Like their comrades elsewhere in the country and around the world, health care workers in Quebec are currently leading the front-line battle to contain the COVID-19 pandemic. And as in other countries, they have been sent to the front lines by capitalists without the necessary protective equipment and without sufficient resources. While the epidemic is just beginning in the province, a shortage of masks is already being felt. A large number of nurses and orderlies have been exposed to the virus because of the bourgeois state’s scandalous mismanagement and lack of preparation, and several of them have already contracted the disease. The situation is unprecedentedly serious. With the pandemic, the general chaos engendered by capitalism is exacerbated and this is manifested vividly in the health care system. Workers in the network are currently bearing the brunt of the bourgeoisie’s inability to respond to the needs of the masses and to organize work rationally.
Nurses and orderlies are forced to work in unsafe conditions
Since the beginning of the state of public health emergency in Quebec, nurses and orderlies have been sounding the alarm and expressing their concern about their working conditions and, above all, about the lack of protective equipment they have at their disposal. As early as March 13, the nurses’ union, the Fédération interprofessionnelle de la santé du Québec (FIQ), said it feared a shortage of N95 masks (the most effective masks to protect against the virus). The union also deplored the lack of information about the virus given to workers in hospitals and health care institutions – a lack of information that shows a total lack of preparation on the part of provincial authorities and puts health care workers at risk.
FIQ Vice-President Linda Lapointe said at the beginning of the crisis that the pandemic would highlight the problems that have long been present in Quebec’s health network: “It just goes to prove even more how the network is being stretched to its limits. We never have any backup”. It should be remembered that over the past two years, nurses and orderlies had mobilized throughout the province to denounce “mandatory overtime” and the irrational management of the work force by the network’s administration. To protest their grueling and inhumane working conditions, they had taken spontaneous work stoppages and sit-ins across the province. Already exhausted by the exploitation to which they were subjected by bourgeois managers in normal times, the nurses and orderlies were therefore preparing, with the declaration of the state of emergency on March 14, to have to work under even greater pressure and in even more difficult conditions. A week later, on March 21, they received a real slap in the face: the Minister of Health and Social Services, Danielle McCann, issued a ministerial order extending the authority of the management of institutions in the health network and allowing them to make changes to work schedules, leave and workforce mobility, among other things. Among the workers in the network, this was a real shock wave. While they were ready to go to the battlefront to fight the virus and serve the population, the bourgeois state was pulling out the heavy artillery and preparing to bring them to heel… and this, at the very moment when the Prime Minister was hypocritically thanking his “guardian angels” in his press briefings!
In the meantime, the workers have begun to denounce several dangerous situations related to COVID-19. For example, many pregnant nurses asked to be removed from emergency and first-line care. Employers’ instructions were contradictory: because pregnant women’s immune systems are weaker than average, pregnant nurses were advised not to be in the same room as a coronavirus-infected patient. But patients arriving at triage could very well be infected without anyone knowing it. On March 17, the FIQ demanded that the government remove pregnant nurses from the emergency room. But it was only on March 30, after the union had to negotiate with the bourgeois state to ensure that a minimum of protective measures were put in place, that the government finally agreed to satisfy the demand. Thirteen days therefore elapsed between the time the demand was made and the time it was finally heard – thirteen days too many in which nurses were forced to work at great risk to their health. In addition, some institutions have been slow to implement the new measures since they were enacted. In fact, on April 3, we learned that a pregnant nurse had contracted COVID-19 at her workplace and that she had been in contact with several of her colleagues who were also pregnant.…
In the meantime, nurses and orderlies were beginning to express their concern about the lack of protective equipment in hospitals, CLSCs and CHSLDs with increasing frequency. On social networks, testimonies of dangerous situations were multiplying. And these workers were not the only ones who were worried. On March 24, a bourgeois newspaper reported that emergency specialists had been imploring the government for five days – without success – to tighten the safety protocol in emergency rooms. According to them, the protocol in place was completely inadequate to the situation. Indeed, because of government directives that only patients “with risk factors” should be treated in isolation with protective equipment against infected droplets, many patients with COVID-19 were being treated by hospital staff without proper protective equipment, i.e. without yellow body jackets, waterproof gloves and protective masks with visors. According to the president of the Association des spécialistes en médecine d’urgence du Québec, some hospitals refused to give masks and equipment to their staff. The day after the article about this situation appeared, under pressure from emergency specialists, the government agreed to change the protocol. All patients with “infectious symptoms” would now be isolated and treated by staff equipped with “droplet” protection. However, the problem of lack of equipment was far from being solved.
