In a rare foray into a labour dispute, the Canadian Medical Association is forcefully demanding that the Ontario government get back to the bargaining table and settle the festering dispute with its doctors.
Delegates to the CMA general council meeting in Yellowknife threw their support behind a Charter challenge launched by the Ontario Medical Association, which is arguing that the province is bargaining in bad faith.
The national physician lobby group also called for amendments to the Canada Health Act to make conciliation or binding arbitration mandatory in cases where no negotiated settlement is possible, saying it fears other provinces will mimic Ontario’s heavy handed tactics.
Each year, Ontario spends $11-billion on compensating its physicians. But strapped with a $15-billion deficit, the province has said it needs physicians and all public-sector workers, including teachers, to agree to a two-year wage freeze.
A letter sent by Ontario Premier Dalton McGuinty to other premiers earlier this year spurred discussions in other provinces about how doctors are compensated. Alberta’s Health Minister said in May that he was looking closely at the province’s pay formula for doctors, months after agreeing to give physicians a raise.
“We stand beside our colleagues in Ontario. That contagion of confrontation needs to be quarantined, period,” said Dr. John Haggie, president of the CMA, which represents the country’s 76,000 physicians, residents and medical students.
“It is unacceptable and the CMA will not stand by idly,” he said, adding that the desire to slash physician fees unilaterally “must not infect other jurisdictions, whether Alberta, British Columbia or Prince Edward Island.”
On May 7, Ontario imposed a contract on physicians that includes cuts to some fees paid to specialists and a two-year freeze of other fees. The OMA says that amounts to $340-million in cuts.
Ontario’s Health Minister, Deb Matthews, has defended the move, saying the province’s doctors have had massive pay increases over the past eight years and they must give back in austere times.
“We continue to hope to reach an agreement with the OMA,” said Zita Astravas, press secretary to Ms. Matthews, in an e-mailed response to questions about the CMA backing the provincial organization.
At the CMA’s general council meeting, which is oft-described as the “Parliament of Canadian medicine,” presidents of all 12 provincial and territorial medical associations made a united stand in support of Ontario doctors. (There is no medical association in Nunavut.)
The delegates did not mince words.
“Clearly, our government needs some help and guidance to understand what it means to negotiate in good faith,” said Ved Tandan, a surgeon at St. Joseph’s Hospital in Hamilton.
Stan Lofsky, a family physician from North York, Ont., quoted from a 1964 report by Mr. Justice Emmett Hall that served as the foundation for medicare legislation that says physicians cannot be a law unto themselves, nor can they be conscripted.
He said the section of the Canada Health Act that outlines the bargaining rights of physicians operating under medicare has become “a cruel hoax.” (That part of the law recommends conciliation to end labour disputes but does not make them mandatory, a provision the CMA wants changed.)
“This is starting to look like conscription,” Dr. Lofsky said.
Bill Shipley, a general practitioner from Belleville, Ont., said that with expenses rising faster than fees, Ontario’s move “is going to bankrupt family doctors. “This is a severe action against doctors and it’s turning out to be an action against patients,” he added.
While there was much passionate support for the plight of Ontario’s doctors, what exactly the national group will do is not clear.
“What we will do is contingent on what the OMA requests,” Dr. Haggie said. It could, for example, be advocacy, political lobbying or financial support.
He was also careful to say that physicians understand the financial bind that many governments find themselves in. “Governments are in a defensive position,” Dr. Haggie said. But he was quick to add that this is not an excuse to abandon good-faith bargaining.