Heavy machinery has begun the destruction of forest and parkland to erect a $3-billion “mega-hospital” at Dow’s Lake. According to the Ottawa Hospital website, the 2.5 million square metre building will be “the largest and most important health-care infrastructure project in Ottawa’s history.” The new facility will also be the first hospital built in Ottawa since the amalgamation of the Civic, General, and Riverside Hospitals by Mike Harris’ Conservative provincial government in 1997. It will also be the first to be built on the “private-public partnership” model (the same model used for Ottawa’s last mega-project, the disastrous LRT line). Cameron Love, President and CEO of the Ottawa Hospital (TOH), has described the project as “a new civic crown jewel for health care in this city.”
“One day our society will come to respect the sanitation worker if it is to survive, for the person who picks up our garbage, in the ﬁnal analysis, is as significant as the physician, for if he doesn’t do his job, diseases are rampant. All labor has dignity.”
— Martin Luther King, Jr., Memphis, March 18, 1968
Ask the rank and file workers at the Civic campus of the Ottawa Hospital, however, and you will hear little enthusiasm for the new construction. Instead you will find disillusionment and distrust in an employer which for many years was heralded by the National Capital Region’s Top Employers List as one of the city’s best bosses.
I say this based on the personal experience of working as a cleaner at the Civic Hospital. What I have discovered about the inner workings of the Ottawa Hospital administration has convinced me to come forward as a whistleblower, in order to expose abuse, misconduct, and neglect within the system.
Doug Ford is the public face of healthcare privatisation in Ontario, but in Ottawa, Cameron Love is quietly advancing the privatisation agenda — by introducing secretive private orthopaedic surgeries at the Riverside Hospital, for instance — and failing to control wasteful and detrimental practices in the hallways of our hospitals, at significant expense to patients, workers, and taxpayers alike.
Far from being the result of lazy or burnt out staff, the failures of the Ottawa Hospital are the direct result of an administration that is viciously attacking its employees — especially so-called ‘low-skilled’ workers — and treating patients as inconvenient bodies that must be fed, cleaned, and discharged at ever-increasing rates of profit.
Under Cameron Love, TOH claims to be “Creating Tomorrow” for healthcare in Ottawa. Yet every day it is destroying the working conditions of its employees, worsening outcomes for patients, and wrecking the legacy of generations of hardworking people, in order to entrench corporate control and maximise profits.
And if corporate administrators such as Love are allowed to control our hospitals and healthcare systems, the result will be a broken-on-purpose system riddled with inefficiencies, wastefulness, and corruption. There will be no care remaining for the public, only private services for the rich.
Milk and Money Down the Drain
One of the most obvious and shocking examples of systemic disorganisation and waste in the hospital is seen in the Food Services department. I worked in restaurants while attending so-called-Ryerson’s School of Journalism two decades ago, and hospitality became a parallel career to my journalism work.
“There is so much waste… Even the recycling, it’s all going in the garbage.”
Based on my experience and observations and discussions with fellow workers, I believe the Civic Hospital discards thousands of dollars per day in unused foodstuffs. This includes scores of unused Sealtest milk cartons, full cans of ginger ale, unopened cereal boxes, masses of unused creamers and other single-serving items such as salt, pepper, and sugar packets, tea bags, instant coffee, peanut butter, jam, syrup, and margarine. Expensive dietary supplements such as Boost, Compleat, Ensure, Resource 2.0, and Novasource Renal are also regularly wasted.
Combined with the General and Riverside campuses, the sum total of discarded foodstuffs generated by the Ottawa Hospital must be enormous and egregiously expensive. There appears to be no systems in place to control food waste, and workers are required to discard masses of unused foodstuffs — including all liquids such as unused milks, which must be opened and dumped.
“All the containers of milk and juice, they all need to be emptied and poured down the drain but we don’t have time,” says Bree,* a former Civic food services worker with decades of experience in healthcare. (*All source names have been changed to protect their identities.) “If we did our jobs properly it would take so much longer.” Workers are further monitored by CCTV to enforce the threats of dismissal should they take anything.
The industrialised foods supplied to patients are also questionable, especially hyper-processed foods full of sugar and preservatives. The first item on the menus workers use to prepare patient trays is almost always “Sugar,” followed by other items containing sugar such as jam, biscuits, cookies, single-serve Jello and pudding, fruit salad and juice. So much sugar cannot be healthy for patients but must be a boon for corporate profits.
Regardless of its nature, however, all food delivered to TOH patients is prepared off-site, leading to higher costs, more waste, and less healthy outcomes for patients and workers.
The industrialised food supplied to TOH is not just unhealthy, it is also over-packaged. Almost every item on an average patient tray at the Civic is wrapped in single-use plastics and most cutlery is disposable. “There is so much waste,” Bree decries. “Even the recycling, it’s all going in the garbage.”
The amount of waste generated by this corporate food system is shocking to behold — not to mention hazardous for workers to collect, transport, and compact for disposal. And who knows where it all ends up and what such waste will do to the environment over the long-term?
Overpackaging also makes mealtimes more challenging for patients and workers. For example, the majority of patients struggle to open sealed items such as single-serve Kellogg’s cereal, requiring more staff time and labour.
For those workers who deliver food trays to the in-patient units, the workload has increased significantly due to a new food delivery system. The hospital allegedly spent more than $300,000 on portable food warming machines that have made it more difficult and strenuous for workers to deliver food to patients and return the trays and waste. Food services workers who were already under enormous time pressures and exposed to injuries on the job are now required to work faster on longer routes.
“Everything is timing,” Bree explains. “From the dishroom it all works in a circle. If we’re late (there), then the cold room is late, everything’s late, then the trays are late going up (to patients).”
