Bracing for a ‘perfect storm’

“Privateers see our health system as an untapped oyster.” – Linda Silas

Canadian nursing unions want greater emphasis on community and home care as part of a survival strategy for their threatened Medicare scheme.

The 200,000-strong Canadian Federation of Nursing Unions warns that, despite overwhelming public support, Canada’s public health care system is under unprecedented threat. “We face an approaching ‘perfect storm’ created by a slowing economy, ageing population, increased chronic disease and greater reliance on expensive technology,” the Federation’s president, Linda Silas told the NSWNA annual conference. “Cries that Medicare cannot be sustained are getting louder the more our economy slows down.”

Linda says the threat comes from “privateers who know they can make a buck on health care. They see our health system as an untapped oyster – if they tap on it loud enough they might grab that big rich pearl.” Canadian Medicare – similar but not identical to Australia’s health system – is a publicly-funded universal health insurance system, mostly free at the point of use, and with most services delivered by private providers. Almost all doctors’ services, and 90% of hospital care, are publicly funded.

Linda said Canadian government revenues were shrinking “as a matter of choice, not fate: foregone revenue from tax cuts for the past seven years was equal to $220 billion.” She said this would have paid for a pharmaceutical scheme, an adequately funded universal health care program, safe water and education for every Aboriginal child and a budget surplus. Linda said health authorities were closing emergency departments and cutting the number of beds, especially in rural and small hospitals. Day care programs were under the knife and registered nurses were being replaced with less qualified staff. “Canadian nurses are walking round with targets on their backs. Managers are thinking, how can I cut a nurse in my hospital or long-term care facility?” Linda warned that health budgets were stretched at a time of rapid increases in chronic diseases. “Thirty-six per cent of Canadians with diabetes have two or more chronic conditions. One quarter of patients in hospital hallways are 75 or over. Half a million Canadians are living with dementia and this will double within the next generation. “We need to move beyond acute care to nurse-led clinics and home care.”

Linda said the NSWNA’s success in winning nurse-to-patient ratios in 2010, building on similar victories in Victoria and California, had encouraged every nurse union in Canada. “We are at the bargaining table in three provinces with safe staffing as our number one priority. My activists are saying, if it’s good enough for California and Australia it should be good enough for Canada too.”