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Summary of concerns about the Corpus-Sanchez Report
As you have heard in news reports, the MacDonald government has accepted all of the 103
recommendations contained in a consultant’s (Corpus Sanchez) report aimed at ‘transforming’
Nova Scotia’s health care system.
CUPE has analysed the entire report and believe it raises a host of serious concerns both for
CUPE health care workers and for Nova Scotians in general.
General observations
The report poses infinitely more questions than it answers. It calls for nothing less than a "radically
altered healthcare system in Nova Scotia" without defining what that actually means.
There is no room for dissent or alternative approaches, especially when they insist "there must be no
return to existing models”. While they pay all kinds of lip service to more consultation and community
input, the government and the District Health Authhorities (DHA’s) are already well underway with
implementation.
Meanwhile, other than senior managers, we never find out who was actually consulted. With no real
details on methodology, it is almost impossible to comment on the legitimacy of the report’s conclusions.
It sets out to establish a context of alarm - ‘the health care system is in crisis’. On this so-called crisis, we
should be asking, ‘If the sytem is in crisis, then why did they sit on the report for a full year?’
It proposes several ‘task forces’, but gives us no idea who will sit on them, or provides a more specific
mandate, timeframe, etc.
Most notably, there is no mention anywhere in the document of consulting organized labour regarding
working conditions and the delivery of services and how this blizzard of proposed changes relate to
collective agreement provisions.
Specifics
Chapters 1-4
The report tries to equate itself with the Romanow Commission, the federal commission into Medicare
conducted by former Saskatchewan premier Roy Romanow, even his report was about preserving and
strengthening the public system.
There is nothing objective about the report’s ‘premise’: only total transformation will allow us to achieve
sustainability. The report has a predetermined outcome.
The smokescreen in the report is ‘improving the overall health of Nova Scotians’. The real goal of the
report is ‘financial sustainability’. Integration and consolidation of services, as one of their three broad
goals, is a clear example of this.
They raise the spectre of looming staff shortages due to aging workforce, but don’t distinguish between
eligibility for retirement and people actually leaving. They also ignore the changes to mandatory
retirement laws.
They do acknowledge the rapid rise in the cost of prescription drugs. This is actually a good argument
for implementing a universal Pharmacare program, which CUPE has calling for for years.
They do not recognize the need for a jointly negotiated labour adjustment strategy. Either they’ve
already figured one out without us, or they simply forgot about this gigantic piece of the puzzle.
They seem to abandon the Provincial Health Goals that were prepared through extensive public
consultations in 1992 and later reaffirmed in 1999.
They plan to task a CEO Council with creating ‘one overall shared vision’. This is top down, which
belies all of their talk about ‘communities’ driving the change.
Chapters 5-8
They want to give even more power to the NSAHO. This is the same organization that fiddled
with our members’, a problem that we had to fix in the last round of bargaining. The fix,
however, cost the government and taxpayers $70 million.
They propose ‘devolving’ continuing care to DHA’s. This raises questions about union
representation.
They want to set up a ‘Rural Health Task Force’ but give us no idea who will be on it,
structure, timeframe, etc.
In Chapter 6, they stress it may be necessary for us to use ‘alternative human resource
models’. This should sound alarm bells for unionized health care workers.
They acknowledge the consequences of previous staffing cutbacks & how this has resulted in
inefficient work processes, yet they still insist that hiring more staff is not the solution.
They argue the overuse of Emergency Departments (ED’s) is due to a lack of community-based
alternatives and solutions. They say it is “integral” to expand primary healthcare initiatives to
reduce non-emergency visits to EDs, but don’t explain how or what that entails.
They acknowledge that recruitment has become an issue, esp. in light of the recent cutbacks in
training programs.
They want to partner with private sector pharmacies in small communities to ensure trained
and experienced resources are available.
There is an open and direct discussion about the benefits of private sector partnerships in
providing non-clinical support (e.g., laundry, housekeeping, food services). This could quite
eaily result in contracting out of CUPE jobs.
They want to revisit the definition of hospitals with the potential goal of redefining specific
facilities. They do not address how staffing levels will factor into any resulting definitions.
They charge the Clinical Services Task Force with a mandate to deliver its recommendations
no later than April 1, 2008. This is a totally unrealisitc deadline to work with.
The report seems to propose that fiscal responsibilities and staffing issues in ED’s will be the
sole responsibility of the DHAs and the Department of Health (DOH) will no longer play any
role in this.
They want to conduct a feasibility study of current lab delivery models, in order to develop a
consolidated model for future delivery of services. This has the potential for job loss.
Chapters 9-12
There is a new emphasis on OH&S which, on the surface at least, appears to be something we
could support.
They want to strengthen the role of the NSAHO to provide common human resources services
to all of the DHA’s. Again, the NSAHO hasn’t exactly shown itself to be a friend of frontline
workers.
A review of adminstrative versus program costs has the potential for job loss.
A provincial ‘patient care information system’ sounds like something the private sector would
love to get its hands on.
In Chapter 11 they make a blatant recommendation to consider P3’s (Public-Private-
Partnerships). This would most certainly result in job loss and a racheting down of wages. They
also talk here of immediate changes to staffing to reduce staffing costs.
