Health Care Institutions Under the National Labor Relations Act

• Date: 01 September 1978
• DOI: http://doi.org/10.1111/j.1744-1714.1977.tb01437.x
• Author: DAVID TWOMEY
• Published date: 01 September 1978

CURRENT LEGISLATION DEPARTMENT

HEALTH CARE INSTITUTIONS UNDER

THE

NATIONAL

LABOR

RELATIONS ACT

*

DAVIDTWOMEY

The purpose of this article

is

to examine the recent nonprofit

hospital amendments to the National Labor Relations Act

(NLRA)' and to place these amendments in the perspective of

existing labor laws in the United States.2 The article will first

review the legislative background of the amendments and then

present a study

of

labor relations in the health care industry

under the Act. Congress left

a

number of statutory gaps that are

currently being filled on

a

case-by-case basis by the National

Labor Relations Board (NLRB) and by the courts. The develop-

ing case law is made a part

of

the presentation in order to present

a complete picture of the underlying problems involved.

LEGISLATIVE

BACKGROUND

The National Labor Relations

Act

of

1935

(Wagner Act)3 ex-

pressly exempted governmental hospitals from its provisions, but

no statutory reference was made

to

private, nonprofit hospitals.

*

Associate Professor, Boston College.

I

Labor Management Relations Act,

29

U.S.C.

5

141

(Supp.

IV

1974).

*

The primary sources

of

existing labor law are the Labor Management Relations Act,

as amended (specifically Title

I

of

this Act), commonly referred to as the National Labor

Relations Act

or

the Taft-Hartley Act, and decisions made pursuant to the Act by the

National Labor Relations Board.

:I

Act

of

July

5, 1935, 49

Stat.

449.

226

I

Vol.

15

1

American Business

Law

Journal

In the NLRB’s 1942

Central Dispensary

decision,J however, the

Board chose to exercise jurisdiction over a nonprofit hospital. In

1947, section

2(2)

of the Act was changed by the Taft-Hartley

amendments

to

exclude nonprofit hospitals from coverage,5 and

this exclusion remained in effect until enactment of the recent

amendments.

The

1974

amendments to the National Labor Relations Act

extended the coverage

of

the Act to some 1.5 million persons

employed by private, nonprofit hospitals.s Congress enacted this

legislation in the belief that the lack of unionization at these

hospitals caused low wages, poor working conditions, and a lower

standard

of

patient care. Testimony before Congress showed that

the absence of coverage under the NLRA often resulted in recog-

nitional strikes which disrupted patient care.’ Coverage under the

NLRA eliminates the need for any such activity, because the

procedures of the Act are designed to resolve organization and

recognition disputes. Congress, aware

of

the vulnerability

of

health care institutions to strikes, added amendments that apply

to all nongovernmental health care institutions. These amend-

ments set forth certain contract negotiation notices, impasse reso-

lution procedures, priority NLRB case handling procedures, and

specific strike notice requirements.

RIGHTS

OF

EMPLOYEES

UNDER

THE

NLRA

The keystone of the NLRA is contained in section

7.

This sec-

tion specifies that all employees covered under the

Act

have the

right to participate

or

refrain from participating in “concerted

activities.” The phrase “concerted activities” means employees

acting together in an organized manner. Examples of concerted

activities include organizational activities, the negotiation and

ratification

of

collective bargaining agreements, and legal strike

or picketing activities in furtherance of employee goals.

’

44

N.L.R.B.

533

(19421,

enforced,

145

F.2d

852

(D.C.

Cir.

1944).

Section

2(2)

of

the Act contained the following exemption: “[Alny corporation or

association operating

a

hospital, if no part

of

the net earnings inures to the benefit

of

any

private shareholder or individual.

.

. .”

29

U.S.C.

4

152(2)

(Supp.

I

1971).

li

29

U.S.C.

5

152 (1974).

120

CONG.

REC.

4587

(daily

ed.

May

30,

1974).