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Amidst what is being called the worst nursing shortage in our history, thousands of highly educated and skilled Filipino nurses are being recruited into Canada. They are brought into this country to work under the Live-In Caregiver Program (LCP) not as nurses, but as nannies and 24-hour home support workers, providing a marginalized source of cheap labour that furthers the movement toward private health care.
Denying the presence of these nurses, the media, government and nurses' regulatory bodies are creating a climate of panic about a nursing shortage. Hospital beds are closing, people are pushed out of hospitals earlier, and less operating room time is available. This makes private health clinics, purported to reduce waiting time and increase quality of care, seem like the only way for people to access necessary health services.
But what does privatization really mean? Instead of health care being about a basic human right to health and wellbeing, it is an industry driven by demand for profit. In a private system, health is about the bottom line.
Signs of privatization in Canada — including private clinics for procedures not covered by our medical plan, and long term and senior care facilities — already exist. User fees are being charged for more and more essential services. In British Columbia, Medicare premiums can cost more than $400 per person each year.
Due to nursing shortages in hospitals, patients are released while still in need of medical attention. With massive funding cuts to home support, private companies step in, making care available to those who can afford it. These companies benefit from the accreditation barriers faced by foreign-trained nurses. "Once they found out I am a nurse in the Philippines, they have me doing all of the most complicated medical cases like working for patients with muscular dystrophy. Yet they only pay me a third of the wages a nurse makes," explains Andres, a member of the Filipino Nurses Support Group.
Because the Citizenship and Immigration Canada point system does not give credit for being a nurse (professionals are upposedly plentiful in Canada), the Live-In Caregiver Program (LCP) is often the only option for Filipino nurses wanting to immigrate. Driven out of their home country because of chronic unemployment and desperate poverty they, along with other Filipino women, make up the majority of those who enter Canada under the LCP.
The program brings foreign workers into Canada to do child care, cleaning and home support for wealthy families. Under the guise of helping Third World people gain citizenship, it creates a pool of highly skilled, yet low-wage workers to use in private health care, providing well-off families with their own private nurses and home support workers for as little as $700 per month.
Under the program, Filipino nurses are given temporary immigration status and required to live in their employer's home for a minimum of two years. "Because of the LCP requirements, we become responsible for our employers 24 hours a day, but we are only paid for eight - with no overtime pay. For some of us, we accompany our employers to the hospital and even sleep there at our employer's bedside," says Mayette Laureano, a nurse and domestic worker under the LCP.
Motivated by the $3.5 trillion that is spent globally on health care every year, privatization is being pushed by international bodies like the World Trade Organization, International Monetary Fund and World Bank. In the Philippines the IMF-World Bank has demanded that, as part of their imposed austerity programs, the government stop spending money to provide health services. The government is selling hospitals to private, often foreign, companies making health care even more unaffordable to the people and increasing the pressure on health care workers. Some nurses, on their own, are responsible for 80-100 patients per shift.
The Free Trade Area of the Americas would accelerate opening health care across the Americas to private interests. Under this agreement, for-profit health companies would be eligible for government funding just like public hospitals and health care facilities. In Alberta, under NAFTA, the passing of Bill 11 means that private health companies are allowed to compete for government funding, to open for-profit facilities, and to sue for compensation if they are not allowed to open.
The Canadian government has refused to change immigration law, particularly regarding the LCP. Why? Because it decreases public costs and responsibilities, and allows the presentation of a 'balanced budget.' Government benefits from globalization policies that create poverty in Third World countries. Their people can be used as an inexpensive labour source, such as in undercompensated live-in work.
Nurses' regulatory bodies have been very slow to address the nursing shortage. Instead of advocating on behalf of foreign-trained nurses, and encouraging recognition of their skills and qualifications, the Registered Nurses Association of B. C. recently announced it "feels pressured" to lower standards for nursing practice in order to ease the accreditation process. Scapegoating foreign-trained nurses for worsening the state of health care diverts public attention from privatization of the health care system.
Recognizing the need to expose unjust treatment, the Filipino Nurses Support Group (FNSG) was formed by the Philippine Women Centre and SIKLAB, an overseas Filipino workers organization. Since 1995, its members have been actively organizing, educating and mob-lizing to gain recognition for foreign-trained nurses, to end exploitation and to fight against privatization. The Filipino Nurses Support Group believes health is a human right. Health is not for sale!
Rachel Rosen is an advocate with the Filipino Nurses Support Group. FNSG can be reached by phone at (604) 255-6870
or e-mail:pwc@attcanada.bc.ca.