The system of universal health care in Canada is founded on public trust and accountability. The labor union provides a solid foundation for promoting public accountability in the Canadian health care system by protecting jobs so that workers can always work in the interest of the public even when that conflicts with their employer’s interest.
There are three stakeholders in the universal health care system in Canada. In the interest of the Canadian public all three groups must work together to deliver health care services.
These three groups are:
1. The government – the Canadian health care system is funded federally but administered by the each of the thirteen provinces and territories. All funds flow from the federal government, to the provincial government,and then to the employer. All provincial and territorial governments must maintain accountability to the federal government for the way that funds are dispersed and annual reports are necessary to ensure compliance with the Canada Health act.
2. The employer -Regional health boards administer local health care services. They employ people to deliver services to clients and customers who are the members of the community they serve. In smaller provinces and territories the provincial or territorial government may be the employer.
3. The workers – These are the people who provide patient care and services as well as the workers who support those services such as the cleaning staff, food services workers, carpenters, electronic data specialists and others.
Each of the stakeholder groups also has a self interest which could be described as:
1. The government – self interest is often directed only toward fiscal accountability and balancing the budget. Sometimes this means increasing taxes or even decreasing services if funds are limited. In most provinces in Canada governments have passed labor laws that put restrictions on a labor union strike in health care in order to protect the public they serve.
2. The employer – the employer’s self interest is to maintain the flow of funds so that services to its customers can be maintained. The employer also has a self interest in maintaining the skills and education of its workforce so it can continue to provide services and meet present and future challenges.
3. The workers – people work in their own self interest. They have families to feed and mortgages to pay. People do not want to work for nothing. They want to feel valued and know that they are making a contribution to their organization and their own community.
All three of these stakeholder groups work in their own interest, but in order to provide health care in Canada they must all work together in the public interest. Therefore there has to be a strong public accountability framework that supports the Canadian health care system, because self interest and public interest are not always compatible.
It is only when the parties work together in the public interest that health care can be delivered in the way that the Canada Health Act requires.
Labor Union in Universal Health Care in Canada
The labor union provides a necessary foundation for the public accountability required within the Canadian health care system and this becomes especially important when the interests of the stakeholder parties are in conflict.
It is quite reasonable for an employer to direct an employee in their work and this is accepted within the labor union movement in Canada. However, it is not accepted that an employer can direct an employee to perform their work below an acceptable standard. In other words an employer cannot direct an employee to be a bad employee and do poor quality work.
Employers in the public sector in Canada know that labor unions must work to protect the social and economic welfare of members and therefore, they are aware that the public interest can only be served when employees and employers work together in a common interest. In universal health care in Canada that common interest is the public interest.
With labor unions protecting jobs, workers know they can work in the public interest and still fulfill their own self interests because they have confidence that there are mechanisms in place to resolve conflict and that employers cannot arbitrarily change the nature of their working conditions.
It is a system that works well most of the time. And the Canadian public remain confident that the system works in their interest most of the time as well.
From time to time however, when conflicts arise, labor laws such as essential services legislation are in place to regulate strike action. and ensure the Canadian public that health care services will continue while the parties in conflict work towards a resolution.