The Lessons of Health Care Union Resistance in Finland and Canada
Jyrki Katainen, the Finnish government’s current Finance Minister, made an infamous promise to voters during the last elections: to address the crisis affecting the Finnish public health care sector – the main concern of Finnish voters. More particularly, he promised to raise the salaries of trained nurses “significantly”. Kokoomus, the National Coalition Party was elected on the basis of these promises which the Finns feel have been broken. TEHY, the union of health care workers, fought long and hard, resorting to exceptional measures to make the government honour their promises. The union’s labour struggle brought into the open the hypocrisy and contradictory discourse of neoliberal politics and their advocates. The debate over the legitimacy of the unions’ demands and chosen methods of collective bargaining became highly symbolic and fierce; it went to the core of what is at stake in the current downsizing and overhaul of the Nordic welfare state and how it affects in particular fields in which women predominate.
The following news report by the main Finnish newsdaily, Helsingin Sanomat (HS) sums up the labour conflict involving TEHY and its resolution: “The council of Finland’s Union of Health and Social Care Professionals (TEHY) unanimously approved a settlement proposal put forward by the mediation board set up to resolve the labour conflict, in which over 12,000 nurses had threatened to resign en masse on Monday night. The decision thus averts a situation that had caused alarm and fears that the country’s health service would be more or less paralysed. The nurses have struck a deal bringing wage increases ranging from 22% to 28% over a four-year agreement period. This will amount to between Ä 350 and Ä 650 a month over the four years. There will also be a “Christmas bonus” of Ä 270. The wage increase will apply only to TEHY members. The Commission for Local Authority Employers (KT) has also given its unanimous approval to the contract, while warning that it will inevitably cause municipalities to tighten their local taxation. KT’s head of labour market affairs, Markku Jalonen said he believes that the agreement will force one municipality in four to increase the tax percentage. He also warned that customer charges for public sector health care services would increase.
HS also reported that with approval of the deal from both sides preparations need no longer go ahead for the implementation of measures called for by the recently-passed patient safety legislation. The law, voted on by Parliament earlier, would have allowed local authorities to compel some of the nurses taking part in the threatened industrial action to stay at work in order to perform tasks considered vital for patient survival. The TEHY staff, consisting of a variety of employees besides the trained nurses, has enjoyed a broad measure of popular support for their demands, in spite of public worries over the possible fallout from the planned mass resignations. All is well that ends well, one might assume from the corporate perspective.
The HS analysis of the threat of mass resignation by the trained-nurses focus group is a most telling example of media bias, that is, the blatantly one-sided reporting of issues that are of extreme importance for female workers, the fields in which they dominate, and the entire future of the welfare state. It epitomises at the same time the other strategies used by those in power to subject vulnerable unions or employee groups to the corporate perspective. The TEHY “deal” is now seen by leftist and many other analysts as a “pyrrhic victory”; the final contract is so complex and contingent on ambiguous, contextually shifting interpretations that many fear no real gains will have been made at the end of the day (four years from now).
Because women, more than men, have been conditioned to internalise the ethics of care, sacrifice and flexibility as a “naturalised” essence of femininity, they are also more vulnerable to labour manipulation, misleading promises and bully politics. They also have less negotiation power and resources than the male-dominated fields, with their much stronger unions.
As the cited HS report reveals, the corporate interpretation foregrounds the costs of the nurses’ demands as a future burden for taxpayers, as if other union demands did not have the same impact. Instead of the article voicing solidarity with the legendary low salaries of women in jobs labelled as “calling professions”, it lends support to the politics of blaming the victim, i.e. questioning the legitimacy of the labour struggle on the basis of public reaction (patient security) and the consequences of the increases on municipal budgets. Why did it not focus instead on the government’s right-wing priorities: deficit cutting in a context of unprecedented economic growth, a thriving economy and numerous breaks given to corporations and the wealthy?
The media have in the main given the impression that TEHY made major gains even though the key issues (lack of staff, burnout, poor working conditions) were not addressed at all, and even the salary increases are tied to the demands of productivity, something that merely reproduces and aggravates the existing problems. Massive layoffs are condoned by the government in the name of “competitiveness” but the nurses’ mass resignation led to prompt legislative action and was outlawed. When corporations closed factories, created mass unemployment and threatened the well-being, working rights and health of its staff, the government was passive; nothing could be done. Both measures reflect the interests of the corporate agenda.
The strike by over 40,000 hospital and long-term care facility workers in British Columbia in 2004, as well as the many other labour actions flowing from adjustment programmes and “restructuring” in Canada, likewise epitomise the tensions between corporate-identified governments and rights-identified workers. They are telling examples of public-sector unionists struggling to defend themselves and the services they deliver from employers and of a government intent on reorganising the public sector on neoliberal lines.