As a housekeeper, I have personally witnessed an increase in food waste due to the new system, especially as it fails to account for the movement of patients within the hospital. Because of perpetually-strict time limits, food trays may also be taken away before the patient has eaten. “Either patients are asleep or they’re gone for tests and their food is gone,” says Bree, who experienced this phenomenon first-hand as a patient. “The trays get taken away and they come back and have no food.”
Hospital administration appears to be undeterred by the increase in waste and threats to worker health and safety posed by the expensive new equipment, despite complaints from workers and an apparent increase in workplace injuries.
Housekeeping House of Cards
Food services is just one department suffering under Cameron Love’s regime. Support services workers in general are under attack, particularly Housekeeping, a department that has for many years been systematically abused, neglected, and understaffed.
Not only are cleaners at the Civic working under abusive and deteriorating conditions, we also face the consequences of decades of funding cuts. Most of our equipment is decrepit or outright broken — especially basic equipment such as mops, brooms, wet-floor signs, cleaning carts, and garbage bins and carts. And because of staffing shortages and poor in-house laundry system, crucial items such as mop heads are often unavailable, while cleaning rags are delivered still damp by the overworked person attending to the dilapidated laundry machines.
“When it happened a third time I knew I had to report it… I can’t be getting assaulted at work.”
For Civic housekeepers, every shift begins with a search for mop heads, which are hoarded by workers and supervisors because there are never enough. It may seem like a minor complaint, but workers have quit because of this lack of basic supplies, which is a source of constant stress for the remaining staff.
The practical result of generations of budget cuts, abuse of workers, and neglect of facilities is plain for anyone to see: a dirty and decrepit hospital. The Civic might have been recently declared an “Exemplary Standard” by Accreditation Canada, “an independent, not-for-profit, 100% Canadian organization” which according to its website “delivers a wide range of high-impact assessment programs for health and social service organizations.” Yet the process of assessment and on-site inspection does not seem to include metrics on basic cleanliness, otherwise the Civic would fail.
Dust and grime are visible to anyone who enters the hospital, but staff areas are particularly neglected. As I wrote to Love himself in a letter dated December 3, 2021, “the majority of staff areas in the hospital—nurses’ stations, staff lounges, and staff bathrooms—are in need of systematic deep cleaning.” I proposed a solution, and a meeting was set up with my manager at the time. (There have been four different housekeeping managers at the Civic in the last 22 months). My suggestion was ultimately ignored, and the acting manager, Michael Lajuene, was subsequently promoted to director of the environmental services department — despite coming from the labour relations department and having zero employment history or practical experience in the work of actually cleaning the hospital.
In short, the Civic is not dirty because we cleaners are lazy, but because successive administrations have systematically abused and mistreated us as the lowest of the low within the hospital hierarchy. And since the pandemic, the Love administration has reduced the number of housekeepers and changed the nature of our work.
According to a ‘master list’ of job codes — made available by administration after workers such as myself persistently demanded it — there are currently 174 full-time and 70 part-time positions in the housekeeping department at the Civic Hospital. Yet a check of the actual number of scheduled employees shows 131 full-time and 32 part-time workers.
According to our schedule, there are currently 129 casual workers, almost double the number which is considered to be the ideal number by veteran workers I spoke to. More casual workers mean fewer hours for workers and less job security.
The loss of full and part-time jobs and workers is being felt in all support services departments, not just housekeeping. As more workers retire, the hospital is failing to rehire their positions and is instead choosing to fill the shifts with casual workers who don’t get benefits or job security as a result. There is a constant stream of retiring support services workers leaving the hospital whose jobs are not being replaced, a phenomenon that will cause significant internal crises throughout the hospital.
I can personally count at least one or two retirements per month since I joined the hospital in June of 2021, and the rate seems to be increasing as workers become more fed up with the collapse of our working conditions. Tragically we have also lost workers who have passed away, such as Stephen Matthews, a veteran transportation worker who was beloved by patients and staff alike.
Besides retirements, certain categories of workers are being quietly removed from the ranks by Cameron Love’s regime, in what can best be described as a purge of ‘undesirable’ and marginalised workers. I personally know of at least ten full-time housekeepers who have been pushed out the door recently because of long-term injuries — often sustained on the job — that required the workers be placed on “modified duties” and receive a second worker to assist them.
“They were all full-time workers, so of course they (Admin) want to let them go,” says Mae,* a long-time Civic support services worker. “They’re saving the money and putting it in their pockets.” Many veteran hospital workers such as Mae believe administrators get year-end bonuses from the savings on labour costs. When I asked a CUPE 4000 representative about the matter of administrative bonuses, he acknowledged the long-standing rumours but told me there was no evidence of the practice.
Workers who are struggling with mental health issues are also being targeted for abuse and dismissal by TOH administration, despite stated policies that espouse care and compassion for hospital employees. The worst case I am aware of, in which a worker was systematically abused and then dismissed, happened to a housekeeper who started at the same time as me.
“Things started to go wrong when I started speaking about incidents and things I was seeing, like sharps (needles) being left out,” according to Wes,* who says he was told by a supervisor not to file a report. “Then six months later they came back to me (saying) ‘we need you to do that report’… I was met by a supervisor that stood over me the whole time, intimidating me while I was writing the report about her. And I asked her to leave.”
Wes said he began experiencing incidents of harassment from supervisors, including one man in particular slapping Wes on the back several times. “When it happened a third time I knew I had to report this. I can’t be getting hit at work. I can’t be getting assaulted at work.” According to Wes, the response from the acting manager at the time, Michael Lajuene, was “dismissive,” and the Occupational Health and Safety department was similarly unhelpful. “When I started reporting how I was feeling and talking to Occ Health and telling them how I was feeling… they did nothing.”
Although the Occupational Health department supposedly exists for the benefit of workers, in practice it seems the system is failing. For example, Wes’s situation became worse after Occupational Health got involved. In February 2022, an Occupational Health nurse called Ottawa Police Services to execute a mental health “wellness check” on Wes.
