Nurses' strike fuels scrutiny of Canadian health care

"honk for your health!" the picket signs say.

Quebeckers have been doing just that. As striking nurses have staffed picket lines in front of hospitals across the Canadian province, motorists cruising by have beeped their horns in time with the union chant: "So-So-So-Solidarit!"

Quebec's 47,500 nurses - arguably the most beloved civil servants in the province - have been striking for better wages and working conditions for two weeks now. It's the latest in a string of labor actions by nurses across Canada this year, as they have wearied of continual budget cutbacks within the health-care system, which is nothing less than a touchstone of national identity.

Now there are prospects for a "pause" (the union hesitates to say "truce") in the job action. Union leaders expect to announce by noon today that the rank and file have endorsed their offer to return to work for 48 hours, starting at 8 a.m. Tuesday.

Premier Lucien Bouchard's Parti Qubcois government has refused to negotiate hitherto, maintaining that the strike is illegal. The "pause" will provide diplomatic cover to resume talks. "It will be a very long and a very short 48 hours," says Michelle Boisclair, vice president of the Quebec Federation of Nurses. "But we're ready to work" around the clock to conclude a deal.

This spring, nurses also struck in Saskatchewan and Newfoundland. In January, a walkout by nurses in British Columbia was averted only by a decision to hire 400 more nurses.

It would be hard to overestimate the importance of universal health care to the Canadian psyche. Polling data show that Canadians consider their system "the crown jewel of our social safety net," says Jane Armstrong, senior vice president of Environics Research Group Ltd. in Toronto. And it distinguishes Canada in the minds of its citizens from the United States, where tens of millions have no health insurance.

But this national icon has taken some hits over the past decade. Canada, like many other developed countries, has struggled to control its budget deficits. Governments of all political stripes, from conservatives to what might be called market-disciplined social democrats, have trimmed social spending to balance the books.

Federal Finance Minister Paul Martin's latest budget is in the black - in no small measure because Ottawa simply slashed its transfer payments to the provinces a few years ago - and most of the surplus went back into health-care spending.

As a result, "Health-care providers see an opportunity to make up for lost ground," says William Robson, senior policy analyst at the C.D. Howe Institute in Toronto. Hence a new assertiveness on the part of nurses in their wage demands.

"The basic issue is that nurses in Quebec and in Saskatchewan needed major changes," says Rosalee Longmoore, president of the Saskatchewan Union of Nurses. As the result of cutbacks, she adds, "Nurses are doing more with less and looking after sicker people."

Quebec has the lowest entry-level wages for nurses of any of the provinces - about US$20,000 a year. For the most experienced nurses, Quebec salaries are about in the middle, at US$30,000.

The nurses are asking for a 10 percent increase up front, and 6 percent more over the life of the three-year contract. Mr. Bouchard has not budged from his counteroffer of 5 percent over three years. If he gives in to the nurses, he says, he will have to give in to 400,000 other civil servants across the province, whose contracts are up for renewal this fall.

With its citizens feeling squeezed by falling disposable incomes (by about 5 percent through the 1990s), Canada is now a leader among the Group of Seven industrialized countries in work stoppages.

Air Canada, for instance, which plunged into red ink last year after a costly pilots' strike and just averted a strike by its flight attendants last week, now faces tough negotiations with its 7,500 machinists. Other strikes over the past year have included those by Ontario schoolteachers, Toronto Transit Commission workers, and grain handlers out in the prairie provinces.