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PubMed1996

The future of health care in six European countries: the views of policy elites.

A recent study was made of the views of politicians, representatives of trade unions, business organizations, and others likely to be influential in policy making, on the future of health care provision in six European Union (E.U.) countries. This article discusses the findings. While common problems of rising cost resulting from population aging are recognized in all countries, the way these issues are interpreted and the policies seen as appropriate to tackle them differ. Views are strongly influenced by the organizational structure of the existing provision. This supports the "new institutionalist" view that policy feedback plays an important role in shaping policy reform. It also indicates that the potential for convergence in E.U. social policy is more limited than suggestions that the single European market will lead to an "ever closer union" might imply.

Attitude to Health↗
PubMed1984

Collective bargaining and strikes among physicians.

UNLIKE EMPLOYEES IN OTHER SECTORS OF THE ECONOMY, HEALTH CARE WORKERS ARE DIRECTED TOWARD ONE ULTIMATE GOAL: making people well and keeping them healthy. The development of collective bargaining and union activities during this century has had a great impact on all industries in the United States and the western world. However, only in recent years have workers in the health care sector been affected by the organized labor movement. The history of collective bargaining and strikes among physicians, the key decision-makers in the health care sector, is even more recent. Because of their central position, physicians' collective activity has had and will continue to have tremendous implications for the viability of the present health care system and the quality of patient care. Even though most physicians continue to function as individual, entrepreneurial service providers and "professionals," physicians as a group are more frequently being seen as members of a utility like industry. Their importance to individuals and society as a whole, it can be argued, is second to none; if physicians refuse to work there can be no worse set of outcomes. To estimate the potential future impact of growing collective action on the part of physicians, this article explores the general historical developments.

Allied Health Personnel↗
PubMed2004

Unintended consequences: two critical events from the 1960s and '70s and their legacy for nursing in Ontario.

In the late 1960s and early '70s, two key events occurred in Ontario that greatly affected the nursing profession: the unionization of the workforce and the move of diploma-granting nursing schools out of the hospitals (first to regional schools, then to the community colleges). At the same time, university nursing programs were undergoing significant changes. A paradigm shift occurred in which baccalaureate-prepared nurses were being educated for practice as well as for roles in education and administration. While all these activities had overall positive implications, there were unintended effects that continue to influence the profession today. These include the detachment of employers from clinical nursing education; fragmentation of the profession between front-line staff and the professional elites (proletarianization); rejection by front-line practitioners and college educators of nursing scholarship in favour of experiential and technical knowledge; and rivalry between college and university educators that has hampered the development of effective collaborations. For this study, interviews were undertaken with three informants, and their recollections were considered in the context of documentation from the College of Nurses of Ontario (the regulatory body), the Ontario Nurses Association (the union) and the Registered Nurses Association of Ontario (the professional association).

Education, Nursing, Baccalaureate↗
PubMed1979

Unionism in the health care industry: an overview.

Block profiles the two unions that are the most active in organizing non-nurse health care employees: the National Hospital Union (NHU) and the Service Employees International Union (SEIU). The two international unions present a contrast in structure and ideology. The SEIU is a truly international, decentralized union, whereas NHU is a far more centralized affiliate. As an international union, SEIU characterizes, taxes, and disciplines locals. Its decentralized strategy has been to permit locals to do the bulk of the organizing and collective bargaining, while the national union merely coordinates and offers financial and technical support. Conversely, NHU is an affiliate of the retail, wholesale, and department store union, deriving authority from, paying tax to, and subject to discipline by the parent organization. Its centralized approach has been for national officers to determine when a district will be created and what its jurisdiction will be. The structural differences of the two unions can be traced to their respective histories. As an old-line AFL union, SEIU had an existing structure of independent local unions that operated in health care as they did in other industries. NHU, however, originated as a union of drug store employees and its structure evolved over time. Membership growth and geographic expansion elevated it beyond the status of a local into a division with its own districts. The unions also diverge in their ideology; SEIU takes a more traditional business union approach to collective bargaining and unionism, while NHU is oriented to social welfare, involving itself in more than the work aspect of members' lives. These differences again can be attributed to contrasting histories of the old-line SEIU and the more radical NHU. The authors emphasize that unions are not homogeneous entities but organizations that respond to a similar environment as a result of their respective structures and histories.

Health Workforce↗
PubMed2003

Mondays without dread: the Trade Union response to byssinosis in the Lancashire cotton industry in the twentieth century.