“The police showed up, I then called a lawyer, and then the SWAT showed up,” he explains. “They put me in handcuffs outside my unit, right at the door in the hallway.”
(Wes is not the only worker I am aware of who had a so-called wellness check by police imposed on them by Occupational Health. Another worker, a senior nurse, told me of being forced to take anti-psychotic medication after complaining to Occupational Health about depression and anxiety.)
Later that day, the same OH nurse called and offered to place Wes on medical leave for a month. Following this, he was not returned to the schedule. One year later, after several meetings between the union and the employer in which he repeatedly asked to be returned to work, Wes received a letter of termination from the Ottawa Hospital, citing job abandonment as the reason for his dismissal.
“I just want to go back to work,” Wes maintains. When the union raised the prospect of compensation, Wes responded, “I don’t want money, I just want to go back to work.” Wes continues to demand his job back. Meanwhile the supervisor who Wes accused of abuse, Agron Ahmeti, has temporarily transferred out of the housekeeping department but continues as a TOH administrator, despite accusations of abuse — such as intimidation and targeted harassment, constant criticism and trivial fault-finding, stalking and spying, threats of future discipline, and more — levelled against him by multiple workers at both the Civic and General campuses.
As I wrote in my own letter of complaint against Agron, dated June 7, 2022: “I am aware that many of my coworkers have similar feelings and experiences when it comes to being supervised by Agron. I am also aware that formal complaints against him have been lodged by other workers. So it is fair to say that hospital Administration is well aware of the problem and yet Agron’s behaviour remains apparently unchecked. On the contrary, he seems ever more bullish and unapologetic… To put it bluntly, maintaining such a supervisor as Agron makes a mockery of the claim that housekeeping staff are appreciated by hospital Administration.”
Problematic Tech Solutions
Newly hired housekeepers at the Civic are also being victimised if they speak out or are too persistent in asking for shifts or clarifications from supervisors. After giving up a full-time supervisor position at Tim Hortons for a casual housekeeping attendant job at the Civic, Jill* found herself struggling to get more than two shifts per week at the Civic. When I started in housekeeping, in June 2021, I was told I would be scheduled for a minimum of two shifts per week, and if I wanted more I could ‘bid’ on two additional shifts, for a maximum of four shifts per week. According to Jill, new hires are apparently being promised four shifts per week.
Workers bid on shifts using a digital application called Vocantas, which shows available shifts and “temporary full-time” positions. In theory the worker who has the most seniority wins the bid and gets the shift. But in practice the system hasn’t worked for many employees.
Supervisors armed with black lights searching for dots of invisible UV ink are literally overlooking unidentified stains on the walls, perpetually grime-covered floors, and staff areas that rarely get a good cleaning.
During the first weeks of her employment, Jill could not get access to the Vocantas app, despite using her TOH login and password as instructed. The training coordinator suggested she talk to the supervisors, who directed her to Staffing. “So I called Staffing, left a message, left another message, message, message… I knew there were shifts.” Jill’s partner Jack* is a support services worker at the hospital and has access to the staffing app, so she could see the app and the jobs available. As she says, “I’m willing to work, I want to work” yet she could not find a way to pick up shifts.
After less than five weeks of employment, Jill was ushered into a conference room and handed a termination letter. “I didn’t even bother reading it because it just said ‘We regret to inform you’ and all that. And I was like, ‘what the hell is this?’ So I asked them why. And they said, ‘when you were talking to the supervisors and when you were calling in to Staffing for the extra shifts it came up as being too aggressive and they thought of it as being threatening.’”
Jill says she was also accused of being “very rude” and “dismissive” to supervisors. Despite paying union dues from the moment she began working at the hospital, Jill was told by the attending CUPE 4000 representative that nothing could be done. “This was Valentine’s Day, and I had started on the ninth (of January) so just over a month. And she’s like, ‘you’ve only been here a month, there’s nothing I can do for you, so I don’t even know why they called me in, so I’m just going to leave’. And it’s like, ‘good luck’. So they came back in… and then I was like, you know what? Here’s my ID, goodbye, I’m done.”
Says her partner, Jack: “She was crying when she got home. I woke up because I was doing overnights… and I thought it was a joke that she got let go.” I personally was enraged when Jack told me what happened to Jill, particularly because I know all too well the supervisors involved, none of whom can be trusted.
Jill’s story is just one of literally countless workers who are being chewed up and spat out by the Civic administration. It is also an indication that some technology introduced by the hospital is failing in its intended purpose and causing chaos for workers.
Vocantas was being introduced when I started at the Civic in June 2021. For Jill and many other workers, Vocantas has not worked as well as promised, leading to significant stress and frustration as the app fails to perform or even load for newer hires and casual employees who use it most. Less than two years after Vocantas was introduced, TOH has announced a replacement staffing app, UKG Dimensions, to be adopted in 2023.
Also used by employees of the City of Ottawa, the UKG Dimensions app is owned by Blackstone Group, a transnational private equity company. In 2019, the Intercept accused Blackstone CEO, Steve Schwartzman, of being a driving force behind Amazon deforestation.” According to Intercept reporter Ryan Grim, Blackstone-owned companies Hidrovias do Brazil and Patria Investimentos “have wrested control of land, deforested it, and helped build a controversial highway to their new terminal in the one-time jungle, all to facilitate the cultivation and export of grain and soybeans.”
Also in 2019, Blackstone was further criticised — in a letter sent to Schwartzman by United Nations housing rapporteur Leilani Farha and Business and Human Rights expert Surya Deva — for “using its significant resources and political leverage to undermine domestic laws and policies that would in fact improve access to adequate housing [for people of colour in the United States].”
Another Blackstone-owned company, Packers Sanitation Services, was recently fined $1.5 million for employing more than 100 children as young as 13-years-old to cover overnight shifts at slaughterhouses across America.
