Thank you, Madam Chair, and good afternoon. My name is Sheri Oliver and I'm the director of Strategic Nursing Initiatives with the Registered Practical Nurses Association and we're known as RPNAO.
As I suspect many of you already know, the RPNAO is the voluntary professional association for registered practical nurses within the province of Ontario who are registered to practise in Ontario under the Nursing Act of 1991 and the Regulated Health Professions Act of the same year. The RPNAO is also a member organization of PN Canada, the national professional organization for practical nurses. We appreciate the opportunity to be here today.
I would like to brief you about one of Ontario's practical nurses and, in doing so, perhaps correct some of the misunderstandings that we characteristically encounter.
As I've indicated, registered practical nurses are regulated health care professionals and are known as RPNs in Ontario. In other jurisdictions you will know practical nurses as LPNs or licensed practical nurses. We constitute the second largest regulated health care profession. In Ontario both RNs and RPNs share the same statutory scope of practice and study from the same body of knowledge.
While you will find both RNs and RPNs in all health care sectors, they differ primarily in the populations with which they practise. Those differences relate to the depth and breadth of education received, and I'll speak more to the availability of education in just a moment.
Since January 1, 2005, new graduates applying to register to practise as an RPN with the College of Nurses of Ontario must have a two-year diploma in nursing from a community college of applied arts and technology. Across Canada there are over 64,000 practical nurses, of which half, 29,000, are from Ontario.
Now, with that as background, I would like to recount some of the issues facing the profession that are relevant to the Standing Committee on the Status of Women. Ninety-four percent of RPNs are female. As such, we experience many of the challenges that face other female professionals in the workforce, and some are unique.
The majority of RPNs work shift work, weekends, and holidays. Having access to quality, affordable, and flexible child care is an issue consistently raised by our membership. For RPNs, having access to child care isn't a frill or a luxury; it is essential to allow them to practise and to contribute the human resources that our health care system desperately needs.
Financial security is also a major issue for many RPNs. Salaries for the RPN vary widely in Ontario. The best salaries for RPNs are available in hospitals, where a full-time RPN can earn between $42,000 and $47,000 annually, not much in today's economy, especially given the onerous responsibilities that nurses encounter on a daily basis.
Every day nurses face physically and emotionally taxing situations that are inherent to their chosen profession. For example, registered practical nurses working in the long-term care or community sectors have extremely large workloads, practise at high levels of autonomy, yet receive some of the lowest overall wages in provincial health care. But the RPNs who do have full-time employment, especially those who have full-time employment in hospitals, are relatively fortunate in our profession.
This statistic will surprise you, given all you've heard about a nursing shortage, but only 55% of RPNs in Ontario are able to find full-time work. There are about 2,000 in Ontario today, about 7% of the total profession, who are looking for full or part-time employment. Some are currently employed as unregulated health care providers or have jobs outside of health care. This is a chronic problem for our profession. l suspect you'll agree that it makes absolutely no sense during a so-called nursing shortage that much needed health care professionals are unable to find employment within the health care system.
I am sure you can also appreciate the systemic stressors that the lack of secure employment has on their own personal health, the well-being of their children, and attempts to balance personal and professional lifestyles as we encroach deeper into a sandwich generation. Our members describe the ability to find secure full-time work in their profession while controlling their overtime hours as their most important work life aspiration.
The Government of Ontario has put financial incentives in place to increase full-time employment opportunities for nurses, but the uptake of those initiatives by health care organizations has been greater for the registered nurse, and as a result, their full-time employment has improved at a much greater rate than that of the RPN. In fact, RPNs have seen little improvement in the availability of full-time employment.
Women, as a group, are less able or willing to accept a job or job advancement that will adversely affect their ability to care for their families. Accordingly, female professions must tolerate lower job security, limited career advancement opportunities, and less financial security.
You may ask yourselves how we find ourselves in this very peculiar situation of having a significant number of unemployed or under-employed RPNs in a time of a shortage of nurses. There are several factors at play.
One is a misunderstanding by hospitals and other health care delivery organizations about the competencies of RPNs. In Ontario, some hospitals have decided to implement an all-RN model, believing that this will result in higher-quality care. RPNs who were working in those hospitals were laid off or dismissed outright.
This all-RN model usually reflects studies done in the United States. l must point out, however, that licensed practical nurses in the United States are not educated to the same level as registered practical nurses in Ontario and do not have the same skill sets. Accordingly, those American studies do not reflect the knowledge, skill, and judgment that RPNs acquire.
We know that access to and availability of education has a positive impact on health care outcomes. However, for the practical nurse, educational opportunities related to collective agreements, child care opportunities, lack of employment recognition, and barriers in the educational system limit the impact these nurses can have and, in turn, are less able to manage educational opportunities available.
