For the third time in recent months, members of the Fédération interprofessionnelle de la santé du Québec (FIQ) union are striking for higher pay and better working conditions for healthcare workers across the province.
The federation, the members of which include more than 80,000 nurses, licensed practical nurses, respiratory therapists, and clinical perfusionists, has demanded serious discussions at the bargaining table, especially as workers face burnout. The group's membership is nearly 90% female, and FIQ calls itself a feminist organization dedicated to defending members and patients in the public health network.
"Money is obviously important. We have to pay healthcare professionals what they are worth, in accordance with their expertise, and we will never accept an agreement that undermines this," Julie Bouchard, FIQ president, told Medscape Medical News.
"But salaries are not the only thing at stake. There's also working conditions," she said. "We have to stop exhausting healthcare professionals to the point where they only have two choices — to burn out or resign. This way of doing things is leading nowhere."
FIQ Moderates Demands
The FIQ strike coincides with the strike held December 8-14 by the common front, a coalition of unions that encompasses more than 400,000 workers in health, social services, and education. Like FIQ, these unions are calling for better wages and working conditions. The common front is also participating in its third strike this fall, following a strike on November 6 and another November 21-23.
The FIQ has mooted an unlimited strike if a deal isn't reached by Christmas. Discussions have intensified this month, Bouchard said, but the deal still appears far away.
"To discuss a topic as simple as parking for healthcare professionals, who are required to have a vehicle — it took 48 hours for the government's negotiations team to respond to us," she said. "They cannot say that negotiations are a priority when it takes that long to discuss such simple things."
Since January, the FIQ has called for reasonable workloads and laws to regulate the patient-to-healthcare-worker ratio, in addition to the aforementioned demands. The union's collective agreement with the government expired at the end of March.
Following negotiations throughout the summer and fall, FIQ members voted in October to strike in November. About 95% of members voted in favor of their first strike in nearly 25 years.
Last week, the FIQ rejected the Quebec government's new salary offer of a 12.7% increase over 5 years (from 2023 to 2028). The union had been asking for a 24% increase over 3 years but is now asking for 20% — as a 14% increase over 4 years plus a 6% boost for one year to battle the 6.6% of inflation in 2022.
Bouchard pointed out that the offer is lower than the 21% increase given to police and the 30% increase given to the legislators themselves.
"Why is it that the offer for public sector employees, mostly women, is so low, compared to the police and members of the National Assembly?" she asked. "Would the government have offered the same to a predominantly male profession? I don't think so."
In addition, FIQ representatives have expressed major concerns about policies that would allow nurses to be moved to other institutions for work.
"The government keeps repeating that this offer is completely dependent on more 'flexibility' and a willingness to send anyone wherever at any time, regardless of how," Bouchard said. "That will never be acceptable."
"A Temporary Slowdown"
Marie-Claude Lacasse, spokesperson for the Quebec Ministry of Health and Social Services (MSSS), refused to answer Medscape's specific questions but provided a statement on the strike, which she said is "leading to a temporary slowdown in certain activities." The MSSS is collaborating with union organizations to mitigate the effects of the strike and provide safe care and services for users.
"The priority of the MSSS for strike days is to support establishments in maintaining essential services, while ensuring that the impacts on patients are reduced as much as possible," said Lacasse. "During strike days, intensive care unit and emergency services are provided as normal to the entire population requiring this care. However, certain nonurgent appointments may be postponed."
Only elective surgeries, and not urgent, semi-urgent, or oncologic surgeries, are affected by the strike, she added.
The Fédération des médecins spécialistes du Québec (FMSQ), a consortium of medical associations that includes approximately 10,000 members, voiced support for the strike. "Medical specialists stand in solidarity with nurses and all healthcare professionals in their fight for better working conditions," Charline Onillon, FMSQ's senior advisor for public affairs, told Medscape.
"The FMSQ hopes for a swift resolution of the current conflict, enabling a prompt return to work to collectively address the pressing medical backlog and waiting lists," she added. "Every day of strike action bears consequences for patient care. A speedy agreement is essential to enhance the quality and continuity of patient care, our collective priority."
Maintaining Essential Services
While on strike, some of FIQ's healthcare workers are maintaining essential services so patients won't be harmed. Many of these professionals are wearing civilian clothes at work to demonstrate their disagreement with the Quebec government's latest proposals.
So far this week, some surgeries have been canceled, and nonessential services have slowed down, the FIQ reported, but emergency rooms shouldn't be affected. For instance, the CHU de Québec-Université Laval in Québec City, said that more than 3000 nonurgent appointments and 200 surgeries were rescheduled.
"Please be advised that widespread strike action from unions in the health and social services network across Quebec may impact certain services," the CIUSSS West-Central Montreal announced on its website.
"Essential services will not be affected," according to the statement. "If you have a scheduled appointment at any of our sites during this time, unless otherwise indicated, that appointment will be maintained."
The McGill University Health Centre in Montreal also reiterated that essential services would be maintained across all hospital facilities.
"We have carefully planned the operation of these services to preserve the health and safety of the public," Bianca Ledoux-Cancilla, spokesperson for McGill University Health Centre in Montreal, told Medscape.
"It is possible that the strike will result in a slowdown in some nonessential services," she said. "We are committed to the health and safety of our patients and are aware and sensitive to the impact this situation may have on them."
Carolyn Crist is a health and medical journalist who reports on the latest studies for Medscape, MDedge, and WebMD.
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