Union fears staff cutbacks following Nunavik hospital deficit
"We are really worried for the future of health and social services in Nunavik"
The union that represents workers at the Tulattavik hospital in Kuujjuaq says it’s concerned that cutbacks planned for the health centre will produce damaging impacts on staffing and health care service for the Ungava region of Nunavik.
Late last month, the hospital, which serves communities all along the Ungava coast, announced that it is facing an accumulated deficit of $6.8 million for the fiscal year that ended March 31, 2014.
Now the health centre must make major spending cuts to balance its budget.
The Nunavik Regional Board of Health and Social Services said the hospital’s administration is looking at a number of different measures to cut back on its budget: the abolition of vacant positions; reduction of overtime hours; cuts in administrative and travel expenses; and negotiations on the costs of user transportation.
Tulattavik administrators have said those measures will not interfere with patient services, or increase the workload of Tulattavik’s staff.
The union, called Syndicat des travailleurs et travailleuses du centre du santé Tulattavik de l’Ungava, represents more than 600 employees along the Ungava coast - the majority of Tulattavik’s staff, excluding managers, pharmacists, dentists and physicians.
And the union says administrators have proposed 23 measures to cost cuts, some of which could eliminate jobs.
“We think that the operations budget of our establishment is not sufficient,” said union presidents Isabelle Vaillancourt and François Crépeau in an email to Nunatsiaq News.
“At a time when issues for Aboriginal communities have an important place in the news, we are concerned that these cuts will also have an impact on the services provided to the community.”
Tulattavik’s budget in 2013-14 was $56 million.
A report prepared by BDL Groupe Conseil Inc. for Nunavik’s health board — yet to be shared with the union, but obtained by Nunatsiaq News — offers a number of recommendations on how Tulattavik’s administrators can better cut costs.
The report recommends the hospital cut the following positions:
• director of financial services and director of technical services, and create a new position overseeing both;
• director of hospital services;
• administrative agent;
• two nursing positions at the elders home;
• one clerk and two maintenance positions.
It suggests evaluating the need for other positions, such as the driver for patient services, and reducing the number of pharmacy assistants.
The report also found that the hospital paid 375 hours of overtime a week in 2012-13, the equivalent of 32 full-time positions with an average salary of $36 per hour.
To remedy that, it recommends limiting overtime to 90 hours per year.
As part of its analysis, the BDL Groupe report also suggests:
• that employees begin to pay rent for their housing provided to them by the health board based on the area of the unit and number of rooms;
• limiting to two the number of annual trips lasting more than a week that certain employees can take;
• evaluating the cost of transporting people whose mental health poses a personal threat;
• and developing a procedure to ensure that all cafeteria food is paid for.
The union contends that there are many unionized employees at Tulattavik who continue to have temporary status although they’ve held their positions for more than a year.
Generally, the union said positions should become permanent after six months.
“That situation is not good for the attraction and the retention of local personnel, nor for the personnel coming from the outside (because) the temporary employees have less benefits than the permanent ones,” the union presidents said.
“These proposed measures will not help to increase the satisfaction of the personnel in place.”
And the measures come as the health board launches a new trilingual campaign to attract staff to its health centres.
Instead, the union proposes that Tulattavik management stop contracting out maintenance projects or other services, review management structures and competencies while investing in training programs that would benefit the community.
“In the end, we still hope as a union that this process is a temporary step to… a return to better financing of the hospital and its services, for the well-being of the youth and the communities of Ungava,” the union said.
“If not, we are really worried for the future of health and social services in Nunavik.”
This isn’t the first year Tulattavik ended its fiscal year in the red; in 2012-2013, the health centre finished the year with a $2.6 million deficit.
The Quebec law that provides for balanced budgets in the public health and social services network requires that every public institution must maintain a balance between its expenditures and its revenues.
And Tulattavik is not the only health centre in the region to be faced with cutbacks.
After battling an accumulated deficit that grew to more than $100 million in the late 2000s, Puvirnituq’s 25-bed Inuulitsivik hospital managed to produce a surplus of more than $500,000 in 2012.
But Inuulitsivik was able to recover only after Quebec decided to write off the hospital’s long-term accumulated deficit.