Increasingly, nurses also began to complain that they had to manage the cleaning and disinfection of their uniforms themselves. Because hospitals did not offer such a service to their employees, they were forced to take their potentially contaminated uniforms home, putting their families at risk of becoming infected with the virus. On March 20, a bourgeois newspaper reported these words from the president of the Chaudière-Appalaches section of the FIQ, Laurier Ouellet: “We don’t have an answer and we’ve been after them for a week. ». Finally, it was only 10 days later, as part of a six-month agreement between the FIQ and the Québec government, that the latter agreed to require employers to provide and clean uniforms in “priority sectors”, including emergency, medical-surgical, intensive care, respiratory therapy, imaging, pneumology, clinics and units dedicated to COVID-19, as well as CHSLDs where there is an outbreak of infection.
Meanwhile, the lack of protective equipment in the province’s hospitals, CLSCs and CHSLDs was leading to increasingly absurd and dangerous situations for workers. Some CLSC nurses making home visits even had to make home-made masks out of fabrics and filters recovered from vacuum cleaners. One of them, a nurse from a CLSC in the Laurentian region, said: “We are desperate for protection measures that are almost non-existent in our workplace. Equipment is given out in dribs and drabs. ». Nurses from a Montreal CLSC also complained that they do not have access to gloves or disinfectant for their home visits. A growing number of unions have begun to denounce the flagrant lack of N95 masks, waterproof suits and other protective equipment for many employees at risk of contracting COVID-19. Concern also began to emerge that the guidelines were not the same in all facilities. According to FIQ President Nancy Bédard, the guidelines are constantly changing and contradict the basic health instructions learned by the nurses. On March 26, the FIQ denounced the lack of protective equipment in the CHSLDs, where there were not enough masks and gowns. Commenting on the fact that nurses are reduced to making their own equipment, the union’s vice-president stated that “it’s like being in an underdeveloped country”. She also said, “On the one hand, we are told that there is equipment, but it is kept under lock and key because there have been thefts, but the last three or four days make us think that there is not that much. “The fact that the lack of equipment is so glaring in the CHSLDs is certainly not unrelated to the fact that a large number of these institutions have been contaminated by the virus. In fact, on March 31, the government revealed that 184 of them were infected.
To date, the government’s criminal negligence has already led to the infection of several health care workers. On March 29, we learned that some 20 employees of the Hôtel-Dieu de Lévis, including a pregnant woman, were removed from their workplace after coming into contact with a patient infected with COVID-19 when they were not wearing protective equipment. When she was admitted to the hospital, the patient in question was not showing symptoms of the disease, which shows that the criteria for having access to protective equipment are ridiculous. On March 30, a similar case at the CHSLD de Lasalle was reported in the media. On April 2, the Canadian Medical Association (CMA) stated that the shortage of masks and protective supplies was far greater than what governments were claiming and that it was putting the lives of health care providers at risk. The next day, April 3, Quebec’s Ministry of Health and Social Services announced that a total of 204 health-care workers, including 148 in Montreal, were infected with COVID-19 in the province. And this is only the beginning: the wave of patients expected during the week of April 13 that could overwhelm hospitals has not even arrived yet!
All this time, the FIQ was trying to negotiate with the bourgeois state to obtain minimum protection measures for nurses. For several days, the government stubbornly refused to listen. On March 28, the FIQ denounced “today’s refusal to negotiate exceptional measures for an exceptional situation,” a refusal that it described as “a low blow, which threatens the entire health and social services network, already weakened by years of catastrophic reforms and cuts. ». Nancy Bédard, FIQ president, said: “The Premier calls them his guardian angels. And yet, again this morning, he is unable to ensure their safety”. It was not until March 30, 16 days after the health emergency was declared, that the FIQ managed to get the government to take basic protective measures, such as having employers take responsibility for cleaning uniforms and removing pregnant women from health care facilities. The fact that health care workers must pressure and negotiate with the Quebec government to obtain minimum protection measures shows just how ridiculous the dominant media discourse on François Legault and his role as a “good father” is: within a family, children generally do not have to fight against their parents to obtain what is essential to their survival! In truth, even in this period of health crisis, the Quebec state continues to be what it is, a capitalist state, a “boss state”, an exploiter state. And despite the fact that the Prime Minister keeps calling health care workers his “guardian angels”, the Quebec state continues to unscrupulously exploit them.