The second factor is that, for a number of historical reasons, RPNs are represented by multiple unions and are usually a very small component of those union memberships. It's completely understandable, therefore, that those unions rarely give RPNs' issues much priority. Registered nurses, on the other hand, have their own union that has focused exclusively on their issues.
The third factor is that RPNs are rarely found in management positions in health care organizations, most particularly hospitals. The heads of nursing are almost always registered nurses, and quite frankly and unfortunately, there's inevitably some intra-professional turf protection.
One final point I want to make, about which women in general encounter in the workplace, is one that is rarely discussed openly, and that is verbal abuse. Particularly in the high-pressure, high-stress environment of health care, verbal abuse directed at nurses and other female workers still frequently occurs. The ability to withstand verbal abuse is seen to be part of your job description as a nurse. Few nurses complain about or report verbal abuse, because doing so may be career limiting and because few health care organizations have effective reporting procedures or whistle-blowing protections in place. The same challenges exist in reporting verbal abuse to the professional regulatory bodies. So verbal abuse continues to be an unfortunate part of the job for nurses.
Madam Chair, I've almost exhausted my 10-minute allocation, so I shall stop now in order to leave as much time as possible for questions.
Thank you for your time.
Thank you to the committee.
The conference was a rousing success. If we seem a little tired, it's because we were running hard for the last three days, getting that finished. Thank you, again.
I'm going to talk a little bit about the numbers of women in teaching, and then move from that into a more general look at women in terms of society in general, and then turn it back to John for some of our suggested remedies.
In 2003-04, 67% of full-time Canadian teachers were women and 78% of part-time Canadian teachers were women—Stats Canada figures, and they relate with ours as well. It's interesting to note that 57% of male teachers in the 2001 census reported earnings of $50,000 or more compared with only 37% of female teachers at the same time, for the same education. In 2001, 26% of male teachers earned under $40,000 compared to 26% of female teachers.
Lower average salaries of female teachers result in lower average pensions for female teachers, so that not only is there less buying power currently in their career, they are also saddled with this lower economic status for the rest of their life and their pensionable service.
It's interesting to note that women occupy only approximately 45% of school administrator positions in spite of the fact that they represent 67%. That fact alone is also one of the factors in why their salaries are lower, because of course, administrators receive an allocation, a bonus for being administrators.
That's changing gradually. In our elementary schools we're seeing more women become administrators. But it's still true that it's a male-dominated profession at the high school level.
The average earnings of employed women are still substantially lower than those of men, even when they're employed on a full-time basis. In 2003, women working full-time, full-year, had an average earning of $35,000—71% of what their male counterparts made.
Women are more affected by chronic unemployment than men, particularly female lone parents. Lone women had the highest degree of volatility in earnings of any family type during the last two decades, as noted by Stats Canada.
Earnings over the past two decades have been stagnant for men, increasing in 2000 for the first time since 1980. The good news is that in contrast to that, earnings have increased steadily in each decade for women. So some of the work that committees like yours have done and the work of the teachers' and nurses' associations has begun to bear fruit. However, despite gains in earnings over the past two decades, women still earn less than men, not only in teaching but right across the board.
Women have made gains in employment because of increased hours and weeks of work, and notably because they have invested heavily in higher education, leading to better-paying occupations. Income of women in the early years of their careers, though, is affected by many factors—child care, access to unemployment, provisions for top-up from such things as maternity leave, and of course, bearing the brunt of their children's educational costs.
Therefore, the cuts in programs like the status of women program and the literacy skills that have happened over the last little while have definitely reduced the probability of improvement of circumstances for women and other groups. As John mentioned earlier, we believe that programs focused on helping children will do much to help those women as well.
I'll turn it back over to John for some of our suggestions.
:
As an organization, we have been long saying that early intervention and enhanced learning opportunities at early ages are keys to long-term prosperity and social cohesion for all Canadians. In that regard, programs and services that strengthen families are the targets we attempt to advocate for.
We think it's important to take a very, very close look at what we are doing in Canada with respect to child care. We would argue that the reinstatement of the funding agreements reached with the provinces and territories to establish 100,000 more child care spaces is a laudable goal. It should be a target for any government.
We have major concerns with respect to the funding of first nation child welfare agencies. We would recommend strongly that they be funded so they can deliver community-based in-home support and prevention services to their clientele.
We are now entering an era where greater numbers of immigrant and refugee children are entering our schools. The demographics of the country would lead us to conclude that this is not a short-term phenomenon but one that we will be facing for many years. Schools need assistance. Parents, teachers, and students need assistance, particularly in resources for English and French as second language school programs, but also including programs for teachers and parents that address cultural differences and language skills building.
