Paramedics’ Place in HSAA - The Union of Healthcare Professionals
What is a Union?
Let’s start with the basics to get everyone on the same page. What is a Union? The simplest definition is that a Union is an organization of workers who join together to maintain or improve the conditions of their employment. I want to emphasize that a Union is comprised of workers. Never think of a Union as a 3rd party that is separate from the workers. Unionized labour relations are not a triangle between the employer, the workers, and the Union. It’s still just the employer and the workers, however the workers band together as a Union to fight for themselves. Some people may suggest that a Union is a business and Union dues are “membership fees” paid by workers to receive a service. This is not so. Our Union, HSAA, is comprised of over 30,000 healthcare workers. Without those 30,000 workers, there is no HSAA. The workers are HSAA. We are HSAA. It stands to reason that any of our complaints about HSAA are a call to action for us to change how HSAA operates.
Unions are important because they are the only way workers can have power. As individual healthcare workers, we do not have any power. The power of workers comes from large numbers. A great analogy is breaking pencils. One pencil is easy to break, but a large handful of pencils is much harder. A Union turns powerless individuals into a powerful group. Power is an important concept for us to think about. Everything a Union does is about power. Either gaining it or exercising it.
The Organizational Chart of HSAA
I love using this chart to reinforce the idea that workers are one and the same with our Union. You will notice that the members of HSAA are at the top of the organizational chart. A Union is one of the only organizations in the world where the rank-and-file members are at the top. This is because the members comprise the Union, so of course they are the highest-ranking authority. Members democratically elect representatives and decide what matters the Union will focus on. If members want a Union to change, they can accomplish it through the established democratic processes of the Union. A Union is ultimately only as strong as it’s members.
Where Do Paramedics Fit in with HSAA?
I think it’s important to recognize that as paramedics, we are healthcare professionals as well as first responders. Political changes to healthcare administration and policy greatly effect our jobs and livelihoods. We are also employed by a large healthcare authority. Therefore, it makes sense for us to join forces with other healthcare workers to form a Union. We are lucky that our profession has great representation amongst the Executive of HSAA. Our president, Mike Parker, is an Edmonton paramedic. Two Edmonton District Board members are Edmonton paramedics. One Central District Board Member is a paramedic. One Calgary District Board Member is a paramedic. Our AHS bargaining committee has two paramedics on it, including one from Edmonton. Everywhere you look within HSAA, there are paramedics present and fighting for us. But how many paramedics are in HSAA?
In March of 2024, the top 5 largest professions in HSAA were[1]:
1. Laboratory Assistant 3,401
2. Primary Care Paramedic 2,093
3. Laboratory Technologist 2,064
4. Respiratory Therapist 1,482
5. Advanced Care Paramedic 1,481
You can see from these numbers that the combined total of Lab Assistants and Technologists outnumber the total of PCPs and ACPs. Furthermore, these numbers show that out of approximately 30,000 members, paramedics make up about 12% of the HSAA membership. I demonstrate these numbers to further establish the idea that being a part of HSAA gives paramedics more power than if we were in our own Union. The power of workers comes from large numbers. Our power is greater when we are part of a group of 30,000 as opposed to 3,500. As it stands, our profession has a disproportionate amount of representation in the Executive of HSAA, which gives us a large and powerful voice within our Union despite only making up 12% of the membership.
I strongly believe that we need to abandon any thoughts of leaving HSAA. Notwithstanding the logistical and legal hurdles that would entail, we are still better off focusing on changing HSAA from the inside to address our Union’s shortcomings.
[1] HSAA 2024 Annual Report
Q. Why is it stronger for us to be in a union with other healthcare fields with little to no overlap with our own, and whose goals in a negotiation may even contradict our own?
