Alberta’s doctors say proposed changes to their pay and practice rules are cynical and heavy-handed and will make future physicians think twice about working in the province.
Dr. Christine Molnar, the head of the Alberta Medical Association, says a bill now before the legislature would allow the government to unilaterally rip up the current master pay deal — and any future pay deals — it reaches with doctors.
“Government is cynically asking us to work toward agreements when it appears we are the only party to be bound by them,” Molnar wrote Wednesday in an open letter to members.
“This bill effectively gives government the power of pre-approval to cancel any physician services agreement without recourse. This is a violation of the sanctity of contracts.”
Molnar said the bill also moves decision making to cabinet, behind closed doors, apparently in the name of the public good.
“What is the value of an agreement when it can be revoked at any time with no public discussion?”
Molnar said the AMA is getting a legal opinion on the proposed changes and is seeking a meeting with government.
Health Minister Tyler Shandro said he understands the AMA’s concerns, but the government needs physicians to help it reduce costs.
“Our payments to physicians are out of line with other provinces: average fee-for-service payment per physician is more than $100,000 higher than comparable provinces, and per capita spending on physician services is 19 per cent higher than the national average,” Shandro said in an email.
He said the government must also deal with the longstanding issue of physician distribution.
“We now have more physicians per capita than the national average but large parts of the province outside metro Calgary and Edmonton have shortages, especially in the North.”
Shandro said he met with Molnar a few weeks ago and would be happy to meet with her again.
On Monday, Finance Minister Travis Toews introduced legislation as part of his budget that would allow the government to cancel its master agreement with doctors if the two sides can’t negotiate a new deal.
The province is working off a recent report from a panel headed by former Saskatchewan finance minister Janice MacKinnon.
It stated that Alberta public-sector workers, including doctors, are paid at much higher levels than comparable provinces and that savings must be found immediately to end the run of multibillion-dollar budget deficits and resulting debt spiral.
The report said physician costs last year were more than $5-billion — about 25 per cent of the health budget — and have grown 300 per cent in the last two decades versus 200 per cent in other provinces.
It said the main obstacle in getting physician costs down is the master agreement that is difficult to amend.
Toews’ bill also proposes giving the government the power to tie any new doctor’s billing privileges to where he or she works in order to get more physicians to practise in under-serviced rural areas.
This change would apply only to doctors who begin work after March 2022.
Molnar, in the letter, said such a plan has already failed in New Brunswick and Nova Scotia.
“It is flawed because it restricts the number of physicians practising, restricts the mobility of physicians and impedes recruitment,” she said.
“I would like all of us to think about the environment that will be created. Will our future physicians, our young colleagues, want to practise in Alberta?”
Molnar said the AMA agrees with the government that there are many opportunities to improve the health system and for fiscal sustainability. But she notes the association has helped the government in recent years reduce planned expenditures by $500-million.
NDP health critic David Shepherd said when you create unrest among doctors, there’s only one group of people that suffers — patients.
“Kenney needs to listen to the physicians who care for our loved ones, especially in rural communities where recruitment can be challenging, and scrap Bill 21,” he said.
The province is also targeting wages in the broader public sector.
On Tuesday, Toews announced the government is seeking rollbacks in upcoming binding wage arbitration sessions with more than 180,000 public sector workers, including social workers, nurses, teachers and justice staff.
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