We have long held that increased access to unemployment benefits for maternity, adoption, and parental benefits will have a significant impact on the economic security of women in their younger years. We would also like to see a greater degree of encouragement at the policy development level for the growth of top-up provisions in contracts of employment. When you lose that portion of income at the front end of a career, it impacts all those benefits that one would accrue along the way. That is why female teachers--even though the pay scales are the same as for male teachers--will have an average income that is below male teachers.
We are suggesting an increase in the drop-out provisions of the CPP/QPP for those who leave the labour force to raise children under the age of seven. We have reviewed recent studies that show that women still contribute much more time to household duties than men. In addition, they are more intensively engaged in elder care than are men. Sheri's comment about the sandwich generation was interesting. That's precisely where we are.
We believe that assistance for elder care is a significant component of the economic security for women, particularly in the 40- to 60-year age group. Increased access to family care leave benefits under the employment insurance program would help considerably in this regard, as would additional recognition for drop-out time under the CPP/QPP. If drop-out time is legitimate for addressing issues related to young children, it should be equally legitimate for addressing drop-out periods for elder care.
Senior widows outnumber senior widowers four to one. As measured by Stats Canada, many senior women slip into low income as a result of widowhood and stay there for a longer period of time than others. We believe changes can be made to the CPP to avoid that, or at least minimize it. One of them is that where a retired contributor to CPP/QPP dies and leaves a surviving spouse, the spouse should receive a survivor's benefit that is unaffected by any other benefit paid to the individual under CPP/QPP.
I will stop there, Chair, and look forward to questions or comments.
:
Thank you, Madam Chair.
Thank you for your presentation. All of you were very good.
It's not an easy area to solve, because it's very broad and many different pieces affect it. You have women's economic security, and I think we all agree with that, just from the three who have presented today.
I want to start off with Ms. Oliver, with respect to the RPN part-time work. One of the reasons that were given when the agreement with the provinces on our child care was dropped was that we needed a system that gave everybody choice, so that women who worked nights or days or shifts could then choose where they liked to put their money. This is why we have the $1,200, which is taxable, as you know, and it doesn't create spaces at all. No spaces have been created since.
Can you tell me a little bit about the reality? You mentioned the dire need for child care, but can you address the part-time aspect of it specifically and what structure would help in that context, keeping in mind that when the national government funds child care, as we did under the agreement we had before with the provinces, we don't dictate how to deliver; it's more or less a broad objective.
:
Thank you, Madam Chair.
I want to thank Madam Oliver for her testimony. It has been interesting and nuanced. But I want to actually address my comments to the Canadian Teachers' Federation.
You talk a great deal about equality, but there's one intellectually inconsistent element to your organization that I'd like you to address in a moment. A second problem that your organization, I think, needs to address, the intellectually inconsistent basis for your organization, is that one of your members is a Catholic Teachers' Federation.
We all know that in the province of Ontario the government funds Catholic schools. It's the only religious denomination funded in the province of Ontario, yet you say you support a strong public education system. That's intellectually inconsistent. It's inconsistent, pointe finale.
Ontario is the most diverse population in the country. Toronto is over 50% visible minorities. We have a situation where we're funding Catholic education—you're supporting that because one of your members is a Catholic organization—but we're excluding other Christian denominations, we're excluding parochial schools of the Muslim faith, of the Jewish faith. So it's interesting for you to appear in front of the committee and talk to us about equality, but that's a gross example of inequality, something that's been highlighted by the United Nations as well.
Either you truly believe in public education and you fund only a single public education system to the detriment of all religious denominations, or in a society that's becoming increasingly diverse, rapidly changing, you fund all parochial schools, whether they be of certain Christian faiths or Muslim faiths or other faiths.
That's one intellectual inconsistency that I think needs to be pointed out, because you do say you support public education, you do say you believe in equality.
The second thing I point out is my belief that society needs to encourage equality of the sexes. I think that's very important. I think it has been a key determinant of societies; an indicator of societies that are good is societies where women and men have achieved or are in the process of achieving equality. But I suggest that one of the big challenges facing your organization is a lack of diversity, a lack of minority representation amongst your members, and I'm interested to hear what initiatives you're undertaking—
:
Thank you, Madam Chair.
Thank you very much for your presentation, Ms. Oliver. I would just like to tell you that I am quite aware of how difficult your job is. I worked for three years in a public health centre for the elderly as a social worker, and I had to manage the recall list of registered practical nurses. I can tell you what a puzzle that was and I also know about the precarious working conditions facing registered practical nurses working in public institutions in Quebec. It appears that these conditions are similar in Ontario. You have my full respect, and I think you are right to be fighting for better working conditions from your provincial government, because your problems do come under provincial jurisdiction. You want to be able to offer better services to people in institutions and to those who need your health care services.
