter of Understanding No. 6.

As soon as Bill 10 was announced by the Minister of Health and Social Services, the FIQ thought about the best way to reorganize its offer of services based on the new configuration of the network. Concerned with getting closer to its members and anchoring its different sectors and services in the union reps and members’ daily routine, after two years of a joint initiative the labour relations consultants’ work was put into components that include labour relations, occupational health and safety, organization of work and professional practice, local negotiations, training/animation/communication/multimedia, status of women, mobilization/organization and union life, legal issues, social security and secretariat.

The employees in the Labour Relations Sector and union teams have already worked hard to set up this new offer of services. Therefore, its deployment in the field must continue in all regions where the FIQ is present. This will certainly require adaptation and adjustments on both sides, but will ensure a closer fit between the services offered by the Federation and the affiliated unions in the post reorganization of the health and social services network. At the same time, this new offer of services will allow the sectors and services to better support the future mobilization and actions of unions while taking into account their territorial reality.

Priority 2 actions – Continue setting up the new offer of services and support mobilization

• Continue the deployment of the new offer of services in the field in all regions where the FIQ is present;
• Make the necessary adaptation and adjustments.

Getting safe ratios has become essential for our members over the last few years. In fact, they are constantly concerned about giving quality care in a safe manner both for their patients and themselves. This concern must also be shared by the healthcare institutions whose obligation, according to the law, is that patients receive continuous, personalized and safe adequate care and services at the scientific, human and social levels. We know that this right has been jeopardized for many years by a management that stubbornly installs models from the manufacturing industry and cuts the healthcare professional labour force. The basic teams are reduced, absences often not replaced and substitution has become commonplace. However, the population’s needs are not decreasing, quite the contrary. The result? The care teams are not able to truly address the patients’ needs at a time when the quality and safety of care are diminishing.

This excessive workload is a breeding ground for organizational violence. It also causes moral distress, burnout, work accidents and even sometimes leads to the decision to stop practicing. It is clearly and scientifically demonstrated that an insufficient number of healthcare professionals affects patient health: higher mortality rate, less effective pain management, higher infection rate and longer hospital stays. We are convinced that basic safe ratios must be set up as a sustainable resolution of the healthcare professionals’ excessive workload problem. These ratios must be applied everywhere and respected at all times. They will be the minimum standard, adjusted upwards based on the patients’ clinical needs, and not based on electoral whims or administrators’ handiwork. Safe ratios, prescribed as a gold standard in the network, will stabilize the teams, better plan resources, attract new healthcare professionals to the network and keep those already there thanks to a setting that promotes work satisfaction and a safe and rewarding practice.

We introduced the idea of safe ratios to the Québec public at the Safe Staffing Symposium organized by the FIQ in collaboration with the Secrétariat international des infirmières et infirmiers de l’espace francophone (SIDIIEF) in October 2016. It was also an opportunity to learn more from our colleagues in other countries who have waged long battles and won their battle for ratios. During the last provincial negotiations, we obtained an historic gain, Letter of Understanding No. 17, which, for the first time in Canada, foresees the parity study of the pertinence and feasibility of the ratios as pilot projects. Although the work began more than a year ago and the pilot projects are on the horizon, it seems unrealistic to believe that this committee alone can achieve the FIQ’s objective: to obtain safe ratios for Québec, regardless of the care mission. The work continues, but the ratios file must also be particularly important for our organization, union representatives and members and also in the eyes of the population.

To ensure a better balance of power with the government which has not yet embraced the FIQ’s concerns for the safety of care, a sizeable, unifying project has been set up. With this objective, we hope to take advantage of the 2018 electoral context and kick it into high gear. A publication denouncing the current failures in the system will set the tone for the coming year while positioning the problem and the solution of safe ratios more clearly with the population. It will also work on proposing a concrete ratios model later in 2018 which will be promoted on a provincial scale.

Mobilisation of the members and union reps is necessary for obtaining a gain of this magnitude. To do it, awareness and a better understanding of the demand by everyone is required in order to promote this model at all levels to raise public awareness in Québec. With this in mind, direct training of the members involving the union reps, is scheduled in 2018. At the same time, the research will continue for developing the FIQ ratios model adapted to the reality in Québec and working towards its adoption. In 2018, you will thus be solicited to promote this demand, which will give us all the means to offer care that lives up to our skills and aspirations.

Priority 3 actions – Safe healthcare professional-to-patient ratios: Letter of Understanding No. 17 and the ratios “work project”:

• Continue the committee’s work on Letter of Understanding No. 17;
• Emphasize awareness-raising on the ratios file with union reps, members and the population;
• Mobilize the teams and members to establish a better balance of power with the government;
• Launch a publication denouncing the current failures in the system;
• Give direct training to the members;
• Continue the research to develop the FIQ ratios model adapted to the reality of Québec.

The FIQ action priorities for 2018 must be the consolidation and mobilization engine of all the components of our renewed organization. It looks like there are difficult battles ahead, but we have experienced many others that we came out of as big winners! The key to our success has always been, and remains, our solidarity and capacity to mobilize for causes we believe in. 2018 will be no exception.

Priority 1 – Local negotiations and Letter of Understanding No. 6:

• Complete the negotiation of the local provisions of the collective agreement preserving our gains and taking into account the new territorial reality of our unions;
• Complete the analysis and evaluation of the quantitative data for finishing Letter of Understanding No. 6.

Priority 2 – Continue setting up the new offer of services and support mobilization:

• Continue the deployment of the new offer of services in the field in all regions where the FIQ is present;
• Make the necessary adaptation and adjustments.

Priority 3 – Safe healthcare professional-to-patient ratios: Letter of Understanding No. 17 and the ratios “work project”:

• Continue the committee’s work on Letter of Understanding No. 17;
• Emphasize awareness-raising on the ratios file with union reps, members and the population;
• Mobilize the teams and members to establish a better balance of power with the government;
• Launch a publication denouncing the current failures in the system;
• Give direct training to the members;
• Continue the research to develop the FIQ ratios model adapted to the reality of Québec.

Political Responsibility
Marie-Claude Ouellet

Coordination
Alain Leclerc
Michelle Poirier

Writing
Vanessa Bevilacqua, Union Consultant, Sociopolitical Sector
Katia Fecteau, Union Consultant, Task and Organization of Work Sector
Linda Perron, Union Consultant, Labour Relations Sector
Marie-Ève Viau, Union Consultant, Task and Organization of Work Sector

Revision
Myrna Karamanoukian, Union Consultant, Communication-Information-Web-Translation Service

Translation
Susan Millroy, Union Consultant, Communication-Information-Web-Translation Service

Secretariat
Francine Parent, Secretary, Communication-Information-Web-Translation Service