With the complicity of the media, the Legault government is lying to the public about the stocks of masks available
The lack of protective equipment and especially the lack of masks in the health network has emerged as the central issue and the main problem afflicting the workers. Until very recently, the Prime Minister kept telling the media that the situation was under control, that the stocks were well filled and that there would be no shortage of equipment. This was an obvious falsehood, in complete contradiction to the testimony of workers in hospitals, CLSCs and CHSLDs. However, the government’s message was nevertheless being widely disseminated by the major media to the population. According to journalists and political commentators, it was impossible for the government to be wrong, since it was in the process of saving Quebec from disaster. The truth is that the government could not admit publicly at that stage that there was a lack of equipment, as this would have highlighted the fact that he had not prepared for the arrival of the coronavirus in the province, despite the fact that everyone had witnessed what had happened in China and that it had been clear since January that the threat of a devastating pandemic was imminent. He had to conceal at all costs the fact that his management of the health crisis was a dismal failure in order to avoid the emergence of a protest movement among the masses. The government therefore lied openly to the population and the media followed up. Moreover, since the beginning of the crisis, the media have perfectly played their role as a propaganda apparatus and a transmission belt for the official discourse of the bourgeois state, allowing the ruling class, with remarkable efficiency, to transform in the petty-bourgeois perception the complete bankruptcy into exemplary and heroic management!
But the government knew that it could not silence the voices of health care workers forever, whose testimony contradicting its version of events was beginning to accumulate. On March 25, after several days of intensive government and media propaganda to sell the idea that the government had done everything right, the Prime Minister began to say that there had been problems with the distribution of materials in some facilities, although there was no shortage of equipment across the province. On the other hand, to justify the fact that the protective equipment was under lock and key and to divert attention from the fact that the equipment was being rationed, Health and Social Services Minister Danielle McCann began to use the excuse that there had been thefts from hospitals. This version of events was widely reported by journalists. For example, on Radio-Canada, star presenter Patrice Roy began to assert that there was a slight “distortion” between the statements of those “from above” and the reality on the ground in the hospitals, while pointing out that the government was “full of good will” and suggesting that the problem would be resolved quickly….
Then, on March 31, the Prime Minister’s speech changed completely: all of a sudden, the masks were going to run out in three to seven days! We also learned that the Quebec bourgeois state was engaged in a frantic race with other states around the world to obtain protective masks. So it became clear that the government had been lying from the beginning. But the pressure had become too great and the cat was out of the bag. From the beginning, health workers were forced by the capitalist state to work in dangerous conditions and to put their lives at risk. Following the press briefing on 31 March, a few orders arrived in the province, but the margin available to the network before stocks run out is still about a week. The situation is extremely worrisome, not only for the health care workers whose lives are in danger, but for the masses in general, who could be deprived of care in the event of a situation where masks and other protective equipment are no longer available.
The shortage of masks and capitalist anarchy
Despite the Premier’s attempts to reassure the public and health care workers, the truth is that the province’s supply of masks and protective equipment is now completely uncertain. Capitalist anarchy and aggravated international competition could mean that the country will not be able to secure its supply of medical equipment in the medium term. The government says it is doing everything it can to avoid shortages, even paying cash (!) for shipments of masks and having them escorted by the police. But action should have been taken before that. Bourgeois politicians (both provincial and federal) are trying to convince us that they were “caught off guard” and that it would have been impossible for them to predict the current situation. Yet they had a window of at least two months to react before the virus arrived in the country, not to mention the fact that the health care system should have been prepared a long time ago for the possibility of a pandemic like the one we are currently experiencing. Moreover, in this regard, it should be noted that the Quebec government did not have a national reserve of medical equipment useful during an epidemic (surgical masks, N95 masks, gowns, gloves, etc.) before the current crisis began. To justify this choice made by the Quebec State, the spokesperson for the Department of Public Security, Louise Quintin, invoked the fact that the equipment in question has expiry dates! This is a completely bogus explanation: all that would have been required would have been to periodically drain part of the stored stock into the health network and replace it as it was needed. In addition, federal Health Minister Patty Hadju admitted in a press conference on April 1 that Canada’s emergency reserves were not sufficient to deal with a situation such as the COVID-19 pandemic, and that successive governments in Ottawa had not invested enough to prepare the country for future public health crises. In other words, to avoid having to spend too much, the bourgeois state compromised the security of the majority of the population.
