Recruitment and retention hampered without a contract
Members of the Manitoba Association of Health Care Professionals union voted overwhelmingly in favour of a strike last month, citing critical and enduring staffing shortages, increasing workloads, increasing patient wait times and at-risk care despite the provincial government’s promise to fix Manitoba’s health-care crises.
MAHCP has about 7,000 members working in about 50 allied health specialties. Its members voted 96 per cent in favour of striking, and the union is currently in negotiation with the government. The union has been without a contract since last March.
Allied health professionals are an integrated and integral part of the health-care system, and the reality is patients don’t get treated without the work of allied health professionals, said MAHCP president Jason Linklater last Friday.
He said the strike mandate can be interpreted as the membership’s overall displeasure with the favourable health-care messaging coming from the government as their workplace realities say the opposite.
“The good news the health minister delivers is not well taken by people who work in health care because they can see firsthand things are not improving,” said Linklater. “MAHCP has 96 per cent in favour of a strike, and I think that says they haven’t seen change happen. This is an ultimate wake-up call.”
Linklater said the union represents a number of allied health professionals who work in the Interlake-Eastern Regional Health Authority, but who are actually employed by provincial Shared Health. Some of those staff include paramedics and diagnostic staff in areas such as laboratories, X-ray, CT and ultrasound. Because Shared Health is their employer, the IERHA is not responsible for staffing or possible delays resulting from staff shortages.
As far as paramedic positions in the IERHA, there are 159.5 full-time equivalent positions out of a total of 228 positions, said Linklater based on his research. That’s represents a 30 per cent vacancy rate that’s “on par” with other regional health authorities. The actual number of paramedic positions in IERHA is slightly higher because part-time positions do exist, but he doesn’t know how many there are.
In terms of delays getting an ambulance because of paramedic shortages, he said he doesn’t have current data for the IERHA. But in 2022, the IERHA had the “worst response time of any region” at the median, which was 18 minutes, and at the 90th percentile, which was almost 50 minutes.
“The response time targets are 15 minutes in rural areas. So that means in 2022, Shared Health wasn’t meeting their target half of the time,” said Linklater.
In the event of a strike, the IERHA would see some disruption such as patients having “routine” blood tests or diagnostic appointments postponed and a possibility that “some mental health and addictions” services” being disrupted, he said. But emergency services would continue. So would lab and other diagnostic procedures that are required in life-and-death situations. Because staffing is already below baseline, many places “already operate like they would during a strike” all the time.
“We absolutely don’t want to go on strike. Nobody ever wants that because it’s bad for everybody,” said Linklater. “That said, essential service agreements are in place to ensure patients won’t be harmed by a possible strike. EMS and paramedics are absolutely essential staff. And since Manitoba is already short the number of paramedics we are – that is, we’re staffed below baseline already – there would be minimal to no reduction in paramedic staffing during the strike. If you call 911, someone will be coming.”
The [NDP] government promised to hire 90 new paramedics in 2024, but hired only seven, said Linklater, and “call volumes have gone up compared to five years ago.”
With Manitoba’s rural areas in rough shape, there are some instances in which there are not enough staff to meet essential service agreements on a normal day, let alone during a strike, he said.
Compounding the staffing shortage crisis is the absence of a contract. Contracts possess inherent power to retain and attract workers.
MAHCP members have been without a contract since March 31, 2024. A survey the union carried out at the end of 2024 showed a majority of respondents citing worsening staff shortages, increasing workloads and plummeting morale. Without a contract, allied health staff could start leaving for greener pastures.
Allied health was without a contract for five years and there was a significant outflow of staff, said Linklater, explaining what has generally happened in the past. When the last contract got implemented, the union saw that hole get plugged and a “slight uptick” in staffing numbers. Although they’re holding fairly steadily as of now – not losing “a whole lot of people” – they’re not gaining staff either.
“We know that the longer our members go without a contract, the worse it’s going to get,” he said. “When this government came in, allied health in particular was told that they [the government] wouldn’t let this happen to them. And they have; we’re approaching a year without a contract again.”
With other provinces or territories experiencing similar health-care staffing crises, jurisdictions need to be as competitive as they possibly can to attract medical staff.
Health-care professionals rely on information to make decisions, diagnoses and inform their medical practice overall, and that mindset is applied to job-seeking opportunities. Having a contract that potential recruits can assess is a way to get eyeballs on Manitoba. No contract is a crapshoot.
“The success of recruitment and retention depends on having a contract. How could you recruit a person to come work in Manitoba while there’s no employment contract in place?” said Linklater. “I’ve seen advertisements for all sorts of allied health jobs, including paramedics, but when [a potential candidate] doesn’t have a contract to look at, how can they make a decision to come to here?”
Linklater said he’s had paramedics call him from the United Kingdom – Manitoba lost paramedics to the U.K. when the National Health Service made positive changes – saying they’d consider coming back to Manitoba, but in the absence of a contract they have no idea whether it would be the right move.
Some of MAHCP’s allied health groups are very small and specialized, he said, and losing one or more members could impact access to service. For example, if Manitoba lost one of its 10 perfusionists – allied health specialists who keep a patient’s blood circulating during heart surgery and without whom surgery can’t be performed – it could have a significant impact on wait times. Because Manitoba doesn’t offer perfusionist training, people who are interested in the career have to move to another province – and they might not come back unless there’s an incentive to do so.
Incentives are another tool the government could employ to attract new allied health professionals, he said. Newfoundland and Labrador, for instance, is offering a variety of incentives to students, graduates and experienced professionals that include signing bonuses, bursaries, travel-related support and salary advances to pursue education, and it advertises those incentives on the government’s website.
Linklater said MAHCP has “encouraged” the Manitoba government to follow Saskatchewan, Alberta and British Columbia’s “proactive” lead and craft an all-encompassing human resources strategy for allied health for the entire province, looking at getting youth education in health-care professions all the way to planning for retirements and so forth, and also come up with incentives that could include paying for education, implementing return-of-service agreements or offering signing bonuses to recruit staff.
As far as a possible strike goes, Linklater said the union is still at the bargaining table for another eight days (as of Jan. 31) but is preparing for a strike.
The Interlake-Eastern Regional Health Authority said its supports a new and fair collective agreement for the province’s employees.
“Interlake-Eastern RHA supports the successful negotiation of a new and fair collective agreement for our province’s professional technical/paramedical sector employees,” said an IERHA representative. “Negotiations are underway and we support the work towards a new collective agreement for these valued health-care staff members.”
A spokesperson for Shared Health said the organisation is “committed to the successful negotiation of a new and fair collective agreement for our province’s professional technical/paramedical sector employees. While we won’t publicly comment on specifics of active negotiations, we remain at the bargaining table and continue to work towards a new collective agreement for all of these valued staff.”