However, as in the case of TEHY’s action, the workforce being overwhelmingly made up of women and people of colour, its demands were quickly labelled as unreasonable and impossible to meet. This is well in line with the differential treatment of women-dominated fields, resulting from centuries of practices that have regarded male employment as more important, with women’s work functioning as a form of reserve or collateral labour and a more easily dispensable resource (Wichterich 2000). In Canada, the Hospital Employees Union (HEU) has one of the more left-wing leaderships in the Canadian labour movement. This means that the resistance was militant and that the labour activists would not give in easily to the corporate agenda. Still, in 2004 the B.C. government managed to end their strike by legislative order, echoing the harsh measures adopted by the Finnish government in 2007.
In 2002, Minister Campbell’s liberal government passed the infamous Bill 29, The Health and Social Services Delivery Act. It allowed for extensive privatisation as well as the elimination of transfer of services without consultation. It also made it illegal for health care workers to discuss alternatives to privatisation with their employers, and it enabled the closing of hospitals with two months notice. In a direct attack on unionised workers, it stripped key provisions from the Health Services and Support Facilities Subsector collective agreement that covers members of HEU along with members of nine other unions with a small presence in hospitals and long-term care facilities. It also added new provisions: workers lost their strong “no contracting-out” protection as well as successor rights that had helped higher-seniority workers avoid unemployment. Retraining and job placement rights were cut, along with the Health Labour Adjustment Agency, a body responsible for assisting laid-off workers, which had been established as part of the Health Accord signed under the previous New Democratic Party (NDP) provincial government. Employers were given the power to move workers between hospitals and to temporary assignments at distant workplaces. This bill was blatantly biased in favour of health-care managers and private sector contractors and has been viewed as “the most severe government intrusion into collective agreements in Canadian history”.
David Camfield (2006) provides an analysis of the neoliberal background to Bill 29 in which the restructuring of health care in B.C. is understood as an integral part of processes unfolding on a global scale: “broad-based changes in the financing, administration and management of public service delivery” are under way at all levels of the state, not only in Canada but across the advanced capitalist countries and beyond. It is commonly observed that the central thrust of this reorganisation of the broader public sector is a shift from the welfare state to a new kind of public administration whose “primary objective is the fostering of a globally competitive economy”. By “reform”, neoliberal decision-makers understand a transition as absolutely necessary because of the “fundamental economic constraint” on governments today.1
Most of the workers at the centre of B.C. health-care restructuring were members of HEU, which represents over 90% of health support workers in hospitals and long-term care facilities: a broad range of clerical, food services, housekeeping, laundry, maintenance, technical, trades, and patient-care workers, including Licensed Practical Nurses. Camfield points out that it was a mature and predominantly female workforce, whose jobs were very important to them and the other members of their households, which was subjected to these harsh labour measures. The most radical measure that the liberal government adopted, however, (Bill l8) in the wake of the neoliberal attacks against unions across Canada, was declaring the female-dominated, vulnerable fields of health care and schooling to be “essential services”, legislating that they would not enjoy the right to strike. This epitomises the contradictory bully politics directed against female-dominated fields. On the one hand, they are declared so “unproductive” (by business standards which should not be applied to them) that they deserve lower salaries. On the other hand, they are recognised as “essential services”, but instead of this leading to appreciation it is used to legitimate the annulment of their right to strike.
Finnish labour unions, leaders, politicians and other likely critics of the neoliberal “corpocracy” would do well to heed the developments that resulted from HEU’s labour struggle. The HEU and TEHY labour struggles clearly have systemic root causes and are part of a much broader class project for reshaping state and society than is publicly recognised.2 The Finnish left is well-advised to follow the example of Canadian activism that finally led to a victorious ILO ruling condemning Gordon Campbell’s government for trampling workers’ rights which Canada had pledged to uphold in international conventions. In 2007 the Supreme Court of Canada likewise repealed Bill 29. This was a major victory against corpocracy. Since this victory points to the importance of using international labour-rights instruments, I will elaborate on The UN convention of the ILO-#87-Freedom of Association and Protection of the Right to Organize Convention (1948) which was signed by Canada and all 10 provinces in 1972.
Several unions lodged complaints against the government in light of this and other ILO conventions. Although the UN body cannot enforce its rulings, it does have the power to embarrass governments that violate UN standards. It can also exert moral pressure on them to reconsider their actions. The B.C. government seems to have upset the ILO on two counts: (1) the long list of violations it had committed against workers rights and (2) the dismissive attitude it displayed when dealing with the complaints. The appeal to the ILO attests to the power and possibilities of collective resistance and action, as the reply given by ILO proves: “The committee notes that the impugned Acts affected large numbers of employees in the health and education sectors, and imposed terms and working conditions for an extended period of time, i.e. three years. … Furthermore, they do constitute … an interference by the authorities in the regular bargaining process, since the government intervened legislatively to put an end to a legal strike (Bill 2) and to impose the contents of collective agreements (Bills 15 and 27)”.