Despite the fact that the reserves were not sufficiently full, governments could have invested heavily early in the year to replenish stocks of equipment in anticipation of the approaching epidemic. Why didn’t they place large orders earlier? Furthermore, we know that Quebec and Canada have the industrial capacity to produce the necessary medical equipment, since the provincial and federal governments have just reached an agreement with capitalists in Quebec and Canada to convert their plants to be able to manufacture this type of equipment. Why was such a reorganization of national industrial production not carried out as early as January, when it was already clear that the virus was going to spread across the country? The answer is clear: it is because the decisions taken by bourgeois politicians are dominated by the law of maximum profit and not by the need to meet the needs of the masses. Moreover, it must be remembered that under the conditions of bourgeois private property, it is impossible to set up a real production planning on the scale of the whole society. This means that rapidly reorienting a country’s production to meet a specific need is practically impossible. Today, it is the health workers and all the proletarians contaminated by the virus who will pay the price. In a planned economy led by the proletariat, it is clear that a large number of factories would have been reassigned to the production of medical equipment before the epidemic began.
The health care system in bourgeois society
As the FIQ stated, Quebec’s health care system was “already weakened by years of catastrophic reforms and cutbacks” before the pandemic began. Workers in the network were working undernumbered, in overloaded teams and with indecent schedules. Hospitals were overcrowded and under-resourced. In particular, the number of hospital beds was insufficient. Buildings were dilapidated and deteriorating. Thus, the current situation of the nurses and orderlies who were sent to the front without the necessary protective equipment did not come out of nowhere: it is in continuity with what is happening all the time. The pandemic has simply added to the usual chaos and inefficiency, creating new challenges and problems.
To understand the underlying reasons behind the state of the public health care system in Quebec, we must look at the real function of the health services provided by the bourgeois state under capitalism. In other words, instead of focusing on the decisions of this or that bourgeois politician (for example, the famous Barrette reform), we must seek to understand the objective role played by the health care system in a society where the engine of production is the pursuit of private profit. On the surface, the system serves to care for the population and keep it healthy. But if things were that simple, it would be necessary to explain why the capacity of the system is always below the real needs of the masses, even though we live in a rich and prosperous society. In truth, under capitalism, the public health system does not serve the well-being of the proletarians, but rather to maintain exploitation and the accumulation of profits. The health services provided by the bourgeois state serve, on the one hand, to ensure minimum public hygiene in order to prevent the process of capital accumulation from being constantly threatened by general health crises and, on the other hand, to ensure that the health of the proletarians does not deteriorate to the point where the capitalists could no longer buy their labour power for profit. The bourgeois state therefore does not aim to keep the proletarians healthy, but only to ensure the conditions for the proletarian class to continue to work and reproduce. This is why the financing granted by the bourgeois state to the health care system is minimal and this is why governments do not hesitate to cut services when the interests of big capitalists demand it.
Of course, the workers employed by the bourgeoisie to provide care have nothing to do with it and do their best to ensure the well-being of patients. But these workers constantly come up against the limits of a system that is not organized to meet the real needs of the masses. For example, nurses and orderlies are forced to work in difficult and exhausting conditions; there are not enough of them and they lack resources, which prevents them from providing care as they would like and as the real state of health of the proletariat would require. The bourgeoisie puts them in an unbearable situation that can only seem completely absurd to them: they are asked to care for people, but they are not given the means to do it properly, even though money is flowing at the top of society, if the problems are perfectly known and if the solutions would be easy to put in place!
Since the health care system put in place by the bourgeoisie is not organized according to the needs of the masses, it can hardly cope properly (from the point of view of the proletariat) with an extreme situation like the one we are currently living with the COVID-19 pandemic. The bourgeoisie, through its political executive, will deploy all the energy it can to protect itself from the virus and to keep bourgeois society in place. But it will do so at the cost of great suffering among the proletariat and the popular masses. It will do so by sacrificing a large number of workers – particularly those in the health care system, which it has sent to the front as cannon fodder. In 1918, during the infamous “Spanish flu”, one out of every four nurses in the U.S. died of the disease. The efforts of the bourgeoisie were then completely deficient. There was a shortage of beds, medicine and, above all, personnel: the imperialist war was still going on and nurses had been sent en masse to the front. Obviously, conditions are not the same today. Medicine is more advanced and hygienic practices have evolved. In Quebec, we are not in a situation where the population is weakened by years of war, as was the case in many countries in 1918. Also, the virus we are facing is different. But let’s not forget that the capitalist system in which we live is still the same as it was 100 years ago: a system incapable of organizing work rationally and meeting the needs of the masses.
Support the immediate demands of nurses and orderlies!
Let’s denounce the criminals in power whose negligence has put the lives of health care workers at risk!
Let us prepare to fight for a society organised in accordance with the needs of the masses, for socialism!