Staffing apps are not the only problematic ‘tech solutions’ the hospital uses that are negatively impacting workers and the hospital in general. Housekeeping supervisors conduct audits and monitor workers via so-called modern methods such as “dab audits” and digital workflow.
Like any system, these are subject to abuse and manipulation by authorities. For example, supervisors audit the cleaning staff by “dabbing” patient rooms with UV-fluorescing ink and checking with a black light to ensure the dabs are wiped away during the cleaning process. Workers fail if they miss three or more dabs, and failure can result in discipline, retraining, or even dismissal
There are no limits to the number and placement of the dabs, however, and no standard way that supervisors conduct such tests, making this auditing system demonstrably flawed.
Examples of the misuse of dab tests can be found within CUPE 4000 grievance filings. One of the most ghoulish incidents involved a worker who was disciplined for not cleaning a room in which a dead body awaited transfer to the morgue. “I saw the person died… so I didn’t clean the floor in the patient area, only the bathroom,” the worker told me by text message. The worker was reprimanded by a supervisor, however, and was told “you have to clean around the dead body.”
The dab test is an arbitrary system subject to abuse by the supervisors, and it’s not even a good test for overall cleanliness. Supervisors armed with black lights searching for dots of invisible UV ink are literally overlooking unidentified stains on the walls, perpetually grime-covered floors, and staff areas that rarely get a good cleaning.
Another unpopular and intrusive method of controlling workers is the work phone system known as Epic. Owned by US software company Epic Systems Corporation, Epic is an electronic medical information system that was introduced at TOH in June 2019, “bringing patient centred care to the digital age”, according to the hospital website. Most support services workers are issued an Epic-enabled iPhone at the start of every shift. We must constantly check it for work orders during our shifts, such as cleaning a room after a patient is discharged or transporting patients within the hospital.
Supervisors monitor the Epic system and are able to track the location of workers and how long they take to complete their tasks. Administrators can also use Epic to send messages and assign specific tasks to workers. The system itself monitors the workers and sends automated ‘escalation warnings’ if work orders are not accepted quickly enough. These warnings usually come within 5 minutes of receiving the assignment from a supervisor — or, if jobs take longer than the time assigned in the system, usually 25 to 30 minutes for a full room cleaning.
Workers are not given enough time to complete their tasks and then are subject to discipline both by the automated Epic system — which issues the dreaded escalation warnings — and by supervisors, who are able to use Epic data to interrogate or punish us. A system that is supposedly meant to improve our work flow is instead used primarily to monitor, control, and punish workers, contributing to the ‘Amazonification’ of the hospital’s support services department.
Not only are these apps and workflow systems designed to better control and monitor workers rather than improve ‘work product’, these systems are also owned and controlled by corporate entities such as Blackstone, whose methods and interests do not seem to align with an ethical and effective public healthcare system.
These ‘high-tech’ systems also demonstrate the fact that more technology is not necessarily effective in increasing long-term productivity, especially not when it’s in the hands of abusive or incompetent administrators.
Help Is Not Coming
Unsurprisingly, the reduction of support workers due to attrition, abuse, and atrocious working conditions, combined with administration’s neglect of infrastructure upkeep, has led to a more dirty and chaotic hospital environment at the Civic.
“Even when you try and work your hardest it’s not good enough. They push you and push you.”
Even a cursory inspection of the hallways and patient rooms reveals significant amounts of dust, layers of grime on the walls, and floors that are perpetually stained and unwaxed. Eight full-time workers were once assigned to floor care, but now there are only three for the entire hospital. Floors that are not regularly stripped and waxed are more difficult to keep clean and susceptible to stains that require more intensive labour and specialised machinery to remove.
This feedback loop of neglect and deterioration only serves to make things worse for the entire system. For example, food spills are common and leave floors sticky with sugar and walls perpetually stained. Meanwhile the plastic refuse and other food waste—not to mention medical waste and patient-generated refuse — ends up in garbage bags that pile up in the soiled rooms because there aren’t enough workers to collect the waste.
“I started talking to my supervisor, saying I need help,” says Luke,* a former housekeeper who was often assigned to the waste run. “And that’s when I realised, oh, help’s not coming. Nothing is going to be done about this.” After several months of working full-time on the waste run, and making numerous workload complaints, he suffered a significant workplace injury. His immediate supervisor was on a 5-week vacation at the time.
“They’re fully aware of all these problems,” Luke says of hospital administration. “And that’s probably the most offensive thing. Because once I started asking for help, the refrain was ‘there’s no help, we don’t have the labour, we’re so short-staffed right now.’ And I’ve got a room full of supervisors telling me, the one garbage man, that ‘we’re so short staffed.’”
With more waste and fewer workers, post-pandemic garbage collection at the Civic is significantly more hazardous to workers’ health and safety, which is exacerbated by inefficient delivery of food and medical supplies at the Ottawa Hospital. This waste seems to be ever-increasing, especially in units such as the Offload Medicine Transition Unit (OMTU) where disposable PPE gowns are used exclusively, rather than reusables gowns that are available in the rest of the Civic.
Built to mitigate the pandemic, OMTU’s 50 beds now represent 10% of the Civic’s total patient-bed capacity, and the unit has a high turnover of patients and visitors, similar to the Emergency Department. Alongside the staff, this traffic generates a significant amount of waste, especially gowns and other disposable PPE such as face shields, nevermind wasted foodstuffs and medical supplies.
Waste is not the only by-product of TOH that is directly hurting workers and the environment. The hospital’s linen service is inefficient at best — not least of all because the service is monopolised by one private company, HLS Linen Service, headquartered in the Greater Toronto Area.
The Civic Hospital used to launder its linen in-house, but after amalgamation in 1997, the linen service was outsourced, i.e. privatised. Just like in waste collection, the number of workers on the linen run at the Civic has been reduced by attrition and understaffing, forcing the remaining workers to toil in more difficult and dangerous conditions.
