The treatment of New Brunswick's doctors by the provincial government is a disgrace, a travesty of lawmaking that needs to be exposed for what it is.
The draconian and underhanded manner in which politicians have treated medical professionals should concern all Canadians. It offends one of the basic principles of medicare and the laws of natural justice.
But before we delve into some of the gruesome details, a little background: In the single-payer system, physicians bill the provincial ministry of health (or they receive a salary from a health region or health-care facility).
The fees they are allowed to bill are negotiated by groups representing physicians and government. The contract is then approved by the legislature and the law is amended.
In New Brunswick, there are about 1,500 physicians, 1,000 of them paid by fee-for-service. These payments and related rules are set out in the Fee for Service Master Agreement. It has been in force since 1973 and is updated regularly as new fees are established through collective bargaining.
In December of 2008, after months of negotiation, the New Brunswick Medical Society and the provincial government reached a tentative agreement.
The deal called for fee-for-service doctors to get a raise of 3.75 per cent a year for four years. These details are not particularly important. Nor is the fact that doctors are relatively well paid. But bear in mind that New Brunswick doctors are among the lowest-paid in the country, and that they had been without a contract since March, 2008.
The new deal received blessing from on high. Michael Murphy, then provincial Health Minister, said: "I congratulate the members of both bargaining committees on reaching this tentative agreement. ... I greatly appreciate their efforts in this undertaking, which is very important to the provision of health care in our province." It was also endorsed by doctors.
But in mid-March, the provincial government decided to unilaterally back out of the deal, saying it had a budget shortfall.
Instead of honouring the negotiated contract, Premier Shawn Graham told the New Brunswick Medical Society that he wanted to extend the old contract for two years - in other words, impose a two-year wage freeze. Such a move, he said, would save the treasury $36-million.
Naturally, doctors balked at this betrayal.
At one point, the government insisted they had "misunderstood" the contract, one of the most pathetic political utterances in a long time.
After much to-ing and fro-ing, Mr. Graham's government retroactively imposed a contract in mid-June. Some of the terms of Bill 93, titled An Act to Amend the Medical Services Payment Act, are so fiendish that they bear repeating.
The law declares that "any alleged agreement that was negotiated before the date ... and that purports to replace the Agreement is null and void."
It also invalidates the arbitration process and imposes 0-per-cent wage increases. Finally, one of the terms of Bill 93 is that it cannot be challenged in court.
Legislation so sweeping is used in times of war. It cannot and should not be used when a government has second thoughts.
There are those who will say that other public-sector employees were saddled with zero wage increases and that doctors should swallow that bitter pill, too.
The difference is that doctors have a contract. Just like New Brunswick nurses, who negotiated a well-deserved 11.5-per-cent wage increase over three years. A deal is a deal.
In a seeming act of reconciliation, Mr. Murphy offered to negotiate some "non-monetary" aspects of the contract. He also said: "I do recognize that that leaves a very bad taste in physicians' mouths for years to come. I'd like to see that avoided." (Mr. Murphy is now the Attorney General and Minister of Justice and Consumer Affairs.)
Ludger Blier, an Edmundston physician and president of the New Brunswick Medical Society, said the province's doctors feel "betrayed and disrespected" by the entire process.
He said the society will challenge the legislation in court, arguing that it violates doctors' constitutional rights. A court date has been set for Sept. 16.
It is difficult to imagine that such ham-fisted legislation could withstand a legal challenge.
Under the Canada Health Act, the legislation that provides the underpinnings of medicare, it is stated that physicians must receive "reasonable compensation." Further, the legislation demands that provinces must negotiate fees and that, if agreement cannot be reached, they will have recourse to conciliation or binding arbitration.
Legal protections, constitutional and otherwise, cannot simply be cast aside on a whim, or to save a few bucks.
Beyond the legalities, the bully-boy tactics employed by Mr. Murphy's government are shortsighted and counterproductive.
Despite the recession, there is a doctor shortage, and every other province is recruiting. New Brunswick, the land of contract-reneging, is now a prime hunting ground for recruiters.
Regardless of how this sordid affair turns out, it will have left a sour taste in the mouths of all doctors - and of the public, which like its health professionals has been used and abused.
The ultimate loser in all of this will be the patient.
