Call it "cook/chill," "bulk retherm," or plain old "heat and heave," this contracting-out is in very bad taste

"I KNOW I AM A UNION REP," says Local 531 shop steward Evelyn Sarrosa, "but in my heart, I have to represent my clients."

Sarrosa's clients are the 420 people with severe mental illness who live at the Queen Street Division of the Centre for Addiction and Mental Health in Toronto (CAMH). As a diet technician, it is Sarrosa's job to help make sure the food clients eat is both nutritious and tasty. When she found out this summer that CAMH was hiring consultants to help contract-out food services, she joined forces with her co-workers to do something about it.

"If I go outside (of CAMH) to work, I know that I could survive and find a job," Sarrosa says. "But the clients that get thrown out of here, what do they have? Nothing. They don't have a voice. Those are the silent people that we're fighting for."

The largest mental health facility in Ontario was formed in February, 1998 when the Queen Street Mental Health Centre merged with the Addiction Research Foundation, the Donwood Institute, and the Clarke Institute of Psychiatry. It didn't take long before the new management began looking for ways to slash costs. Naturally, they decided to hire expensive consultants to tell them how.

CAMH hired Ernst & Young to look at cheaper ways to provide so-called "hotel services" ­ kitchen, housekeeping, maintenance, and security. It was an insult to workers who work closely with people with mental illness.

"We're not providing hotel services, we're providing patient care services," says nurse Nancy Pridham, vice-president of Local 531. "We care about the patients and clients. We perform valuable services. We are part of the clinical team."

Ernst & Young recommended privatization as a cost-cutting cure for CAMH. Another group of consultants, Brookfield-Lepage-Johnson Controls, was happy to come up with a plan to lay off 400 OPSEU members. The plan would wipe out the equivalent of 29 of the 49 jobs in the Queen Street kitchen.

Their solution? Cook the food somewhere else. Then freeze it. Then thaw it. Then feed it to the clients, buffet-style. Some consultants call it "cook/chill" or "bulk rethermalization." OPSEU members call it "heat and heave."

"There are so many items that don't go well with cook/chill," says Sarrosa. "They really taste awful."

Of the 420 clients at the Queen Street site, 177 require a special therapeutic diet, not counting about 30 vegetarians and 20 people on soft "texture" diets.

"There's no flexibility with the selection of the menus," says Sarrosa. "We can serve them any frozen food and re-heat it every day, but what is the quality of the food, what is the variety of the food, what is the flexibility of the food?"

Meals are a very important part of daily life to people in hospital with mental illness, Sarrosa says ­ both a physical comfort and a chance to socialize. But for some, food is also fraught with risk.

"We have some of our clients here that, because of their mental problems, they are so paranoid, sometimes they think people are poisoning them," says Sarrosa.

Who says it's cheaper?

While trendy with profit-hungry consultants, cook/chill has a spotty record as a money-saver, according to Gord Miller, cook-supervisor at the Donwood site and a member of Local 541.

"Most places that have contracted-out are definitely not happy," says Miller, who helped research an OPSEU presentation to the CAMH board of directors. "The contractors low-ball their bids, then once they get in, all these other costs come up."

At North York General Hospital, the giant Marriott Corporation controlled all food services ­ until the hospital cancelled the contract because of escalating costs and poor quality food.

"According to hospital supervisors, contracting-out cost more than in-house due to hidden costs, creative bidding, and increases after the fact," says Miller.

Numerous studies, including a 1997 study of the largest hospital group in Europe, Paris Hospital, have shown that contracted-out short-term care hospitals have a 16 per cent higher unit cost per meal than publicly-managed hospitals. "The publicly-managed model has the greatest effect on lowering the unit cost per meal," the Paris study said.

OPSEU fights back

OPSEU Locals 531 and 541, as well as Local 5104 at the former Addiction Research Foundation site, are fighting back, forcing CAMH managers to take a second and third look at the rosy pictures painted by the high-priced consultants.

"Bulk retherm will be cost-effective for Brookfield-Lepage- Johnson Controls," says Nancy Pridham. "It will not be cost-effective for CAMH. Better in-house management is the only way to go.

"We're not a hotel, we're not an airline, and our clients are not on vacation," Pridham says. "We're a hospital. We care for people."

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