Collective Bargaining by Nurses in Canadian Health Care: Assessing Recent Trends and Emerging Claims

By Archibald, Tom | Health Law Journal, Annual 2003 | Go to article overview

Collective Bargaining by Nurses in Canadian Health Care: Assessing Recent Trends and Emerging Claims


Archibald, Tom, Health Law Journal


I. Introduction

Since the late 1990s, health human resource (HHR) policy in Canadian health care has been a mixture of consensus and conflict. Consensus appears to have emerged about the broad policy goals for Canadian HHR planning: immediate recruitment and retention goals, and long-term goals of greater cost-effectiveness and productivity from the health care workforce. This consensus has heightened in the wake of the 2003 SARS crisis and other episodes that reminded the broader public--and not just patients--of the courage and dedication of health care workers. This sunny consensus, however, contrasts starkly with the other trend: increasingly rancorous conflict between governments and health professionals on how to achieve these goals. And nowhere has it been as rancorous as in nurse collective bargaining. (1)

Throughout most of the 1990s, a time of fiscal constraint and restructuring across the Canadian public sector, health care unions gained little at the bargaining table. In large part, they did not demand much either, sensing a political climate hostile to ambition on the part of public sector employees. (2) Thus, the 1990s was a period of relative quietude in Canadian health care labour relations. Since the late 1990s, however, ambitions have revived among all health care unions, particularly nurses' unions. Emboldened by more favourable political and labour market conditions, nurses' unions have demanded more hires, higher wages, reduced workload, less overtime, less casual staffing, and other contract improvements. Despite increased resources, governments have been reluctant to meet these demands, citing short and long-term cost consequences. Thus, Canadian health care since 1998 has seen more labour disputes than any other time in recent memory. And these disputes--often involving nurses' unions--have been far more intractable.

In such disputes, labour law in Canadian health care has traditionally prescribed one of two ways out. (3) In one scenario, the parties--and the public--would endure a work stoppage, though usually one in which key essential services are maintained. Whether lawful or unlawful, health care strikes have seldom lasted long before a settlement is reached, or governments legislate an end to the strike and impose the second scenario: binding interest arbitration. Under interest arbitration, a neutral third party decides the outstanding issues in dispute between unions and governments. Since 1998, however, governments appear to be dissatisfied with this traditional script, and some are abandoning collective bargaining altogether in ending disputes.

Among the most colourful of these disputes erupted in Nova Scotia during the summer of 2001. This dispute embodied many of the themes in collective bargaining in the post-1990s health care system. In this paper, I focus on one such theme: an apparently increasing government frustration (not only in Nova Scotia) with collective bargaining at a critical juncture in health care reform, and particularly during a serious health human resources crisis.

With a detailed review of the Nova Scotia dispute and brief outlines of some disputes in other provinces in mind, I explore a deeper issue raised by these episodes: Is collective bargaining the right labour law model for Canadian health care during the HHR crisis? If governments are prepared to abandon collective bargaining in ad hoc, reactive ways--with all the labour relations harms that creates--then they are inexorably drawn to this fundamental question, even if only reluctantly.

This reluctance shows clearly in the utter lack of any direct health policy analysis of this question, something unfortunate yet understandable. For raising the sensitive issue of whether collective bargaining remains the appropriate labour law mode for a "reinventing" system--or even less radical questions--would quickly provoke serious political conflict with nursing and other health care unions. …

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