“Especially on Fridays there’s usually missing staff members,” says Zac,* a worker in the Transportation Department. “If someone calls in sick, or if the soiled rooms are packed, it’s impossible to catch up. And then it stays overnight, and for the person in the morning that’s too much and the cycle continues. It’s never-ending, to be honest.”
Because there aren’t enough workers, supervisors cajole and manipulate the workers onsite to do two or even three jobs at once, leading to higher instances of workplace injuries and increased worker burnout and turnover. “Even when you try and work your hardest it’s not good enough. They push you and push you,” according to Zac.
Unlike doctors and nurses, support service workers don’t exist in the media coverage and public discourse about our failing healthcare system, yet we are essential to the functioning of the hospital. Meanwhile, TOH administration is increasingly casualising our employment, not rehiring positions upon retirement, and abusing us — the most marginalised of its workers — all without any meaningful scrutiny from government agencies, medical authorities, the media, the unions, or the general public.
Yet even a casual observer can see that the Civic is a neglected and broken place, where soiled rooms regularly overflow with garbage bags and bags of soiled linen are stacked like avalanches waiting to fall.
Some of the worst areas are not necessarily seen by the general public, however. As I wrote in a follow-up letter to Cameron Love, dated January 17, 2022, “staff areas throughout the Civic hospital are in desperate need of deep cleaning; some areas are outright filthy, especially staff bathrooms and lounges. This is a systematic problem that requires systematic solutions.”
Love’s administration does not seem to care about the cleanliness of the Civic Hospital, however. Perhaps they think it best to allow the facility to deteriorate, as an inducement to build the new hospital as quickly as possible. This policy of neglect is deeply detrimental to workers and patients, however.
The Shameful Sixth Floor
Besides staff areas, the worst examples of administration’s systematic neglect are visible on the sixth floor of the Civic, home to both the Dialysis and Mental Health units.
“The bathrooms were the sticking point as to why I hated being there so much… It was like we were neglected on purpose, almost.”
The sixth floor is one of the busiest in the hospital, with a near constant flow of patients coming and going from morning until just before midnight on Dialysis, and a steady stream of patients in crisis on the Mental Health side. Such high traffic and challenging patients are cared for by an outstanding group of nurses, patient care assistants, and clerks.
The facilities for patients and workers on the sixth floor are deplorable, however. From several conversations with the medical team, I learned that for many years the clinical manager for Dialysis has made persistent appeals to administration to improve the situation, yet the unit remains messy.
The situation is even more grave — and gross — next door to Dialysis, on the Mental Health units. While the rest of the Civic patient rooms have ensuite bathrooms, on the Mental Health wing all toilets are communal. As one can imagine, this leads to suboptimal sanitary conditions.
“The bathrooms were the sticking point as to why I hated being there so much,” says Mel,* a former patient. “Pretty much every time I went to the bathroom the toilet seat would be covered in urine. The toilets were often backed up and not taken care of. Lots of the bathrooms were out of order. The sinks were just disgusting, and overall it was not maintained at the same level as the rest of the hospital. It was like we were neglected on purpose, almost.”
Ideally, cleaning staff should be attentive and responsive to the needs of both the patients and nursing staff. Failing which, supervisors should monitor the work product and hold ineffective workers accountable. But that’s not happening.
“When it came to the weekends and evenings, anytime there was a mess it was just cordoned off or ignored. So that was stressful,” according to Mel. “It seemed that there was a rapid response when it came to making up fresh beds for new patients, but they weren’t really maintaining our beds and the rest of the unit for us in the same way. So they were always ready for the next client, which I guess is necessary, but they weren’t taking care of who was already there.”
Simply put, the entire sixth floor is an indictment on the current and past administrations of the Civic Hospital. The same could be said of the Emergency Department and Geriatrics unit, among others. Even the cleanest part of the Civic, the Mother and Baby Unit, shows signs of systematic neglect as birthing rooms remain uncleaned for hours because there are not enough workers who have received the 3-day training necessary to clean birthing rooms. (And even when they have workers who are trained in cleaning the birthing rooms, those workers are often sent to do other jobs while the birthing rooms sit idle.)
It’s not just the Civic that is suffering from chronically ineffective administration. Next door, the internationally renowned and locally beloved University of Ottawa Heart Institute is increasingly ramshackle, due to understaffing and neglect of support services — resulting in unkempt units, dusty hallways, and mounds of uncollected linen and garbage in the soiled rooms, just like in the Civic.
The Heart Institute does exhibit more outward signs of recent private capital investment than its neighbour. These include the newly-branded “Patrick and Elaine Butler & Family Cardiac Patient Care Unit” and the recent Big Heart Challenge fundraising campaign. There’s also more evidence of corporate affluence, such as the institute’s recent investment in the production of a custom-designed, Monopoly-style property management board game — called “Heart-opoly” — as a corporate giveaway to staff and stakeholders. Yet the actual working environments of the Heart Institute are deteriorating in terms of care and cleanliness. Even after multiple complaints from nurses and support workers about the cleanliness of staff areas, particularly staff lounges and bathrooms, there has been no improvement and no steps taken by administration to address the problems.
Why is this happening?
Cameron Love’s Corporate Coup
Since the COVID-19 pandemic began and Cameron Love gained control of the Ottawa Hospital as President and CEO on July 1, 2020, there has been a significant increase in the number of supervisors and other administrative staff, and an astronomical rise in executive salaries. While the hospital is failing to retain support services workers, TOH is hiring more administrators, paying them higher wages, and failing to control them when they abuse workers.
“I’ve never seen Cameron Love… I don’t even know who the hell the guy is.”
A generation ago, supervisors made slightly more than workers in terms of hourly wage. Today, the starting wage for a supervisor is $36 per hour, which is on par with nurses and $13 more per hour than the workers they supervise. Housekeeping supervisors allegedly received an 11% raise last year, though actual figures for increases in supervisor pay are not publicly available.