Trade unions have often been criticized for their failure to address occupational health issues. This article explores their response to byssinosis-a chronic respiratory disease caused by exposure to cotton dust that was rife in the Lancashire cotton industry in the early nineteenth and twentieth centuries. Using the archives of the cardroom and spinning unions, it is demonstrated that trade union efforts to combat byssinosis began before the First World War and were sustained for over 70 years. During that period, byssinosis became a recognized medical condition and a compensatable disease, due in no small measure to the trade unions campaigning tirelessly for better dust control, compensation for all affected workers, and more medical research.

Byssinosis↗
PubMed2000

Hospitals and union elections.

This study examines union certification elections in hospitals from October 1994 to September 1997. Results indicate that union win rates were significantly higher in single-union elections and larger bargaining units. On the other hand, union win rates were significantly lower in church-related hospitals and hospitals that belonged to a health care system or had higher payroll costs. Unions also appeared to win elections at a higher rate in this period than in the past.

Collective Bargaining↗
PubMedDate not supplied

A history of union struggles for control of the work environment in Italy.

The article describes, from a diachronic perspective, the struggle to enhance workers' health conditions in Italy throughout the twentieth century. The authors adopt the workers' viewpoint, highlighting the relevance of trade unions' so-called "participatory model," and sketching the recent impact of European legislation on the country's laws.

History, 20th Century↗
PubMed1993

[Collective bargaining and trade unions in nursing].

Nurses are apparently striving towards collective bargaining in order to meet their professional and personal needs. The reasons might be rapid social change and dissatisfaction with values and norms imposed on them. Although the nursing profession has been represented by a professional association since 1914, interest in labour unions is increasing. Various factors, such as administrative practices, support the interest in labour unions. Although labour unions promise a utopia to potential members, membership leads to advantages and disadvantages both for the profession and the individual.

Collective Bargaining↗
PubMed2004

Employee and union inputs into occupational health and safety measures in Chinese factories.

Few studies have addressed the impact of employees' inputs on the protection of their health and safety. The research presented in this paper focuses on Chinese factories and measures employees' evaluation of the effectiveness in OHS issues of their enterprise trade union and staff and workers' representative congress (SWRC). The data for the study draws upon a national survey of employees of enterprises in manufacturing industry conducted in 1997 by the All-China Federation of Trade Unions. The study finds that the input of the trade union and SWRC does have a significant impact on the protection of the workers' occupational health and safety.

China↗
PubMed2003

Individual unionization decisions: a multilevel model of cost-benefit influences.

An important part of the unionization process is predicting the individual's vote for or against union representation. We proposed and tested a multilevel model based on the relative importance of costs and benefits of representation. Regression statistics from within-person analyses were used to show the influence of perceived costs and benefits on judgment policies about intent to vote in a representation election. Using these statistics as outcome variables, between--person analyses were used to show the influence of decision frame on cost-benefit influences, in which framing a vote as one for or against the union was conceived as a contextual variable in an election. Results were used to extend prior unionization research and to suggest how employers and unions may attend to framing effects in an election.

Adolescent↗
PubMed2001

A closer look at the relationship between justice perceptions and union participation.

In this study, a series of nested models was tested to assess the extent to which the relationship between process-related justice and union participation is mediated by perceived union support and union commitment. Members of a steelworkers' local (N = 615) participated in the study. Fit indices most strongly supported a fully mediated model. Unlike previous research, process-related justice was operationalized as 2 distinct variables: procedural and interactional justice. Interactional justice was found to have a substantially stronger relationship with support perceptions than procedural justice. Results also indicated union support accounted for a greater amount of unique variance in union commitment than perceived union instrumentality. The results are discussed in relation to trust theory and the generalization of organization science across different types of organizations.

Humans↗
PubMed1999

Collaborating for breast health education and research. A university, industry, and community agency partnership.

Initiating a collaborative health education program about breast health required talent, expertise, and workload contributions from all involved including university researchers, a regional breast screening agency, and local industries. The credibility and opinions of liaisons or key informants were valued highly, and their support was critical to the success of the project. Participation in any collaborative project is predicated on benefits perceived by each of the partners. The community agency reaped the benefits of greater dissemination of their educational materials through the interventions. The project increased corporate and union awareness of the resources of this agency and in this community. Throughout the project, meetings and telephone conferences were held on a weekly or biweekly basis with the liaisons. Liaisons disseminated updates to management and union representatives.

Adult↗