The following op-ed ran in the Vancouver Sun on September 27.
There's no bigger challenge facing politicians, health-care workers and the public than the task of modernizing medicare under the pressures of fiscal restraint. But the solutions proposed in the Sept. 22 Vancouver Sun editorial, "Health care spending can't be exempt from cuts," are out of touch with the realities on health care's front lines.
The editorial urges the provincial finance minister to reconsider his pledge not to cut health and education spending in his efforts to balance the budget. You have to "hunt where the ducks are," the argument goes. And The Sun places the high cost of labour specifically the wages of "non-medical staff" squarely in their crosshairs.
Based on a slim study issued by the right-wing Fraser Institute in 1995, The Sun says that health-care staff such as purchasing clerks, laundry workers and maintenance staff earn 25 to 63 per cent more than comparable jobs in private industry. By cutting these workers' wages and contracting out their work, Victoria can save money.
The Sun's position is based on a shaky foundation. The Fraser Institute study has methodological holes you can drive an ambulance through. The largest wage gaps identified in the study, for instance, compare ticketed trades people in hospitals with general maintenance personnel in hotels.
But the biggest problem with the study is that it compares apples and oranges. The risks and responsibilities of health care work for "non-medical staff" are fundamentally different from those working in similar-sounding jobs in hotels and other settings.
Hospital laundry workers are required to prepare sterile surgical linens and deal with all manner of health hazards ranging from body parts to needles. Housekeeping staff are constantly exposed to dangerous bio-hazards and have a key role in providing for sterile conditions to prevent the spread of antibiotic-resistant bugs that can be fatal to patients and health-care workers.
Hospital clerical staff juggle patient records, book operating-room time and deal with the emotionally stressed families and friends of patients. Trades people work in and around patients and medical staff on critical electrical and plumbing systems. Food-service workers make sure patients on restricted diets receive the proper meals. And many of these "non-medical" staff provide companionship to socially isolated patients.
While the Fraser Institute and The Sun would have us believe these workers are overpaid for what is in their view hotel work, the public recognizes that delivering good health care depends on more than just doctors and nurses.
As recently as last February, respondents to a McIntyre & Mustel/Hospital Employees' Union poll agreed by a margin of two to one that compensation for hospital cleaners and laundry workers should take into account their unique responsibilities to ensure patient safety and sterile, germ-free workplaces.
It's important to put the wages of "non-medical" health-care workers in perspective. While they are higher than some private-sector wages for similar-sounding jobs, this is not always the case.
The wages paid unionized workers at Pacific Press, publisher of The Vancouver Sun, are a case in point.
Comparisons made last year showed that unionized secretaries at Pacific Press have annual salaries that are eight to nine per cent more than the bulk of "hospital clerks" (admitting clerks, medical records clerks, unit clerks, OR booking clerks). A switchboard operator at Pacific Press earns about 15 per cent more than the switchboard operator at a hospital. A janitor working at Pacific Press earns about 19 per cent more than a hospital cleaner.
Union members at Pacific Press earn every penny they've bargained for — and so do health-care workers.
According to the editorial, cutting health-care workers' wages, contracting out their work and bringing in more private surgical clinics are the "obvious solutions" to improving patient care.
But these solutions are more ideological than practical. Cutting wages will make it harder to retain experienced workers. Contracting out services will result in more administrative headaches, less accountability and a disruption in service delivery.
And study after study in peer-reviewed medical journals says privately delivered care is more expensive.
Does that mean keeping the status quo in health care? Not by a long shot. We need to explore broad-based solutions to improving care delivery — solutions such as expanding reference-based pricing of pharmaceuticals to keep Pharmacare costs down. And solutions such as reforming primary care by expanding the use of community health centres and involving a broader range of health care professionals in the day-to-day prevention and treatment of illness and injury.
But scapegoating support workers in our health care system is no solution at all.
Chris Allnutt is secretary-business manager, Hospital Employees' Union