The Saskatchewan government is making a sensible case in negotiations with healthcare workers. At the heart of the dispute is a straightforward question: when staffing shortages threaten patient care, should union rules stand in the way of getting workers where they are needed?Usually, public-sector unions cry foul over an allegedly stingy government to get better wages, benefits, and work conveniences. In the current case, CUPE 5430 definitely wants more pay, but its strongest objection is to occasionally driving 70 kilometres to make sure a patient has healthcare.CUPE 5430 represents roughly 14,000 healthcare workers in Saskatchewan. Its previous contract expired March 31, 2023. In addition to more base pay, it also wants maternity leave top-up, licensing reimbursement, and bigger premiums for shift differential, weekends, and standby pay.Healthcare unions tend to say their case is about fair pay and ensuring the public’s health. Similarly, teachers’ unions say everything they are asking for is ultimately for the good of the children. But these claims are partly true at best. Let’s be clear: unions ask for what they want. And the governments they negotiate with also care about children and the sick.The claim that patient care comes first is being put to the test in these negotiations. For its part, CUPE is failing. The Saskatchewan Association of Health Organizations (SAHO), which negotiates on behalf of the provincial government, wants more flexibility in addressing staffing shortages. Its proposals make sense, but CUPE doesn’t like them.SAHO wants more flexibility in three areas. One would allow a CUPE employee to work temporarily in another facility or community. Another would allow workers from different health union territories to perform work that currently falls under another union’s jurisdiction. The third would allow a contractor to be brought in when an existing vacancy cannot be filled. SAHO says these changes would not give employers carte blanche to send workers anywhere in the province against their will..The need for that flexibility is especially clear in rural areas where health coverage is sometimes thin. Towns are not cities. There’s not a lot of bench strength to draw on when someone calls in sick. And given all the sick days healthcare workers get, that can happen often.Besides all this, people perusing job offers don’t necessarily jump at a permanent position in a town. However, they might be willing to try a contract.The transfer of workers between territories is an important provision. As it is, many unions have their own turf based on legacy arrangements from when Saskatchewan had 12 regional health authorities. The province abolished them in 2017 and replaced them with the Saskatchewan Health Authority, but the old union territories survived.SAHO gave some examples in August of how it wants to navigate patient care between those old union territories. If SAHO gets its way, a CUPE continuing care aide out of Preeceville could be assigned to provide necessary care to a patient in nearby Kelvington if no SGEU member were available to meet the patient’s needs. Workers there are usually represented by the Saskatchewan Government and General Employees’ Union (SGEU).The fill-in assignment would remain part of the CUPE workday and be covered by the CUPE contract. The worker would be paid for driving time and reimbursed for mileage.The worker would lose no CUPE protection. The sticking point is that the worker would temporarily be doing work in another union’s territory..As SAHO explains, “Some flexibility to meet patient and system demands, without interference with the union territories would assist in reducing workload pressures, provide possible interim relief while a vacancy is being filled, and support better delivery of patient care.” Yes, it would, but do the unions want to give it? No.The previous collective agreement included article 6.02. This prohibited SAHO from transferring work or contracting out “unless it can be established by the employer(s) that contracting out of such services will significantly increase the cost-effectiveness and maintain the quality of health services provided.” Disputes would be handled by “expedited” arbitration.That’s an awfully clunky and slow process to use when a need arises. And curiously, the language of this clause refuses to concede that such arrangements might improve care, not just maintain it. And since when are unions ever interested in cost-effectiveness? And why ever should they be made the judge of it when that’s the job of management?It’s true that some scenarios named by SAHO are not about rural areas. These include allowing CUPE medical radiation technologists or care home cooks to work in Moose Jaw when SEIU-West can’t step up there. That said, such transfers would happen only when necessary.As well, a 72-kilometre drive on a 110 km/h highway takes about 36 minutes. That’s a short commute compared to what many people in large Canadian urban centres endure daily at their regular jobs..Understandably, unionized workers don’t want this occasional inconvenience, especially if they have young children of their own whose care they need to arrange. However, it is hard to say that filling needed spots next door, as the province is asking for, would not result in better service delivery. Isn’t that what healthcare is supposed to be about? Care?In the meantime, CUPE workers continue to enjoy defined-benefit pension plans providing lifetime retirement income. They have gone three years without a pay increase while inflation pushed prices higher, but both sides are proposing retroactive wage increases. CUPE wanted a $5 increase for fiscal 2023 followed by four years of 4% increases. SAHO countered with 3% for 2023, 3% the next year, and 2% in each of the following three years.The union is asking taxpayers for substantially more money while resisting measures that could give management more flexibility to use the workforce taxpayers are already paying for.In September, 99% of CUPE workers who voted authorized their leadership to call a strike. Unfortunately, the taxpaying public has no seat at the negotiating table to say they cannot afford tax increases or borrowing to sustain these pay hikes. And rest assured, that’s what it will take. According to the fiscal update in August, the province is forecasting an $825 million deficit this year.No, Saskatchewan residents remain beholden to a dysfunctional near-monopoly healthcare system full of gaps and long wait times, with few relief valves for the private sector or non-unionized labour to meet demand. Anyone who is not part of CUPE should be cheering the province on in the near-impossible task of keeping a lid on costs while still striving to deliver the care that residents need.Lee Harding is a research fellow at the Frontier Centre for Public Policy.