A: I really want to have these discussions. I believe that it all comes back to power. The power of workers comes from large numbers. Our ability to pool resources with other healthcare professions gives us a stronger voice to combat powerful institutions like provincial governments and AHS. Interestingly, we can draw a case study from here in Alberta of what happens when a small group of healthcare workers leaves a strong union to start their own. Nurse practitioners have started their own union that is separate from UNA. Most people have never heard of the nurse practitioner union because they are small and lack power to accomplish anything.
I’m worried that paramedics would face a similar fate if we left HSAA to form our own union. For starters, we would have way less money collected from union dues. This would make it difficult to hire staff to run the day to day operations that come with a union. We would have less money to help us with bargaining and fighting legal battles that inevitably arise. We would be easier for politicians and AHS to ignore. Because it’s easier to ignore a small group than a big group. Any actions that we took to mobilize would not be as powerful. Think about the difference between 30000 people simultaneously participating in a mass action as opposed to 3500.
Additionally, I would argue that other healthcare fields are aligned with paramedics on almost every front. We all want a strong public healthcare system, we want fair compensation for our labour, we want safe working environments, we want to be able to retire one day, and ultimately we want to be treated with respect and dignity. Everything we fight for as a union is some variation of these aligned principles. Furthermore, I acknowledge that we are unique as paramedics and we face many challenges other members of our union don’t face. But I would suggest that we are not uniquely unique. Every profession and worksite has specific challenges that only apply to them. I believe that it is the job of those individual professions and local units to organize together to address those issues themselves as opposed to relying on “the union” to save them. When I think of challenges like violence against paramedics, end of shift OT and bio breaks being denied. The solution isn’t to find a different union that will fight those battles for us. The solution is for us to realize that we are the union and we need to come together and fight those battles ourselves. It’s not other healthcare professions that hold us back, it’s our own inability to organize as a collective unit and fight for ourselves.
I will also point out that we are very well supported by other healthcare professions in our union. If you take the time to talk to our fellow union members, everyone wants to see paramedics get treated better. It’s a well known issue that our pay is below professions with similar education and scope. And no one I’ve ever met in HSAA advocates for that. It’s our employer that repeatedly refuses to address it. Moreover, at convention in May 2024, there was a resolution proposed to have HSAA try to get a supplemental pension for EMS due to our shorter average career length. Our EMS delegates were worried that no one would vote for it because it was too EMS specific. Much to our surprise, several non EMS members spoke in favour of the resolution and it passed with almost 100% voting in favour. Another great example of the support we receive from our fellow union members.
I want paramedics to start driving change from within HSAA. Just because we don’t have our own union doesn’t mean we can’t use the resources of HSAA to fight for ourselves. A union is only as strong as its members. So the solution is never to start a new union, the solution is to strengthen our current union by organizing at the rank and file level to maximize power.
Q: Don’t we need to have our own union to have our unique needs addressed?
A: I would argue those specific things in the contract in the EMS index are a great example of how we can still address our unique needs while belonging to a larger collective bargaining unit. We don’t need to have our own union to have our unique needs addressed.
A lot of the changes that we want to see for paramedics have failed to materialize because AHS refuses to accept them. However, we often mistakenly blame our allied healthcare professions in HSAA for “holding us back”. When in reality they would be glad to see us get what we deserve.
I’m suggesting that if all we do is leave HSAA and change the name of our union that AHS will continue to refuse to listen to our paramedic specific demands (because they ultimately don’t give a damn about us). A better solution is to use our collective power to start applying pressure to AHS to give us what we want.
I’d love for us to come together as a profession and start a campaign showing the public how rampant violence is against paramedics and why we deserve hazard pay. If we have a good enough plan, we could even ask the board of directors for funding to help us fight this battle. And we could use the communications resources of HSAA to spread our message. We could start religiously filling out msns for everything and drawing attention to how much time paramedics miss due to workplace injury. But these efforts require maximum participation and effort from us. We can’t keep shopping for different unions that will fight these battles for us. We will always be disappointed.
Belonging to a large and established union amplifies our voice. It doesn’t weaken it. We can join together with other professions to fight for common goals while also maintaining autonomy to fight our own specific battles.