I can try to explain this whole debate here about child care services—which I find quite surprising. What we see today—and you have a concrete example of that—is a collision between two different approaches. With the money it is paying the children, which, in my opinion, is more like a family allowance, the government is definitely helping families make ends meet, but it is in no way ensuring the economic security of women.
I have three children and they went to a child care facility. When I started sending them there, I was paying $200 a week, or 50% of what I was earning. When Quebec introduced $5-a-day child care, my economic capacity as a woman improved considerably. Under the program, I then paid $50 a week for my two children. So I had more money left to spend on their education, their clothing and their housing needs.
There is a certain lack of understanding between the government side and the parties on this side of the table. Day care centres in Quebec and elsewhere were established by women; not by the government, but rather by Quebec women who wanted to have access to the labour market to improve their economic security so that they would not have to depend on the father of their children in order to survive. That is a battle that women have waged, and I do not think that Mr. Harvey is aware of this fact.
Women established a network of child care centres, and the women working in them fought to improve their own wages, because they too were workers. We should emphasize that the Quebec child care network has not been in place that long as a public institution. We have a fine network that meets women's needs, allows them to improve their economic position and to join the labour market, and this is thanks in large part to the women of Quebec who fought to establish this network.
I worked in the area of health care in Quebec for 20 years, and when I hear people such as Mr. Harvey say that people should not feel negative impacts because of the reductions at Status of Women Canada, because the money has been invested in front-line services, I realize that for me, the expression "front-line services" means emergency food and other services, truly direct services. I think women need to learn to fight to express their rights, to speak out against abuse and to believe in their importance in society. Unfortunately, they still need support in all these areas.
I have just one question for you, Ms. O'Haire and Ms. Oliver. You have an opportunity to speak to the five Conservative members of Parliament. Speaking as women, and not as practical nurses or teachers, what demands would you like to make to the federal government, which is suppose to be listening to you? What type of measures would really allow women to improve their economic security?
:
Thank you, Madam Chair.
I understand some of the statements that are being made, but two wrongs don't make a right. The reality is that the Human Rights Commission, which has been dealing with all of these appeals, in fact stated that the legislation is ineffective because they haven't been able to deal with it. Women at Bell have now been fighting for 25 years, practically; the post office for as long. I know you say that there are others, more staff. It's still complaint based. It will take forever to do. The Human Rights Commission itself has said that.
While I understand that people talk about the cuts of the early 1990s, we can go on that little record for a long, long time. The reality is that we had found a $42 billion deficit. The cuts were made, but things were changed. On top of that, the former Prime Minister made a commitment to introduce legislation in the fall of 2005. Well, in the fall of 2005 we unfortunately went into an election.
That doesn't change the fact that two ministers and the former Prime Minister made that commitment. It doesn't change the fact that the current legislation, which is complaint based, is ineffective. It doesn't change the fact that the Human Rights Commission has said it doesn't work because they can't work with it. And it doesn't change the fact that two provinces have proactive legislation where in fact it is working, whereas the rest of the country doesn't.
Quite frankly, I think it's time to move on. Thank you.
:
It's a very big issue, because members on this side of the House take pay equity very seriously. I don't want to throw stones, but the previous government had 13 years to do this and it wasn't done. We did study it. We did study it here in the Status of Women. We all agreed this was very important. We put the report in the House, and if you look at the reply when we tabled the report in the House, it did not make a strong commitment at all.
I would say that this report was done, and this is what we looked at. When we went into government, we found out that we already had a lot of the things that we needed in place, but the actual implementation was not there. Our minister got busy, and he implemented—We had dead legislation in the House of Commons, where no implementation program was put into place.
Having said that, I applaud some of the initiatives of our Quebec members. When they talk about what they've had, I would like very much to take a look at what they've had.
We will have to vote against this motion, because we have the pay equity up and running and we have the implementation program on the books right now. The minister is very set on making sure that women in the workplace are treated in a very fair and equitable way.
This motion is redundant. We've already had this motion, we've already had the report, we've already tabled the pay equity report in the House of Commons, and right now, with the pay equity initiative implementation plan that's in place right now, we need to see the improvements that are being made. If we go into something like this, it will take absolutely months and perhaps years to get new legislation, whereas now we're acting on what we have.
I would think that we need to table this motion and have more discussion on this so we know what we're doing, rather than going headlong into something that is going to hold up the pay equity, which is extremely important.