The Ottawa Hospital is currently in negotiations with CUPE 4000 on a new contract after the last expired in September 2021. The hospital is offering workers 0.98%, less than the maximum of 1% mandated by the Ford government’s anti-worker Bill 124. And while that legislation is currently being challenged in court, TOH negotiators show no sign of offering higher wages or better working conditions for workers. In fact, exactly the opposite is true.
According to an update from the CUPE 4000 Bargaining Committee that was posted outside the Civic cafeteria a couple months ago: “We emphasized the crisis in staff burnout, job vacancies, and working conditions and directed our proposals to address these. Although things began on an optimistic note, it soon became clear that the Hospital wasn’t interested in taking our priorities seriously without major concessions to our working conditions. Our membership isn’t interested in making additional concessions as we’ve already conceded wages due to the wage restraint legislation of Bill 124.”
While TOH demands wage restraint and concessions from workers, the hospital is hiring increasing numbers of supervisors, most of whom have no idea how to do the jobs done by the workers. Far from being leaders, most supervisors do no productive work and yet each one of them gets paid almost as much as two actual workers.
Direct coordination between support workers and medical workers is how hospitals have been run since they were invented, however. As workers, even the most ‘unskilled’ of us know what our jobs require, and we are entirely capable of coordinating our work with the work of others.
Inserting ever more highly-paid supervisors between support workers and medical workers only serves to protect and insulate the more senior layers of managers, directors, and other bureaucrats within the hospital. In short, supervisors do the work of policing and punishing the workers, while those higher-up the ladder are aloof and seldom seen in the hospital. “I’ve never seen Cameron Love,” says Mae, who has worked at the Civic for almost two decades. “I don’t even know who the hell the guy is.”
Administrators above the position of manager, such as departmental directors and executives, continue to work from home despite ‘earning’ the highest salaries in the hospital and appearing on the Ontario government’s Sunshine List of those who are paid more than $100,000 per year.
Not only are executives generously-paid, they have scored some stunning salary increases, through a mix of raises and promotions, all during a time that staff are being held to raises of 1% or less. As President and CEO, Cameron Love’s salary in 2022 was $647,124, making Love one of the highest-paid healthcare professionals in Canada. (His salary is currently three times higher than Premier Doug Ford.) In the time he has been President and CEO, since July 2020, Love’s salary has increased by more than 35%. Overall, promotions and raises have seen his earnings increase by 90.5% since joining TOH in 2014.
Another top earner among the senior management team of the Ottawa Hospital is Nathalie Cadieux, Executive Vice-President and Chief Financial Officer. Between 2014 and 2016, as she was promoted and given raises, Cadieux’s salary increased by 62%. Between 2011 and 2016 the increase was 80.5%.
Similarly, Dr. Kathleen Gartke, Senior Medical Officer, saw her salary increase by 60.9% between 2018 and 2020, when her job classification was Medical Director. Meanwhile, Executive Vice-President and Chief Strategy and People Officer, Honorata Bittner, received a salary increase of 33.4% between 2020 and 2021, when she was Chief Strategy Officer, and another 10.4% increase after she became a Vice-President in 2022.
The most eye-watering of all senior management salary increases went to Suzanne Madore, Executive Vice-President and Chief Operating Officer and Chief Nursing Executive. Between 2020 and 2022, her job classification remained the same, yet her salary increased by 96.2% — even as she continued doing essentially the same work under a different name. In 2022 she was paid $337,386, up from $149,300 in 2019 when she was listed as a Clinical Manager.
According to the Sunshine List, the 1207 highest-paid employees of the Ottawa Hospital received more than $145 million in salaries alone in 2022.
Meanwhile, the Cameron Love administration is offering support services workers a pay “increase” of 0.98% and demanding we work harder and faster in ever-more dangerous conditions, in jobs that are less beneficial and secure than they were only a decade ago.
Based on my observations, experience, and conversations with fellow workers and union officials, I believe the current project of the administration is to crush its workers and use austerity — fewer workers doing more work for less pay and benefits — to help balance a budget full of inefficient and wasteful spending, especially at the top.
According to the TOH Budget Management Policy, the hospital must maintain “a commitment to a balanced annual budget while providing a framework for resource allocation on a multi-year basis aligned with the TOH strategic plan to ensure financial sustainability.”
In practice this appears to mean reducing “financial sustainability” for workers by cutting jobs through attrition and understaffing, forcing unfair contracts and sub-standard collective agreements. Meanwhile untold thousands of dollars in medical supplies and food waste are sent to the garbage compactor every day, presumably because those supply chains create profit.
In short, what is happening inside the Ottawa Hospital is neoliberalism in action, and the ‘logical’ next step of the healthcare privatisation process that began after the Liberal Jean Chretien/Paul Martin federal budget of 1993. (The Ford government’s love of austerity, privatisation, and neoliberalism — and the way these all blend together — has been covered before in the pages of The Leveller.)The Ottawa Hospital was formed in the wake of that budget, when Mike Harris’s so-called “Common Sense Revolution” led to the amalgamation of the Civic, General, and Riverside hospitals in 1997.
The ’93 federal budget slashed social programs and transfer payments to the provinces, which encouraged Harris to make draconian cuts to healthcare and social services in Ontario between 1995 and 2002.
According to the Ontario Health Coalition, more than 11,400 hospital beds were lost during the Harris regime, and more than one out of three acute care beds and chronic care beds were closed. At the Civic hospital, the number of beds was reduced by half to approximately 500 today (not counting OMTU). Harris also amalgamated 44 hospitals, closed 39 hospitals — including Ottawa’s Grace Hospital — and shuttered six psychiatric hospitals. This resulted in the loss of tens of thousands of nurses, allied health professionals, and support services staff, not to mention untold damage to the health outcomes of tens of millions of Ontario residents.
