Where will you go to die?

It’s a question former Perram House employees and their supporters asked Wednesday morning as they picketed outside the Procom office at 2200 Yonge Street in Toronto.

Two days earlier, employees were told that they’d been terminated and the facility would be closing permanently.

Procom president and CEO Frank McCrea also chaired the Perram House board of directors.

The staff at Perram House, that included registered nurses, registered practical nurses, a personal support worker and support staff, provided end-of-life care at the eight-bed hospice.

Workers had no pension, no benefits and hadn’t received a wage increase since the hospice opened eight years ago.

“Management made decisions to cut staff on different shifts without any notice,” said Prapti Giri, a registered nurse with 12 years experience who worked at Perram House for just over two years.

“Within a week, they’d say ‘No more RPNs for eight hours.’”

Tired of having no say in the decision making process, workers decided to unionize.

“You can see that they’re closing the hospice in two days,” said Giri, who was terminated when the notice was handed out on Monday.

“It’s typical of their management style.”

That’s one reason why the workers unionized. The other was wages.

“Right now, we’re about 30 per cent less paid than a hospital employee,” she said.

At Perram House, Giri earned $34 per hour with no benefits. When she worked in a hospital she made $41 an hour plus 19 per cent in lieu of benefits, vacation and pension.  

$14 less per hour.

“But we stayed at the hospice because we love the work so much,” said Giri. 

Contrary to popular opinion, Giri said Perram House wasn’t just a hospice for homeless and marginalized men.

“It’s a hospice for everybody. We prioritized marginalized people. But we had rich and famous people die there as well.”

Anybody with approximately three months to live.

In September, employees voted to unionized and began bargaining in November.

“On our fifth bargaining date on March 21, they told us that the hospice was going to potentially close in 30 to 60 days unless we accepted wage cuts,” said Giri.

On April 4, staff voted against wage cuts. Then on April 8, management gave notice to close on April 10.

“We were shocked even though we kind of expected that they would close. But we thought they’d have the courtesy to give people notification so they could find another job.”

Employees received the minimum severance under the Employment Standards Act.

The Toronto Star reported that “public funds from the Toronto Local Health Integration Network and the Ministry of Health through the Toronto Community Care Access Centre make up about 80 per cent of the hospice’s $1.1-million budget — including nursing and personal support worker salaries.”

The remainder came from donations. But that still left Perram House with a projected $250,000 deficit this year.

“It sucks,” said Maxine Irwin, who worked at Perram House for over three years as a registered practical nurse.

“For us to get such short notice is just disgusting.”

Especially when there’s such a shortage of hospice beds to begin with. 

“Of the five residents at the hospice, two have been transferred home and the other three will go to Toronto Grace Hospital,” said the Toronto Star.

But that’s no solution for the ever increasing demand for palliative care facilities.

“We barely had sick days, barely had holidays,” said Denise Thompson, a personal support worker at Perram House.

“We didn’t get shift premiums.”

So the decision to unionize was a way for workers to fight for their basic rights.

“Management pretty much tried to control everything,” said Irwin. 

“They didn’t give us or schedule a month ahead of time. They changed our schedules whenever they wanted to. We have families. We have children. We have a life.”

Employees said they were treated like they were disposable. The union gave them a semblance of bargaining power.

Rebecca Clarke, a registered nurse at Perram House since last September, was not only shocked but quite disturbed about getting her layoff notice on Monday.

“Because now there’s a significant gap in the care for the homeless and drug addicts and marginalized populations in our city,” said Clarke.

“These people are dying and they have nowhere to go now.”

Except hospitals. Where it will cost significantly more to care for them. Without the care they’d receive in a hospice. From staff specially trained in end-of-life care.

“If this is what the province means by having community care, I think we’re in trouble,” said Laurie Miller, OPSEU campaigns officer.

“It’s no wage, no benefits, precarious work. If they don’t want to pay a decent wage, then they’ll threaten to shut down a non-profit charitable organization.”

In 2011, the Salvation Army decided to close down Parkdale’s Liberty Housing and Support without first consulting the Local Health Integration Unit (LHIN), but was forced to keep it open until another organization could pick up the workload.

“It’s fair to say that Perram House was not happy with the concept of having a union in the workplace,” said Paul Myers, OPSEU staff representative/negotiator. 

Perram House’s bargaining team, said Myers, consisted of two board members as opposed to managers from the workplace: Peter Carr and Patty Niles, who both work for Procom.

“From the very first day of bargaining they didn’t show any real interest in obtaining a collective agreement,” said Myers.

“They didn’t have a clue what they were doing across the table. They never presented us with any proposals until the fifth day of bargaining. And that’s when they proposed wage cuts or staff cuts.”

Neither of which were acceptable to the union.

Myers said Perram House wanted to eliminate the registered practical nurses, but neither Carr nor Niles had any idea who would assume that job function.

“It would be impossible to operate without the RPNs,” he said. “And they weren’t going to hire anyone to replace them.”

Perram House also wanted to cut wages — already below the industry standard — by up to 10 per cent, said Myers. 

So a personal support worker making $16 an hour would now be making $15.50 an hour. While similar organizations were paying support workers $18-20 and hour.

Last Thursday, the employees voted against the Perram House proposals, giving them a strike mandate.

“We thought this might send the employer a message,” said Myers. 

“But when we returned to the table on Monday, the employer handed out termination notices, advising that they would be closing Perram House on Wednesday.”

Although employees had an inkling that Perram House might close, they thought they might be given adequate notice so they could find alternative employment.

Myers said that the Perram House strategy of closing down a facility that’s trying to unionize has become more common in the last few years.

It began in the private sector when Walmart closed a store in Quebec while employees were in the midst of bargaining their first contract.

“The union movement must respond with one voice,” said Myers. 

“We need to pressure the government to increase funding. Money is an issue. These community care agencies are being underfunded. 

“And we need tougher laws against someone simply pulling the plug on an organization.”

John Bonnar

John Bonnar is an independent journalist producing print, photo, video and audio stories about social justice issues in and around Toronto.