Employers propose single Ontario health care bargaining agent

The Ontario Hospital Association and the Ontario Association of Community Care Access Centres (which oversee home care) have deepened their alliance by releasing on Tuesday a policy document Four Pillars.

Three points of interest. [1] They call for the creation of a single government designated health care bargaining agent.

Stability and consistency are essential to collective bargaining within our health system. So is expertise. We believe that having a single organization – a registered employers’ bargaining agent – bargain collectively on behalf of all health sector organizations would ensure that these essentials are brought to bear on every negotiation, and that efficiencies are maximized.  We believe:
(7)  The Government of Ontario should designate a registered employers’ bargaining agent  for the health system

This would mean a major change in collective bargaining, likely creating a dynamic towards much more coordinated, if not central bargaining across the variety of health care sub-sectors.  The ability of local hospitals, CCACs, long term care, and other health care employers to bargain their own deals would almost certainly decline.  This may also lead to changes in bargaining unit structure.  

[2] There is some recognition that placing 'alternative level of care' (ALC) hospital patients (patients who need a different type of care than what they are currently receiving in hospital) may require an expansion of hospital capacity, especially for rehabilitation and complex continuing care:

...it should not be forgotten that targeted expansions in institutional capacity – particularly in the complex continuing care and rehabilitation sectors – may also be necessary and appropriate.

This is a (modest) break from the usual suggestion that home care alone can solve the ALC issue.  In fact capacity will have to be expanded in a variety of fields to solve the ALC problems: long term care beds, rehabilitation beds, complex continuing care beds, convalescent beds,  home care services, supportive housing, etc. 

[3] The report notes that Canada has the highest bed occupancy of all the OECD countries:

Acute Care Occupancy Rate (% of Available Beds), 2007

Canada (2006)            89                             
Norway                        88
Ireland (2006)            86.7
 Switzerland                85.2
United Kingdom         83.3
Austria                         79.4
Italy (2006)                78.4
Spain (2006)              78.2
Japan                           76.4
Germany                     76
Belgium (2005)          74.8
France                         74
Australia (2006)        73.5
Greece (2005)           73.4
Portugal                     72.6
Czech Republic          72.2
Luxembourg              72
Korea (2003)            71.6
Hungary                    69.2
Slovak Republic       67.9
United States           66.6
Turkey (2005)         64.5
Netherlands ('05)    63.9
Mexico                      59.6

The report cites the Organization for Economic Cooperation and Development for this information.  

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