CONFIDENTIAL

DRAFT V2 - FEBRUARY 7, 2012 NOT FOR DISTRIBUTION

Collective Bargaining in the Nova Scotian Health System (2012) District Health Authorities and IWK Health Centre

QUESTIONS AND ANSWERS

1. Question: Why are the districts taking a common approach to bargaining this time around? How
successful do you think you will be? How committed are you to maintaining this bargaining position as you go through each collective agreement? • We are facing significant challenges in the health care system and as a province. We have to control health care spending, to ensure that we have a system we can afford. • What happens at the bargaining table affects the costs of delivering health care. We

need to be looking at all areas to find savings. Everyone has to be a part of the solution. • We can no longer approach each round of bargaining in isolation. We have to act like a system. • This is the union's opportunity be more efficient • to once again be a partner in helping the health system

and to control costs.

None of us can ignore the reality that we must reduce costs. There are only so many options.

This is not about what anyone

bargaining unit deserves. This is about how much Nova

Scotians can afford to pay for health care. 2. Question: Is the government maintaining the 1% + 1% wage proposal going into this round of

bargaining? Have you put an offer on the table yet? • It is too early to be talking about specific wage packages. This will be addressed in due course at the bargaining table first. 3. Question: Government has indicated that the districts have to cover any increases in wages

within their current budgets. In your proposed business plans, how much have you factored in for wage increases in the next year? What percentage wage increase are you using as an assumption? • 4. We are continuing to use the same assumption as last year, which is 1% wage increase.

Question: How much would 5.1% applied to the Healthcare bargaining unit cost Capital Health going forward? What about the rest of the health care system? (NSGEU has stated that wages

CONFIDENTIAL DRAFT V2 - FEBRUARY 7,2012 NOT FOR DISTRIBUTiON

are the number one issue for their membership this year.) .• First of all, we haven't negotiated

and that they will strive for 5.1% in bargaining

a wage settlement

yet. However, as N5GEU has

already talked publicly about 5.1%, it is a fair question. • For the Healthcare bargaining unit at Capital Health, it represents approximately more a year. • If applied to all remaining bargaining units, including Healthcare, at Capital Health, it represents approximately • • The estimated $12.4M more a year. $8.5M

cost of 5.1% to the entire health system would be in excess of $42M.

Let's be clear. This isn't about how much of 5.1% will Capital Health have to cover and how much the province will cover. Ultimately, can afford to pay significantly there is only one place that our funding comes from, and that is the taxpayer. So, Nova Scotians need to ask themselves if they more to maintain services.

When you factor in that we also have to reduce spending by 3% and absorb wage increases - this would likely result in reduction of services.

5.

Question: Are you trying to balance your budgets on the backs of health care workers? What about the costly and bloated administration • of9 separate districts and the IWK?

We have a saying in the healthcare system, that we are people caring for people. That is not a platitude. It is the truth. We value our people.

But another truth is that we have a finite amount of money to deliver care. We have to control costs and find a balance.

And yes, that includes administration. size and cost of administration.

Over the past two years, we have reduced the represents 5.1% of the total

Currently, administration

cost of the health care system. That is below the national average of 5.2%. • And we are continuing to look for savings in administration and support services,

through the shared services initiative. • This is not about focusing on one area to balance the books. We have to look everywhere. contribute 6. Which is what we are trying to do through bargaining. Everyone has to to the solutions. because you are asking

Question: Isn't the reason you have such costly sick time and overtime them?

your employees to do too much, just as you are cutting back their budgets? Isn't this unfair to

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DRAFT V2 - FEBRUARY 7, 2012 NOT FOR DISTRIBUTION

The reality is we must all look at the way we work. The agreements previously were focused on different forward system. and anticipate conditions the needs of our patients and the affordability

negotiated of the health care

and challenges. Today, we have to look

Yes, we are asking our staff, our leaders and our physicians to work differently. in a period of significant

We are

change - which is challenging us all to look at what we do and

how we do it, to ensure our practices and behaviours are serving the changing needs of our patients, and that we are respecting taxpayers by using their money wisely. 7. Question: You haven't even sat down to bargain yet and you are out making public statements, isn't that bargaining in bad faith? • Not at all. The NSGEU has already made public statements number one issue of importance 2011/2012 • about wages being the

to their members, and that the 5.1% increase is "a

target we will strive for when Locals 42, 19, and 426 begin bargaining for their (and beyond) contract years". that the public know where we are coming from and what we are

We feel it is important

trying to accomplish as a system. • The situation is different this time around. With 50 collective agreements that will need

to be negotiated •

this year, we must approach bargaining as a whole system.

What we are doing is ensuring that we act like a system and that we don't ignore the bigger picture.

In the past, it has been too easy to just focus in on just one bargaining unit. But what happens at one table affects the whole system.

8.

Question: You say that the many separate agreements have resulted in inequalities employees and inefficiencies in service across the various organizations. Wouldn't be to reduce the number of DHAs!IWK? • • • That is not for me to say. That would be a government decision.

among the solution

What we have to focus on is what we can do here and now to control health care costs. Approaching collective bargaining as a system is part of the solution.

9.

Question: You say that you want to treat all employees equally across the districts - now that the NSGEU nurses at Capital Health have won an arbitration than the other settlements same increase? award that gives them 5.1% more reached last year, aren't the other bargaining units entitled to the

CONFIDENTIAL DRAFT V2 - FEBRUARY 7, 2012 NOT FOR DISTRIBUTION

We have to find a balance between supporting for the entire system.

our employees and what is affordable

• • •

The reality is that 5.1% is not affordable. This would represent an increase in excess of $42M a year. When you factor in that we also have to reduce spending by 3 per cent and absorb wage increases - this would likely result in reduction of services across the districts and IWK.

Reactive only - if employer

proposal is released publicly:

10. Question: We have been hearing for years that there is a shortage of skilled health care workers, including nurses. You are proposing eliminating retention bonuses for RNs and LPNs - won't that have an impact on your ability to provide patient care? • These are issues that are still to be discussed at the negotiation not proper to comment at this time. • OPTIONAL: That reality no longer exists. At Capital Health, we have been unable to hire new graduate nurses and other health professionals there are no vacancies. • OPTIONAL: Our system currently has contradictory incentives. We invest in educating positions, because we have financial into permanent positions - because table next week and it is

new nurses whom we can't hire.into permanent

incentives in place to retain nurses who are nearing the end of their careers. 11. Question: If your overtime is so high, doesn't that mean that you have a shortage of health care workers? Why don't you hire more, instead of spending so much on overtime? • These are issues that are still to be discussed at the negotiation not proper to comment at this time. • OPTIONAL: Overtime is used to fill shifts left open by sick calls, and when we have very sick patients who require more resources than would typically be scheduled. Overtime is necessary to ensure we are responsive to the changing needs of our patients from day to day - however, it is our responsibility affordable. 12. Question: If you are successful in getting concessions from the unions, how much do you hope to save the health system? to ensure it is used properly and remains table next week and it is

CONFIDENTIAL DRAFT V2 - FEBRUARY 7, 2012 NOT FOR DISTRIBUTION

These are issues that are still to be discussed at the negotiation not proper to comment at this time.

table next week and it is

OPTIONAL: Let me clear - there is no one single action that will make the health care system more affordable. We all have to work together. Some actions are about reducing costs. Others are about being more efficient with how we use current resources. And, others actions are about managing the growth in costs over time - so they don't escalate beyond what we can afford to pay.

OPTIONAL: It is important costs better.

to recognize that non-wage items in a collective agreement

can have financial impacts. We are trying - as a system - to manage those financial

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