Like a political tag team, the federal Liberals gave Harris and other provincial premiers the green light to enact massive austerity measures under the cover of “fighting deficits” and “balancing budgets.”
It should be noted that the Harris Conservative’s defeat in the 2003 provincial election did not stop the cuts. In fact, subsequent Liberal Health Minister George Smitherman deepened the fiscal austerity, demanding all hospitals in Ontario submit balanced budgets, a policy that is still devastating our healthcare system and driving privatisation efforts.
Decades later, following the path of their predecessors, Liberal Prime Minister Justin Trudeau is “cautiously welcoming” Conservative Premier Doug Ford’s push for healthcare privatisation, according to TVO reporter Matt Gurney.
According to briefing notes prepared by the Ontario Health Coalition, the Ford government is “opening three new private for-profit day hospitals, expanding other for-profit clinics and shunting tens of millions in public funding to private clinics and hospitals. The premier said that 50% of the surgeries done in our public hospitals could be cut and privatized. This would devastate the services in most of our public hospitals.”
The process of austerity and privatisation is only intensifying, especially since the pandemic, and the negative effects on hospitals, patients, and workers are becoming more visible and impossible to ignore. A recent example is the privatisation of the Tulip Cafe, the main cafeteria at the Civic. The cafe was sold to a private company in 2022, resulting in the loss of all unionised positions within the cafeteria. Those positions were subsequently replaced by non-union workers.
The current TOH Administration is engaged in manifestly anti-worker and anti-union tactics. TOH recently announced the signing of an “historic,” union-busting deal with the Unionized Building and Construction Trades of Eastern Ontario and Western Quebec that “will eliminate risk for work delays and disruptions caused by strikes or lockouts during construction of The Ottawa Hospital’s new campus.”
Yet one of the main contractors for the new hospital, PCL, has inexplicably failed to complete a major overhaul of the main boiler in the Civic Hospital. Documents posted outside the boiler room show PCL was contracted to replace the original boiler in September 2021, with a completion timeline of four months.
Almost two years later the job remains unfinished, however, much to the detriment of the entire facility. On Friday, February 3, 2023, during extreme cold weather there was a system failure in the boiler room that resulted in widespread flooding and damage to several areas of the hospital, as well as significant expenses in private contractors hired to clean up the mess.
Despite appeals from the various hospital workers’ unions over issues of staff burnout and health and safety concerns, the policies and practices of Cameron Love’s corporate administration continue unabated, harming and immiserating thousands of workers and undermining patient care.
And it appears the pandemic had a role to play in demobilising the unions — particularly CUPE 4000, which represents support services workers, patient care assistants, and clerks. Under the guidance of COVID-19 precautions, the administration suspended in-person orientation meetings for new workers — precisely the forum in which such workers learned about the union and its services.
Therefore, workers hired since the pandemic have not learned about the union, unless they sought out the union or required representation. No wonder workers are being abused — we don’t know our rights and who to turn to for protection.
In short, the regime of Cameron Love is getting away with abusing and defunding its workforce, and taking advantage of generations of goodwill and trust, all under cover of a public institution that is a labyrinth of dark corners and disturbing secrets.
Whose Vision Are We Following?
This should come as no surprise to anyone who learns that Love is a ‘healthcare leader’ who has no medical expertise. Love joined the Ottawa Hospital as Executive-Vice President and Chief Operating Officer in 2014 (with a salary $365,316), despite not being a doctor and having no experience providing actual medical treatment.
“Is Cameron Love really the kind of person we can trust to run three of the major hospitals in Ottawa, let alone build a new facility?”
Instead, Cameron Love has a Bachelor’s degree in Biology and Psychology from Queen’s University, a Master’s in Health Administration from University of Ottawa’s Telfer Business School, as well as unspecified “training” from Wharton School of Business — the same alma mater as Elon Musk and former US President Donald Trump. Love’s LinkedIn profile shows he is currently a postdoctoral associate at the Center for Advanced Biotechnology and Medicine at Rutgers University in New Jersey.
Love has no medical expertise and no experience working in the actual environment of a hospital. He has never spent hours sweating in scrubs and full PPE, never gone without food or breaks, nor broken his body doing the work of two or more people on an underfunded unit. Is Cameron Love really the kind of person we can trust to run three of the major hospitals in Ottawa, then, let alone build a new facility?
Past Presidents and CEOs of the Ottawa Hospital have all been doctors of some kind or another, such as Jack Kitts, an anesthesiologist who was President and CEO of TOH between 2001 and 2020. Currently, the President and CEO of the Heart Institute is Dr. Thierry Mesana, one of the leading heart valve surgeons in the world. The driving force behind the creation and construction of the Heart Institute itself, the late Dr. Wilbert Keon, was a visionary heart surgeon who performed the first artificial heart implantation in Canada. Keon was also well-known and liked by his peers and medical staff, and the facility he founded is still the preferred workplace among support services workers in particular. Another local example is Dr. Andrew Falconer, President and CEO of Nepean’s Queensway Carleton Hospital, who has been an Emergency physician at the very same hospital since 1987.
Unlike those doctors who became top administrators, Cameron Love has zero experience in the actual care of hospital patients. Put simply, Cameron Love has always worn a suit and tie to work, never scrubs and sneakers.
It appears that under Love’s leadership, on-the-job experience of healthcare provision is unnecessary for administrators. After all, the hospital hires housekeeping supervisors who don’t have housekeeping experience, and promotes an administrator like labour relations officer Michael Lajuene to departmental director, despite having no experience of actually working in the housekeeping department.
This model of outsider administration seems to be advancing through a recently announced partnership between the Telfer School of Management and the Ottawa Hospital to create a joint “Professorship in Health Care Management and Leadership” to commence in July 2023. According to the job posting, key duties include acting “as a liaison between the Telfer School and the Ottawa Hospital to develop and implement future-focused, customizable, and strategically competitive executive programs in Health Care Leadership.”