The ILO ruled that the Liberal government of Premier Gordon Campbell repeatedly refused to negotiate contracts with the unions and used the legislature to arbitrarily enforce its will. As a remedy, the ILO took the unusual step of asking the B.C. government entirely to repeal one bill. It also recommended major amendments in other statutes enacted by the Liberals to enforce its will on employees. The international body also called on the government to refrain from such heavy-handed action in the future and to restore “appropriate and meaningful” bargaining with provincial employees. It also strongly condemned Bill l8. Furthermore, Canada was invited to hold “full and detailed” consultations, “under the auspices of a neutral and independent facilitator”, to review collective bargaining issues arising from Bill 29. After numerous other recommendations implicitly contesting the temerity of the corporate assaults, the ILO concluded: “When a state decides to become a member of the ILO, it accepts the fundamental principles of freedom of association ... and all governments are obliged to respect fully the commitments undertaken by ratification of ILO conventions”.
The lessons from the Canadian labour action should be heeded by Finnish politicians and decision-makers both on state and municipal levels, and above all by those affected by the draconian measures to erode the welfare state. Finnish political life is characterised by a politics of consensus, with the multiparty system encouraging compromises and avoidance of strong conflict. In the context of the aggressive and stubborn corpocracy, one can only hope that this tradition is replaced by strong citizen resistance, critical thinking and mass mobilisations that are more characteristic in my experience of the Canadian system.3 I worry about the measures the Canadian government tried to impose in the field of education, and which Kokoomus, in its copycat mode, may well seek to adopt, in order to prevent any strike action taken by this other female-dominated field (Bill l8).
Another lesson Finland would do well to learn is that HEU is a union whose leaders took seriously the proclamation in the preamble to its constitution that it is “the right of those who toil to enjoy to the fullest extent the highest standard of living compatible with life within Canada”. HEU is exemplary as a union that has not been concerned only with its members’ wages, benefits, and working conditions but has a broader welfare agenda. The union’s 1958 endorsement of the demand for a comprehensive public health care system was followed twenty years later by its call for taking private long-term care facilities into public ownership, through expropriation if necessary. Women’s activism produced a union that at the end of the century was distinguished by a higher level of militancy and political consciousness than most Canadian unions. TEHY and other Finnish labour unions would be well advised to adopt a more solidarity-based and welfare-oriented outlook beyond the self-interest that characterised some of their leader’s comments. Corpocracy poses such an unprecedented threat to the gains made by the women’s movement that unions cannot afford to compete and envy each others’ gains. They need to consolidate their action, mobilise collectively, and create a critical mass with other activists, union members, parties and individuals who wish to give notice to neoliberalism. Otherwise, as is already happening, the winner takes all.
Camfield, David. 2006. “Neoliberalism and Working-Class Resistance in British Columbia: The Hospital Employees’ Union Struggle, 2002-2004” Labour/Le Travail Vol. 57. 9-43.
ILO Governing Body (Sections No. 239 to No. 305) NUPGE, “Sweeping ILO ruling slams actions of B.C. Liberals”. Web posted, March 27, 2003.
Helsingin Sanomat, “Unanimous mediation board recommends settlement in nurses’ pay dispute” (previously in HS International Edition: “Mediation board begins efforts to reach settlement in labour dispute between nurses and municipal employers” (November 1, 2007). “Health care workers threaten mass resignation in labour dispute” (October 10, 2007). “Nurses’ union accuses municipal employers of illegal industrial action” (October 31, 2007). “Union of Salaried Employees offers to support Tehy” (November 16, 2007)
Wichterich, Christa. 1998. The Globalised Woman. Reports from a Future of Inequality. Spinifex Press, Melbourne.
1 In 2002, the B.C. Liberal government moved to reduce medical services through the elimination of coverage for physiotherapy, chiropractic, massage and other therapies, making cuts to the Pharmacare programme, closing hospitals and long-term care facilities, cutting services and beds in others, and removing housekeeping work from the home care provided to disabled and elderly people. At the same time, the Campbell government encouraged more corporate involvement in health care (Camfield 2006).
2 That the TEHY case is likewise part and parcel of neoliberal politics is not recognized in Finland. The editor-in-chief of the Finnish newspaper Kaleva went as far as to challenge such a phenomenon in his review of Heikki Patomäki’s book Neoliberalism in Finland (2007). However, normally the real global agenda behind the unwillingness to keep the electoral promises has not been revealed in the media.
3 As a member of the Kiiminki municipality’s education board, I have witnessed the near total passivity of most delegates in the face of the vast and radical restructuring measures, as small quality schools are replaced by more “cost-effective” megaschools and teachers are overworked and coerced into making different kinds of sacrifices.