Mega Hospital, Mega Problems
Some internal documents I’ve seen describe the new campus as a “mega-hospital,” a term that should provoke in Ottawa residents the same suspicion and dread as “mega-mall” or “mega-prison.” In fact, plans for the new build look suspiciously like a prison, as each room is single-occupancy with a toilet and sink.
According to an email sent on January 13, 2023, to all hospital staff by Cameron Love, “Single patient rooms are the gold standard for new health-care facilities around the world, and TOH is no exception.” But after generations of cuts to healthcare by numerous provincial and federal governments, our healthcare system is functioning on standards that could be best described as rusted iron rather than gold.
Private rooms may appeal to people who are not familiar with the realities of a hospital. But it should be obvious that our healthcare system cannot be structured on private rooms and increased user fees for patients, especially not in the aftermath of the COVID-19 pandemic and the economic collapse working people are experiencing in this country.
There are no material benefits for patients or workers in Love’s corporate fantasy world of “gold standards,” only more of the same stubborn adherence to corporate control and profit, and policies of administrative neglect and abuse.
I believe ‘hallway healthcare’ will be built into the system if corporate administrators like Love succeed in constructing exclusively private-room facilities. We need look no further than the growing demand for patient beds in Ottawa. Two weeks after announcing the new private room policy, another internal “Message from the CEO” suggested that ‘hallway medicine’ is not going to be contained by private rooms.
“To further help manage these capacity challenges,” Love announced recently, “we will convert some of our existing space to open an overflow unit at the General Campus, called the Offload Medicine Transition Unit… that will help create more surge capacity and improve ambulance off-load times.”
Just two weeks after announcing that “future plans for the General Campus are to move to the same single room structure,” Love announced plans to build an “overflow” facility at the General. Baking single-room occupancy into the structure of the new hospital severely limits its capacity, suggesting Love will be making these kinds of announcements long into the future, even with a billion-dollar hospital upgrade.
Multi-bed rooms allow more bed-spaces to be built on the same footprint, increasing capacity while also helping patients and families to cope with the stresses of being in hospital. Communal rooms are essential for fostering community and care in a hospital setting — something that I have personally witnessed countless times.
Hospitalisation is traumatising for patients and family members, and despite occasional conflicts — which can be mitigated by care and best practices — people who don’t know each other are able to meet and talk and support each other in multiple occupancy rooms. Private hospital rooms may be what corporations and corporate administrators prefer, but such designs will mostly benefit private interests, not the patients — and definitely not the workers.
Put bluntly, besides enriching themselves, the bureaucrats responsible for controlling the system and designing the new hospital work from home, and spend little time in the real world of the hospital environment. Can such people be trusted to build efficient and effective infrastructure for future patients and workers?
Post-pandemic, the Ottawa Hospital is buckling under the pressure of increased demand from ever-more-sickly patients, and an exhausted, deliberately understaffed and overworked labour force. Meanwhile, there are no material benefits for patients or workers in Love’s corporate fantasy world of “gold standards,” only more of the same stubborn adherence to corporate control and profit, and policies of administrative neglect and abuse.
The very phrase “gold standard” is a giveaway to the fact that patients will be made to pay significantly more out of pocket expenses for healthcare in the future — as is the case today when patients with insurance can request a private room. According to an admitting clerk I spoke with, for a person without private insurance, the cost is currently $300 per day for a private room, and $1400 total per day for general admission for anyone who does not have private insurance or OHIP. (Many more people — such as new immigrants, temporary foreign workers, international students, and returning Canadian citizens — will have to pay this base fee out of pocket as the Ontario government ended the Physician and Hospital Services for Uninsured Persons program introduced during the pandemic.)
While the new hospital remains in hasty progress, a cautionary tale of inefficient and wasteful investments in healthcare infrastructure was recently unveiled at the Civic.
Closed to the general public and requiring special access, the Grass Family Men’s Health Clinic was opened in June 2021 in the space previously occupied by the Breast Health Centre at the Civic. Frankly, the clinic could be more accurately described as an “erectile dysfunction centre”.
The facilities were renovated after the Breast Health Care Centre moved to the General Hospital, but the updated design was poorly conceived and executed. For example, all doors have different key-locks, rather than locks that can be open by electronic badges — and the infrastructure is already dusty, unkempt, and under-utilised, given that many of the rooms under lock and key are empty and unused despite the clinic being opened almost two years ago.
When ‘philanthropy’ efforts such as the Grass Family Men’s Health Clinic — or the newly-branded “Patrick and Elaine Butler & Family Cardiac Patient Care Unit” — are announced, there is seldom any media scrutiny or public attention paid to the efficacy of funding models such as philanthropy and charity. Rarely do we hear alternatives to funding healthcare discussed in politics or the media, such as taxing the rich and corporations that have enjoyed obscene increases in wealth, in what is arguably the greatest transfer of wealth in human history and currently in progress.
Unbeknownst to the public at large, the mega-hospital being built over forest and parkland beside Dow’s Lake — a location chosen for the benefit of private developers not the public, as has been argued before in The Leveller — is designed to be a playground for corporate profit-seeking. As such, it will be a vicious and intractable battleground for future workers and patients alike.
The new hospital must be stopped, in order for us to build a facility that will truly care for the patients and workers inside, rather than catering to corporate greed.
For the sake of present and future generations, and for the countless hospital workers and patients today and to come, there must be no more Love at the Ottawa Hospital.
Editor’s Note: Since this article was published, its courageous author, David Wightman, has been terminated by the Ottawa hospital — despite receiving support from his union and, in his words, “a massive amount of positive feedback and solidarity from my fellow workers.” As things currently stand (in July 2023), we at The Levellerand David plan to continue to hold the hospital administration to account with further stories. You can send tips and messages of support for David to email@example.com.